As I write this, we have come to the end of our first ever virtual three-day conference, the Homecare Festival. It has been a successful event with lots of great discussion and debate and I would like to thank everyone who worked so hard to make it a success, not least my amazing colleagues at Scottish Care. We are all of us learning new skills and I think it is a huge testament to the professionalism, dedication and energy of our small team at Scottish Care that the last three days have been such a success. This all culminated in the success of a pre-recorded virtual Awards which was broadcast on YouTube yesterday evening. Whilst we missed the champagne reception, the lovely meal and great conversation, the absolute brilliance of all those nominated and those who ‘won’ shone through. Congratulations to everyone who was nominated and to those who were winners. I wrote in my blog last week and I reflected in my own contributions with the media this week that homecare has throughout the last few months often been forgotten about the marginalised. See https://scottishcare.org/the-invisible-pandemic-the-urgent-need-to-renew-homecare/
I would want to underline to our homecare members that Scottish Care is committed to ensuring this changes and continues to change, not just through holding a three-day event but continually and constantly in the weeks and months ahead. I touched on some of these issues in my blog last week which was picked up by the Herald newspaper as their lead story.
Inevitably the last week has also been one of mounting anxiety and dread. Sadly, we have seen an increasing rate in the number of infections in care homes and also deaths. As the rest of society began to lockdown to a greater or lesser extent yesterday evening, we acknowledge that the next few weeks and months will be ones of challenge and in some places sadness. Again, I would want to underline that despite the obvious sense of anxiety that Scottish Care is here to support all our members in the time ahead.
The following is a summary of some of the main issues in the week that has passed.
Care Inspectorate
The Care Inspectorate is in the process of issuing a letter to all providers in relation to winter planning. It draws upon the work they have undertaken with HPS colleagues and highlights a number of areas of concern in relation to infection control and practice. There is clear evidence that care homes where there has not previously an outbreak and care at home/housing support services which have not previously worked with clients who have been Covid positive are at particular risk. As I stated last week, we will continue to hold discussions with the Care Inspectorate in relation to the Inspection reports which have been being undertaken because we have real concerns about the nature of the inspections and their IPC focus.
Testing.
We continue to see a gradual but very patchy improvement in the level of response from the UK Social Care portal – even in the same care home there are instances where tests are being returned at vastly diverse periods of response from 48 hours to 9 days. We continue to press on officials the critical importance that we get this right. Again, I met with the Cabinet Secretary for our now stated fortnightly meeting and I impressed upon her that all elements of recovery are at risk if we do not get the testing system sorted. I believe that in a letter to providers which will come out next week and which will include references to changes in visiting that there will be a detailed description of when it is envisaged that there will be a full transfer of the current testing system to the Scottish NHS.
As I have previously stated and as we have publicly argued in the week that has past, we are continuing to advocate for the extension of testing to include regular testing of care at home and housing support staff. There has been a commitment to start planning work on this, but I would suspect this is likely not to happen until they are convinced that they have sufficient capacity both to undertake and return the care home testing regime in a manner which is robust.
An information session has been developed by the Testing directorate for all care providers. This will take place on Monday 12th October between 3 and 4,30 pm. Information and sign in details are available at https://scottishcare.org/information-session-on-care-home-staff-testing/
Care at Home
The Scottish Human Rights Commission has this week published a major report exploring the response of various stakeholders during the pandemic, explicitly as it relates to care at home, informal carers and the experience of those with disabilities in relation to the suspension of care supports. Scottish Care took part by giving evidence. It is a hard-hitting report which does not pull its punches and makes 24 recommendations all of which we would strongly support. I would commend you to explore its findings. It concludes with the following words:
“The COVID-19 pandemic has exposed and exacerbated the inadequacies of the ways in which social care is accessed, funded, procured and commissioned in Scotland. The current social care system is unable to provide people with the support that fits their life best and most appropriately, and to ensure their rights are respected, protected and realised.
Short and longer term change is needed to address the significant human rights concerns we have identified, and to ensure the level of level of decline in the realisation of people’s rights that has taken place never happens again.”
I would personally concur with this – not least in that whilst I accept it was necessary for some services to be stood down in the community in the early stages of the pandemic, I remain to be convinced that the extent and degree of the removal of care packages and the failure to speedily restore these is in any sense justifiable. The sharp increase in mortality rates described as being ‘excess deaths’ in our communities speaks to this.
National Care Review
After our initial meetings we are in the process of organising further opportunities to speak to the review team and in particular to Derek Feeley. We are planning further meetings for homecare and care home providers and also for the Scottish Care Executives. We will keep you informed when we get these dates.
General Covid Care Issues.
The Pandemic Response Group met this week and spent a great deal of time reflecting on a paper – which those attending the meeting had half an hour to see – which has been developed by civil servants on the Winter Plan for Adult Social Care. For the second week in a row I expressed real irritation and anger, alongside colleagues from local authorities and Cosla about this shocking presumptuous way of planning. The week before Karen and a number of providers took part in another exercise for winter planning which again was limited and vacuous of a real understanding of the planning needs of the sector as we move into winter. We are now considering the content of this overarching national Plan, but it is clear already that it has been written by those who have no iota of an understanding of the particular realities being faced by providers in both care homes and in the community. I suspect we might be in for a bumpy few days as the politicians and civil servants try to gain some consensus for what they will wish to present as a collective plan. I will keep you informed about this process.
The Clinical and Professional Advisory Group did not meet in full this week, but a sub-group met to explore issues for the later stages of visiting. However, members will be very aware of the media coverage in the newspapers last weekend which mentioned dramatic changes to visiting. This followed a meeting between the Care Home Residents Group and the Cabinet Secretary and part of that private discussion was communicated to the media and to social media. I have underlined with others how unhelpful this was.
Nevertheless, it is likely that next week the Cabinet Secretary will write to providers detailing what has become known as a consolidation of Stage 3 visiting. It is very strongly the desire of Scottish Government to keep visiting open and to underline that visiting into care homes is NOT affected by the restrictions which were introduced nationwide yesterday or indeed earlier. The elements of the consolidation will be to allow longer visits (up to a maximum of 4 hours), to enable a degree (but not continuous) element of touch if the relative wears full PPE, to allow for more proximate visiting (if the relative wears PPE) and to give a clearer understanding of what is meant by an ‘essential visitor’. The Guidance will be more nuanced and descriptive than some of the media comment has been.
Again, can I underline the desire of Dr Jenni Burton who is involved in the research on hospital admissions into care homes to get evidence of the experience of providers in relation to admissions throughout the pandemic.
We are continuing to raise as a matter of very real concern issues relating to the roll out of the Flu Vaccination programme. This was formally launched on Thursday and whilst it is clear that there are many care home and homecare staff who have already been able to access their vaccines – it is also blatant obvious that there is such a variety of diverse practice around the country that staff and organisations are at a real point of uncertainty. We are not, as an organisation, convinced that there is a sufficient supply of the vaccine to make the programme achieve its target given that all purchasing seems to have been estimated on previous pre-pandemic uptake of the vaccination by NHS staff. We will continue to monitor these issues. See https://scottishcare.org/seasonal-flu-campaign-launches-today-8-october/
PPE
Members will be pleased to acknowledge that the Scottish government has decided to extend the current PPE arrangements into the spring. I would want to thank Karen Hedge and Elaine rae for all their work in getting this to the point of agreement. This is a positive step and adds an important degree of reassurance to both. Care homes and homecare services as we move into the next few months. As the document states:
“To ensure continued stability with access to PPE over the winter period, the MoU will now be extended until March 2021… The central principle in the MoU about access to the PPE Hubs and the PPE support centre will not change. We will still be expecting that:
- · Business as usual is for care providers to source their own stock of PPE; and
- · Where this fails, the PPE Hubs will provide PPE, including to Personal Assistants and unpaid carers.
The PPE support centre will continue to handle emergency requests.
Please see full text and MoU at:
https://scottishcare.org/extension-of-social-care-ppe-hub-arrangements-7-october-2020/
Finance and sustainability
As stated last week we are continuing to monitor the issues of sustainability and now have a clearer picture of what the general situation is in relation to occupancy levels and their effects on sustainability. It is strange that we seem to be in agreement now with some of the Chief Officers that levels of sustainability and flow are affecting the very sustainability of some care homes. It is further clear that the level of care at home packages which have been renewed is far lower than some of the estimates which had earlier been mentioned. We will continue to hold our trouble-shooting meetings with COSLA and in Karen’s absence on leave next week any concerns should be communicated to Jim Carle. Having failed to get any movement from COSLA on the NCHC I raised this formally with Scottish Government colleagues at the Pandemic response meeting and I hope we will at least get recognition of the urgency of these discussions in the next week. If we fail to achieve that then we will issue a media statement about the risk to sustainability of the sector and all that that means for care homes as we move into the winter period.
Karen Hedge has established a major review of sustainability and a survey was sent out to members yesterday evening. Please fill this in as a matter of priority. his survey is designed to provide intelligence on the sector’s experience of and need for financial support for pandemic response. We will use this data to provide evidence for further support if the results show this is what is required. Please find it at https://mailchi.mp/scottishcare/urgent-financial-support-for-social-care-survey?e=8b93fe8b46
I noted the announcement of over a £1bn into health and social care made by Scottish government last week. Not surprisingly it is already evident that there is very little of this going to flow through o the sector. The one positive is that the Cabinet Secretary in her discussion indicated that the position would be reviewed in November. It is therefore all the more urgent that members communicate with us the reality of fiscal shortage and sustainability issues you are facing.
On another positive mote we also received notification that the Social Care Support fund is to be extended into the spring of 20201. Details of this can be found at https://scottishcare.org/social-care-staff-support-fund-update-8-october/
Workforce issues.
We have updated Guidance on the issue of staff travel and providers should be aware of this in light of the announcement of latest restrictions on travel and car-sharing. Please see https://scottishcare.org/communications-for-social-care-workers-travel/
Caroline Deane has taken part in constructive discussions with Scottish government and Disclosure Scotland. These are still progressing, and we have been assured that delays are being dealt with. We will closely monitor this and will make sure that promises are followed through. We need you to tell us what is happening – in the next week please contact Jacqui Neil with concerns on this matter as Caroline is on leave. On a positive note the Care Inspectorate has reverted to its former position re references although obviously this can also create a glut in the flow system. Please see https://scottishcare.org/the-care-inspectorate-update-on-pre-employment-checks/
Covid-19 Guidance Notifications
We have set up a new system to allow members to subscribe to receive email notifications every time we post new or updated Covid-19 guidance on the Members Area.
You can find instructions on how to subscribe here: https://scottishcare.org/wp-content/uploads/2020/09/Subscribing-for-Covid-guidance-notifications.pdf
Disclosure Scotland
Please also note a message from Laura re DS:
We have an ongoing issue with counter signatories who are under the Scottish Care Registered Body Code for Disclosure Scotland ticking ‘invoice’ payment rather than inserting their credit/debit card details at the point of application. The invoice is then attributed to Scottish Care rather than the individual service/provider. We then have to forward notifications to members to make payment to Disclosure Scotland. Please ensure when you are making online applications that you pay via the Disclosure Scotland payment portal.
Communication
Next week the Tuesday Surgery will be at the usual time of 11.00 am. We are grateful for the attendance of Prof Graham Ellis and Hugh Masters at last week’s event. This coming week I will lead the Surgery alongside a colleague as Karen is on leave.
Care Home Awards opening.
We’re delighted to announce that the 2020 Care Home Awards are now open for entries. Never has it been more important to support the amazing work done in our care homes. Please support and enter:
There are 13 award categories:
- Ancillary & Support Staff Award
- Nutrition & Eating Well Award
- Meaningful Activity Award
- Training, Learning & Staff Development Award
- Emerging Talent Award
- Outstanding Achievement Award
- Management & Leadership Award
- Palliative & End of Life Care Practise Award
- Nurse of the Year Award
- Carer of the Year Award
- Specialist Service/ Unit of the Year Award
- Care Home Service of the Year Award
- Positive Impact Award
Find out more about the awards and submit your nomination here
And finally,…
Join me as we enter autumn and as things started to become more challenging in keeping the causes and concerns of the sector before a wider audience by lighting a #candleforcare on Tuesday at 7.00pm
Many thanks
Donald
10th October 2020
