LTCcovid Country Profile – Printable Version
1.01. Population size and ageing context
In mid-2020 the total population of Wales was 3,170,000, which represents 4.7% of the total population in the United Kingdom. The median age of the population was 42.4. The share of the population aged 65 and over was 21.1% and the share aged 85 and over was 2.7 (Source: Population estimates for the UK).
Update for: Wales (UK) Last updated: March 8th, 2022
2.02. Deaths attributed to COVID-19 among people using long-term care
The Welsh Government publishes data collated by the Care Inspectorate Wales (CIW) at the Local Authority level of the number of notifications of deaths of adult care home residents by cause and location of death.
As of April 8, 2022, data published by the UK Health Security Agency there have been 10,797 deaths with COVID-19 on the death certificate. As of the same date, the CIW reported 2,163 Covid-19 related deaths (both confirmed and suspected) of care home residents in Wales. Therefore, care home resident deaths account for 25.6% of COVID-19 related deaths in Wales. Of these care home resident deaths, 1,477 (68%) occurred within care homes. There are 24,178 care home residents in Wales. Therefore, the number of COVID-19 related deaths of care home residents represents 8.95% of this population.
Data published by the Office of National Statistics showed that as of March 12, 2021, there had been 7,717 COVID-19 related deaths, with 1,650 of these occurring in care homes (21%). As of the same date, according to CIW data, there had been 1,911 COVID-19 related deaths of care home residents. Therefore, care home residents accounted for 25% of all COVID-19 related deaths in Wales at this point during Wave 2. (Source: https://gov.wales/notifications-care-inspectorate-wales).
A nationwide study in Wales compared certified COVID-19 deaths of people with learning disabilities identified through inpatient services and all Welsh resident COVID-19 deaths, from 1 March to 19 November 2020. This reported a Standardised Mortality Ratio (SMR) of 4.60 for people with learning disabilities compared to all Welsh residents; this was particularly high for people aged under 60 (SMR 12.7) (Watkins, 2021).
References:
Watkins, A. (2021). COVID-19-related deaths in Wales amongst People with Learning Disabilities from 1st March to 19th November 2020. Improvement Cymru
Update for: Wales (UK) Last updated: May 3rd, 2022 Contributors: William Byrd | Chris Hatton | Adelina Comas-Herrera | Disha Patel |
2.04. Impacts of the pandemic on access to care for people who use Long-Term Care
Impact on access to health and social care services for adults with intellectual disabilities
UK-wide interviews with approximately 500 adults with intellectual disabilities and surveys with approximately 300 family carers and support workers of adults with intellectual disabilities who could not take part in an interview, at three time points during the pandemic, have reported that access to a wide range of health services (including primary care, more specialist therapists, and annual health checks) significantly reduced from before the pandemic to the lockdown in the winter of 2020. Access has improved since then up to the summer of 2021, but not to pre-pandemic levels, with more consultations being conducted by phone rather than face to face.
The picture is similar concerning access to a wide range of social care services, including day services, community activities and short breaks, with the exception of support at home which has continued at consistent levels through the COVID-19 pandemic. Reduced access to many health and social care services was evident for a greater proportion of adults with intellectual disabilities with greater needs, particularly adults with profound and multiple intellectual disabilities.
Update for: Wales (UK) Last updated: March 8th, 2022 Contributors: Chris Hatton |
2.05. Impacts of the pandemic on the health and wellbeing of people who use Long-Term Care
A published paper explores the significant and high death toll of COVID-19 on care home residents and social care staff in England and Wales. These mortality figures, alongside differential treatment of residents and staff during the pandemic, are conceptualized as a form of structural abuse. Arguments are made for the inclusion of structural abuse as a separate category of elder abuse. The lack of appropriate personal protective equipment, paucity of guidance, and high mortality rate among care home staff and residents during the pandemic is indicative of social discourses that, when underpinned by ageism, reflect structural elder abuse. If structural elder abuse was to be included in classifications, it would demand a rethink of social and health-care services and the policies and practices associated with them and would reinforce the government message that safeguarding is everyone’s business (Parker, 2021).
Impact on adults with intellectual disabilities
UK-wide interviews with approximately 500 adults with intellectual disabilities across the UK reported that in the four weeks before being interviewed in the summer of 2021: 13% of people said they often/always felt angry or frustrated, 15% often/always felt sad or down, 21% felt often/always worried or anxious, 12% often/always felt lonely with no-one to talk to, and 19% of people said they had a new or worsening health condition. Across all these indicators well-being had improved from previous interviews in winter 2020/21 and spring 2021. In the summer of 2021, 50% of adults with intellectual disabilities interviewed felt at least a little worried to leave the house – this was at a similar level to the winter of 2020/21, reversing an improvement in spring 2021.
The same project included surveys with approximately 300 family carers and support workers of adults with intellectual disabilities who could not take part in an interview. In the summer of 2021, family carers and support workers reported that 14% of people were often/always angry or frustrated in the four weeks before the survey, 12% of people were often/always sad or down, 25% of people were often/always worried or anxious, and 28% were reported to have had a new or worsening health condition in the four weeks before the survey.
Unpaid or informal carers
In a survey of approximately 300 largely family carers of adults with intellectual disabilities across the UK in July/ August 2021, carers most commonly reported their caring role had affected them in terms of feeling tired (66%), a general feeling of stress (60%), or disturbed sleep (53%), with little change compared to previous surveys in December 2020 – February 2021 and April – May 2021.
References:
Parker, J.(2021), “Structural discrimination and abuse: COVID-19 and people in care homes in England and Wales”, The Journal of Adult Protection, Vol. 23 No. 3, pp. 169-180. https://doi.org/10.1108/JAP-12-2020-0050
Update for: Wales (UK) Last updated: March 8th, 2022 Contributors: William Byrd | Chris Hatton |
2.06. Other impacts of the pandemic on people who use Long-Term Care
People with intellectual disabilities and autistic people
Apart from impacts of the COVID-19 pandemic on access to health and social care services and the health and wellbeing of people with intellectual disabilities, UK-wide interviews with approximately 500 adults with intellectual disabilities and surveys with approximately 300 family carers and support workers have reported a range of others impacts on people’s lives. In July – August 2021, largely after COVID-19 restrictions were lifted in England, 19% of people with intellectual disabilities with greater support needs across the UK (including people with profound and multiple intellectual disabilities) were reported to be still shielding. Over a quarter of adults with intellectual disabilities reported that someone they knew well had died (or any cause) during the COVID-19 pandemic. In terms of paid employment, most but not all people with intellectual disabilities in paid employment before the pandemic were in paid employment in July/ August 2021, often via furlough or people’s jobs being held open.
No systematic information is available concerning the impact of the COVID-19 pandemic on autistic people without intellectual disabilities in England.
Update for: Wales (UK) Last updated: March 8th, 2022 Contributors: Chris Hatton |
2.07. Impacts of the pandemic on unpaid carers
In a qualitative study based on co-resident family carers in Wales, interviewed carers stated the negative impact that staying at home (in response to government directives) during the lockdown had an overall negative impact on their subjective wellbeing, including increased depression and low mood. Social distancing measures were also said to strain personal relationships. Unpaid carers also experience lack of access to support services both for themselves and the person they cared for, which in turn led to increased intensification of care responsibilities for co-resident carers (Cheshire-Allen, et al. 20022).
References:
Cheshire-Allen, M. and Calder, G. (2022) ‘No one was clapping for us’: care, social justice and family carer wellbeing during the COVID-19 pandemic in
Wales, 6(1-2): 49–66, International Journal of Care and Caring, DOI: 10.1332/239788221X16316408646247
Update for: Wales (UK) Last updated: March 4th, 2022
2.08. Impacts of the pandemic on people working in the Long-Term Care sector
Data from the Office for National Statistics show that, between 9 March 2020 and 31 December 2021, there were 56 deaths of social care workers aged 20 to 64 attributed to COVID-19 in Wales. People working social care had higher rates of death involving COVID-19 compared to people of similar age and sex. For women working in social care, there were 83 deaths per 100,000 (compared to 43 for the general population and 53 for health care workers in the same age groups), the rates for men cannot be compared meaningfully due very small numbers.
Update for: Wales (UK) Last updated: February 3rd, 2022 Contributors: Adelina Comas-Herrera |
4.07. Reforms to Long-term care regulatory and quality assurance systems
The Health and Social Care (Quality and Engagement) (Wales) Act became law on June 1, 2020. The Welsh Government is working to bring the Act into force in spring 2023. The Act will strengthen the existing duty of quality on NHS bodies and extend this to the Welsh Ministers in relation to their health service functions. This places an overarching duty of quality on the Welsh Ministers and reframes and broadens the existing duty on NHS bodies. Additionally, the duty seeks to strengthen governance arrangements by requiring the Welsh Ministers and NHS bodies to report annually on the steps they have taken to comply with the duty and assess the extent of any improvement in outcomes (Source: https://gov.wales/health-and-social-care-quality-and-engagement-wales-act-summary-html).
Update for: Wales (UK) Last updated: March 28th, 2022
4.12. Reforms to strengthen and guarantee the rights and voice of people who use and provide care
On June 1, 2020, The Health and Social Care (Quality and Engagement) (Wales) Act became law. The Welsh Government is now working to bring the Act into force in spring 2023. This Act will strengthen the voice of citizens, by replacing Community Health Councils with a new all-Wales Citizen Voice Body that will represent the interests of people across health and social care. The aims of this new body are to:
- Strengthen the citizen voice in Wales in matters related to both health and social services, ensuring that citizens have an effective mechanism for ensuring that their views are heard.
- Ensure that individuals are supported with advice and assistance when making a complaint in relation to their care. se the service user experience to drive forward improvement.
- Use the service user experience to drive forward improvement.
This new organisation will be established as a national body but it will be structured in such a way as to enable it to perform its functions at a national, regional and local level (Source: https://gov.wales/health-and-social-care-quality-and-engagement-wales-act-summary-html).
Update for: Wales (UK) Last updated: March 28th, 2022