COVID-19 management in social care in England: a systematic review of changing policies and newspaper reported staff perspectives

  1. Lavinia Bertini
  2. Leanne Bogen-Johnston
  3. Jo Middleton
  4. Wendy Wood
  5. Shanu Sadhwani
  6. Julien Forder
  7. Daniel Roland
  8. Rebecca Sharp
  9. John Drury
  10. Jackie A Cassell

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Abstract

Adult social care has been a major focus of public attention and infection control guidance during the COVID-19 pandemic, with a high mortality both for carers and those receiving care. To protect themselves and others from infection, staff in residential and domiciliary care settings had to quickly adapt to infection control measures that heavily impacted on their working and every-day life, whilst navigating new responsibilities, uncertainties and anxieties. We sought to explore the production and reception of guidance and look at ways these can be adapted to improve the working life of care staff in domiciliary and residential care whilst reducing the risk of SARS-CoV-2 transmission amid this pandemic and of future emerging infections.

We conducted two complementary and integrated systematic reviews of published documents in the pre-vaccination era: (1) National guidance for social care (conducted between 29 July to 28 October 2020), and (2) Newspaper coverage of infection control issues in social care (conducted between 27 th July to 10 th September 2020).

Three higher order common themes emerged in the integrated systematic review of guidance documents and newspaper articles: a) Testing , b) Personal Protective Equipment , c) Employment . The reviews revealed a sharp disjunction between the content of infection control guidance and its usability and applicability in social care settings. We suggest that infection control guidance needs to be better adapted to social care settings and informed by the sector. The practicalities of care work and care settings need to be at the core of the process for guidance to be relevant and effective. Modes and timings of communications also need to be optimised.

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  1. ScreenIT

    SciScore for 10.1101/2021.11.17.21266410: (What is this?)

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

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    To manage and organise data, preliminary codes and sections of data were entered into a Microsoft Excel 2016 spreadsheet.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    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:
    4.2 Limitations: Two main limitations of this study are the narrow geographical and temporal focus of the systematic review of newspapers articles, limited to local newspapers in Kent, Surrey and Sussex published between 1st July and 31st August 2020, alongside national coverage. This is due reasons of resource and funding focus, as these systematic reviews were developed as part of a broader project exploring the impact of COVID-19 infection control guidance on the working lives of domiciliary and residential care staff in Kent, Surrey and Sussex. We are also aware that the issues analysed in this review and reported in newspapers are mediated through journalists and editorial boards. As such, the review does not report the direct experiences and opinions of sector representatives. A qualitative media analysis review of newspaper and/or media coverage of staff perspectives on COVID-19 infection control measures throughout the pandemic might add further insight to the findings presented in this research. Moreover, it is important to note that the majority of the newspaper articles included in the review report comments from sector representatives and care providers whilst the direct voices of carers are less present. It would be fruitful to compare the themes identified in this review with those that might emerge from interviews and/or focus groups with domiciliary and residential care staff on their experience of implementing covid-19 infection control guidance.

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.11.17.21266410v1 on medRxiv