Are we allowed to visit now? Concerns and issues surrounding vaccination and infection risks in UK care homes during COVID-19

  1. Clarissa Giebel
  2. Kerry Hanna
  3. Jacqueline Cannon
  4. Paul Marlow
  5. Hilary Tetlow
  6. Stephen Mason
  7. Justine Shenton
  8. Manoj Rajagopal
  9. Mark Gabbay

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Abstract

Background

vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits.

Methods

family carers of care home residents with dementia and care home staff from across the UK took part in baseline (October/November 2020) and follow-up interviews (March 2021). Public advisers were involved in all elements of the research. Data were analysed using thematic analysis.

Results

across 62 baseline and follow-up interviews with family carers (n = 26; 11) and care home staff (n = 16; 9), five core themes were developed: delayed and inconsistent offers of face-to-face visits; procedures and facilitation of visits; variable uptake of the COVID-19 vaccine; misinformation, education and free choice; frustration and anger among family carers. The variable uptake in staff, compared to family carers, was a key factor seemingly influencing visitation, with a lack of clear guidance leading care homes to implement infection control measures and visitation rights differently.

Conclusions

we make five recommendations in this paper to enable improved care home visitation in the ongoing, and in future, pandemics. Visits need to be enabled and any changes to visiting rights must be used as a last resort, reviewed regularly in consultation with residents and carers and restored as soon as possible as a top priority, whilst more education needs to be provided surrounding vaccination for care home staff.

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  1. Version published to 10.1093/ageing/afab229
  2. ScreenIT

    SciScore for 10.1101/2021.05.20.21257545: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical approval was obtained from the University of Liverpool ethics committee (Ref: 7626) prior to study commencement, and an amendment later granted for the follow-up interviews.
    Consent: Interviews were audio-recorded, with verbal consent obtained and recorded at the beginning of each interview.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Based on these novel findings, we make five specific recommendations for the care home sector, to the benefit of staff, family carers, and residents: Whilst this study benefits from having captured the precise moment when visitation restrictions were officially eased for care homes in England, and being the first study to explore the impact of heightened infection control measures (testing, vaccination) on care home visitation, there were some limitations. This longitudinal study only interviewed family members of care home residents and care home staff, thereby only collecting some proxy information on how people with dementia residing in the care homes were faring. Considering pandemic restrictions of not collecting data in care homes, as well as the difficulty of obtaining experiential data from people who mostly lack capacity to consent, given their advanced dementia, this was the most feasible way of collecting data. Further research needs to explore impact of restrictions on residents’ well-being and functioning, which can be achieved via quantitative measurements. A positive of the sample is the fact that staff were recruited from 16 different care homes across the UK, thus broadening the representativeness of care home experiences. Additionally, our sample was lacking ethnic minority representation, and mostly included family carers and staff from a White ethnic background. In light of increased susceptibility of people from minority ethnic backgrounds to the virus (D...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.05.20.21257545v1 on medRxiv