Another week with a real sense of positive dynamic . On the positive side the news that the MHRA has signed off the Pfizer vaccine has given everyone a real boost. The challenges around operationalising the first amount of vaccine – some 65,000 have been much commented upon. So what we know is that from the 7th the vaccinators and health staff will be the main focus. Cabinet Secretary then announced progress on Thursday afternoon which meant that a roll out to care homes would start from the 14th. Colleagues are working closely with Scottish Government officials to explore what this means in practice given that the amounts of the vaccine that Scotland will receive in this first drop are likely to be relatively low. Be that as it may this is tremendous news. As I said we are working with Scottish Government colleagues to ensure the proper engagement and involvement of the sector in decisions around the vaccine and its distribution. The Chief Pharmaceutical Officer and colleague are also working with the MHRA on widening the vaccinator pool to include registered nurses working in social care – I hope she succeeds! A lot of work is happening in this whole area and matters are changing by the hour – we will ensure that members are kept as up to date as we can through the website discussion board in particular.
The following is a summary of some of the main issues in the week that has passed.
Social Care Bonus Payment.
Another really positive intervention came in the form of the announcement at the start of the week by the First Minster that all health and social care staff would receive a bonus payment of £500.
The full letter can be located at https://scottishcare.org/social-care-covid-19-bonus-payment/
Caroline has been taking part in meetings this week to enable this to be enacted. We are still not completely clear at this stage whether the payments include all staff working in a care home or homecare organisation. We obviously are keen for the widest possible scope.
More details on the how are being developed and operationalised and we will update as soon as we can.
Care home issues including testing
Another major announcement in the week that has passed has been the extension of the lateral flow devices and their roll out to prioritise care home family visits.
On Wednesday the First Minister announced the speeding up and extension of the programme which had been announced the previous week.
The full letter and detail of this announcement has been sent to members. So, in summary the trialling involving homes in 5 local authority areas will begin next week (from the 7th) but from the week beginning the 14th December testing kits will be delivered to all care homes. This is a month earlier than originally announced.
There is a recognition that not all care homes will be able to make use of lateral flow tests available before Christmas, and so it is also planned to make PCR testing of visitors available – when that is necessary – over the festive period.
A Guidance pack is being developed along with training materials which the early adopters will use initially, providing feedback to allow refinement the wider roll-out. They have stated that they are ‘mindful of the additional ask of care home staff and will continue to monitor this with support from Scottish Care, CCPS and COSLA.’
Critically there will be three care home visitor testing workshop sessions w/c 7 December for care home providers and those supporting care homes . Details are available at the website and have been sent to members on Thursday. Please sign up for these. See https://mailchi.mp/scottishcare/newsflash-announcement-on-care-home-visitor-testing?e=8b93fe8b46
I am aware that there have been concerns intimated about the robustness of the lateral flow devices. Having spoken to colleagues in England I think we have to be aware that there has been a degree of politicisation of the concerns by some authorities in England.
Nevertheless, the issue of enabling visitor access has now become absolutely critical. Many of us would have seen the frontpage of last week’s Sunday Mail containing as it did a photograph of 100 individual residents who were not able to see their family. Apart from the most important issue which is the obvious personal damage and deterioration that has resulted in the lives of both residents and their families, I am now convinced that unless we are rapidly and ‘carefully’ address this issue then the public, media and political narrative will be such that there will be irreparable damage to the care home sector. I am using these words carefully, but we now have clear evidence that the self-funder market has collapsed bringing into question the future sustainability of many care homes. The key argument presented by people and their families is the current visitor restrictions. We simply have to get things sorted or we will not have a sector in the spring.
On another positive decision SAGE and the Scottish Government clinical advisors have finally agreed to a reduction in isolation requirements. Currently a care home has to close after an outbreak for 28 days but following consultation with the Directors of Public Health and Health Protection Scotland they are now recommending that this is reduced to 14 days from the last date of COVID symptoms subject to a Health Protection Team (HPT) assessment and confirmation of safety. This brings the advice in line with that from Health Protection Scotland / Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland who declare an outbreak over after 14 days if no new cases or symptoms develop – with an HPT risk assessment.
This will hopefully help to enable more visits and also admissions.
Lastly and very much regrettably we STILL have not seen the publication of the Christmas Guidance. This is despite almost daily requests.
Care home issues
Sadly, the number of those who have died of Covid in our care homes still remain at a disturbingly high level. In the week up till the 29th November the numbers of those in care homes who have died from Covid19 or suspected Covid has jumped to 101 individuals up from 94 the week before and this now accounted for 32% of all care home deaths in that week. In the same week we had a total of 142 care homes, down from 164 in the previous week and from 159, 148 and 135 in the previous weeks.
I am also pleased to say that finally – finally! – the Christmas Guidance was published by Scottish Government yesterday evening. Tis also contains information on testing as well as videos re discharge etc. See https://www.gov.scot/publications/coronavirus-covid-19-adult-care-homes-visiting-guidance/
Once again it is important to stress yet again that the Guidance does NOT ban Christmas decorations, cards, gifts and trees. If you cannot clean the gifts and presents, then put them away for 72 hours and put your decorations and tress at a height or in an area where they will not be touched. In every sense the Guidance expects a continuation of current visiting Guidance rather than the introduction of any new requirements.
Once again I want to underline that an ‘essential visit’ continues to include a situation where EITHER the resident or their family member is distressed, and that ‘end of life’ visits do not just mean the last hours but the last few days of an individual’s life. I am aware of the diversity of interpretation being used for both of these concepts.
Finance and sustainability
Again very late in the week – yesterday – we had confirmation of support for the sector in terms of sustainability payments. The Scottish Government has published a further update regarding the arrangements for financial support for the social care sector from December 2020 to March 2021. This follows an agreement between the Scottish Government and COSLA to help the social care sector with additional costs related to the COVID-19 pandemic.
These arrangements cover support for sustained, significant impacts on service delivery, and offers commitment to meet reasonable additional costs both incurred as a result of the pandemic.
A letter outlining the financial support from Jeane Freeman, the Cabinet Secretary for Health and Sport and Stuart Currie, the Health and Social Care Spokesperson for COSLA can be found on our website at https://scottishcare.org/financial-support-for-social-care-providers-from-dec-2020-mar-2021/ and Guidance around these new arrangements are also available on: www.gov.scot/publications/coronavirus-covid-19-financial-support-arrangements-for-social-care-providers
The agreement is at least a continuation of support and I am grateful to Karen for all the work she has undertaken in arguing the case for the sector.
I am also aware that we continue to have members who have not received monies from March . Please please communicate with us if this is the case and with your local Independent Sector Lead and we will continue to argue the detail of cases with COSLA and Scottish Government at our weekly meetings.
Care at home issues
Along with many members I remain very concerned indeed that there remains a lack of focus on the significant issues facing care at home and housing support. We will be using homecare day on Wednesday (*see below) to try to get both political and media focus on these issues. They remain as they have for weeks, a lack of clarity re Test and Protect and staffing issues; unacceptable changes to packages of care; profound issues of recruitment and all the issues related to financial sustainability, access to PPE, testing of staff etc. Indeed, there is a sense of further delay re homecare staff testing. We have been told that the pathway for this work is due to be published imminently – but we will believe that when we see it!
I have reflected on some of the issues facing Homecare in my weekly blog. See https://scottishcare.org/care-as-community-a-tale-of-springsteen-and-homecare/
Communication
The Surgery this coming week will be held at the usual time, Tuesday at 11am. Karen will be hosting the session as I will be chairing the judging session for the Care Home Awards. Karen will be joined by colleagues from Scottish Government who have been involved in the testing work, Care Home Guidance and related issues. Please sign up for this session – details at https://scottishcare.org/covid-19-surgery-care-home-visitor-testing-8-december/
Workforce
Again late on Friday we got information about the extension of the Job Retention Scheme and its impact on social care workforce and employers. Details of this are contained in another letter from the Cabinet Secretary for Health and Sport, Jeane Freeman. It is especially relevant for workers who were not placed on the scheme this March – October 2020, but who were eligible for health reasons. See https://scottishcare.org/extension-of-uk-government-job-retention-scheme-jrs/
Homecare Day
As mentioned above Homecare Day will be taking place in the coming week on Wednesday 9 December.
The theme of the day is Care Community, to highlight how homecare services are essential parts of the health and social care community, as well as local communities in Scotland and further afield. Homecare services and staff provide high quality, person-centred care to support the health, wellbeing and independence of people in their own homes, with staff demonstrating skill commitment and compassion every day.
#homecareday20 is an online event to celebrate the best of care at home and housing support services across the country. Save this date in your diaries and join us in raising the profile of homecare. The day also includes a live Twitter conversation between Dr Jane Townson, CEO UKHCA and myself at 12 noon-1.00pm.
Vacancy
I’d like to again draw your attention to a job opportunity at Scottish Care. Becca Young who will be known to many of you is off on maternity leave in February and we are looking to fill a 10-month maternity cover post. This is a critical role in the organisation at what is a significant time. Details of the post and the requirements can be found online at https://scottishcare.org/job-opportunity-policy-research-manager-maternity-cover/
Please spread the word.
Care Home Gathering: 19-21 January 2021
The programme for this Gathering is now in its final stages and will be available shortly. The Awards will still be on the same date of the 22nd January.
And finally,…
On the eve of Homecare Day please join me on Tuesday 8th in lighting a #candleforcare in remembrance of not only those who have died during Covid19 but all those who continue to care and support in care home and homecare services.
Many thanks
Donald
5th December 2020
