Award Title: Social Care Recovery and Resilience: Learning lessons from international responses to the COVID-19 pandemic in long-term care systems
Funder: Department of Health and Social Care

Abstract: Research question  What can we learn from international evidence and experiences in order to support the recovery of the social care sector and to inform the development of policies to prevent and manage future outbreaks in social care settings in England?  Background  The first wave of Covid-19 has had an enormous impact on people who use and provide long-term care in England, with substantial excess mortality, compared to previous years, both for people who use home care and who live in care homes, and other impacts on mental and physical health, it has also had a major impact financial impact on care providers. As England faces a second wave and considers the recovery of the sector, there is an opportunity to learn more in-depth from relevant experiences of other countries in implementing measures to prevent and mitigate these impacts in care settings and through taking a systematic and rigorous approach to synthesizing emerging scientific evidence about which measures have worked well or not.  Aims and objectives  We aim to facilitate learning from the scientific evidence and relevant experiences of other countries in preventing and mitigating Covid, as well as recovering from its impacts in social care setting through:    Co-development of a framework to provide strategic direction for how the social care sector in England can recover from, and respond to, Covid-19 (we define the social care sector as care provided in residential and community settings, by paid and unpaid carers)  Synthesis of international evidence and lessons learnt that are relevant to the English social care sector  Informing the development of policies and practices to support recovery and better prevent and manage future outbreaks   Methods  We will use situational analysis and Theory of Change (ToC) to establish a framework from which to assess the relevance of international experiences and evidence to the social care system in England. We will then carry out scoping reviews to map and synthesise empirical evidence on measures that can support the social care sector in preventing and mitigating the negative impact of Covid. We will then use a case study approach, including document analysis and interviews, to review in detail the experiences and learnings from 4 countries. Finally, we will apply the framework developed through ToC to synthesise findings from these work streams.  Timelines for delivery  The project plans to start on the 1st of November and will last for 18 months. The work plan has been organized to deliver outputs in a timely manner as practicable, recognising the critical nature of the Covid pandemic.  Anticipated impact and dissemination  The project s framework and priorities will be co-developed with stakeholders, to ensure that the research is relevant and useful within an English social care context. The team is well positioned to ensure effective and timely dissemination through their own policy and practice networks, their institutions, relationships with media and the dissemination platforms provided by their respective institutions and the LTCcovid.org website.

Lay Abstract: This project aims to understand the important areas that need addressing to improve the English social care system s response to the Covid-19 pandemic, support the recovery of the sector and better prevent and manage future outbreaks. It will also seek to learn from the good and bad experiences of other countries and from the scientific evidence.  We will do this in four main steps:    We will consult with people involved in social care – those using, providing, commissioning and designing services. We will ask them what are the key questions that we should be looking to answer in this project. We will use a structured exercise to map out how to prevent or reduce the severity of future outbreaks, and how to recover from the effects of the first Covid wave.  We will search and summarise scientific studies to find out which measures worked, or not, during the pandemic.    We will review the experiences of other countries in dealing with Covid-19 in social care settings (not just care homes), identifying which measures were successful in protecting people who use care and why. We will consider how structures already in place in these countries, as well as specific responses to local outbreaks, may have contributed to reducing the impact of the pandemic. Building on existing reports, we will identify four countries with both positive and negative experiences during the pandemic and identify the reasons behind their successes and failures by interviewing people, and reviewing policy documents, in those countries.  Finally, we will bring together the learnings from international experiences and the scientific evidence to identify lessons for the recovery of the English social care sector and to inform management of future Covid outbreaks or other infection disease outbreaks. We will again work with those directly involved in social care (as above) to review how these strategies fit onto the route agreed with them in step 1.        It is important that our findings are available to national and local decision-makers as quickly as possible. Therefore, we will regularly publish research evidence summaries, targeted briefings and blogs, using social media to disseminate messages. We will use our wide and established networks among policy-makers, government, providers and organizations that represent people who use care and unpaid carers to ensure that findings reach the right people, setting up meetings with key stakeholders. A final output will bring together what we have learnt across the project and summarise the main lessons and recommendations for the recovery from, and future prevention and management of, Covid-19 in the English social care sector, as well as lessons emerging to inform the longer-term future of social care.

Research Activity Codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;7.1 INDIVIDUAL CARE NEEDS
Health Categories: GENERIC HEALTH RELEVANCE