Collective Care Future: tell us about partnership

Third theme: share your experiences of partnership working during COVID-19

This week the survey is focused on the theme of ‘Partnership’.

We are using the word 'partnership' to describe different organisations or people working together to support care delivery.  We are interested to hear your experiences of working with others in partnership or your experience of care and support as a result of different organisations and people working together.

In this theme we are interested to explore new or different ways of working with wider health, social care, community and other partners that have developed during COVID-19, what the impact of these partnerships has been on care delivery and what forms of support and/or collaboration have been most valuable.

The survey has 3 sections: Experience of Partnership, Impact of Partnership and Future Partnership.

If you would like to see the questions in advance to help you complete the survey fully, you can download a PDF of the survey here - download survey questions.

You can also download Word copies of the survey to complete by hand or to distribute to others - download Word survey questions.

We would appreciate your support in circulating the survey as widely as possible across your networks, including to any individuals who access care and support and their families who may like to share their experiences.

If you don’t feel that you have had direct working experience with the independent care sector during the pandemic but you would like to be involved in the second phase of the programme, please let us know at [email protected] and we will be in contact in due course.

This week the survey is focused on the theme of ‘Partnership’.

We are using the word 'partnership' to describe different organisations or people working together to support care delivery.  We are interested to hear your experiences of working with others in partnership or your experience of care and support as a result of different organisations and people working together.

In this theme we are interested to explore new or different ways of working with wider health, social care, community and other partners that have developed during COVID-19, what the impact of these partnerships has been on care delivery and what forms of support and/or collaboration have been most valuable.

The survey has 3 sections: Experience of Partnership, Impact of Partnership and Future Partnership.

If you would like to see the questions in advance to help you complete the survey fully, you can download a PDF of the survey here - download survey questions.

You can also download Word copies of the survey to complete by hand or to distribute to others - download Word survey questions.

We would appreciate your support in circulating the survey as widely as possible across your networks, including to any individuals who access care and support and their families who may like to share their experiences.

If you don’t feel that you have had direct working experience with the independent care sector during the pandemic but you would like to be involved in the second phase of the programme, please let us know at [email protected] and we will be in contact in due course.

Thank you to those who have participated in or circulated the Care Futures surveys so far. If you haven't done so yet, you can still access the surveys here: https://scottishcare.org/care-future-surveys/

Infrared Thermal Imaging Technology

We are posting some information from Health Protection Scotland on infrared screening because we are aware that many providers are considering such machines. They are a considerable expense and it would appear of limited value. 

Individuals presenting with atypical COVID-19 symptoms (i.e. no fever) and those in which fever has passed but are still infectious, will not be identified by fever screening. This, combined with the issues regarding sensitivity, and the impact of antipyretic medication on sensitivity, indicate that health and care settings should not implement infrared thermal imaging as a means of detecting COVID-19 patients.

 

1_covid-19-rapid-review-thermal-imaging

CEO Review of the week  5th to 11th July

Well we are well and truly on the road to and through Phase 3 with pubs re-opening, hairdressers sharpening their scissors and a whole manner of businesses and activities beginning to plan and actually re-commence. In some sense we are now moving into a stage where there is less intensity in relation to the immediate Covid19 response. However no sooner has the foot gone off that pedal than we are seeing real increase in activity in relation to what I have come to term the three peaks – a second wave, a flu upsurge and the impacts of Brexit whether a No-Deal or a Deal not least its influence on workforce.

The following is a summary of some of the main issues in the week that has passed.

Finance and sustainability

We have held several meetings to try to get movement on the sustainability payments reaching providers and in some instances the SLW. Both Dundee and Edinburgh are disputing the SLW payments to care at home providers and this is now in the hands of Scottish Government. We held meetings with COSLA on Monday and Wednesday morning and raised issues of sustainability at the National Contingency Meeting on the Wednesday afternoon. Whilst there was a willingness to move things forward I am increasingly of the view that COSLA is exercising little authority over its members.  As a result of pressure both the Director of CCPS and I held a meeting with Scottish Government senior officials yesterday morning and they have decided to involve the Director of Health and Social Care at Scottish Government in a direct intervention to get money out to providers. We have supplied them with a template listing our areas of concern on specific areas and payments. I have placed the latest version of this onto the website. See https://scottishcare.org/?p=11906

The information should be treated in confidence but gives an insight into the areas where we believe there still to be problems. If members think that there is something missing please do add this onto the Discussion Board. I hope that with SG recognising the seriousness of this that we will get movement. Both CCPS and ourselves have agreed to hold off from issuing a media statement on this until we get some sense if SG can make things move.

We are again meeting with COSLA and the HSCPs on Monday afternoon and hope to see some indication of progress then and most certainly by the time of another meeting on Wednesday morning.

I want to underline to members that we are acutely aware of the financial risks not least in relation to the Social Care Fund payments.

COSLA is formally giving consideration to the commencement of the NCHC talks with Scottish Government involvement and I would hope to hear about this after the COSLA Leaders meeting in the coming week.

Members will be aware of the host of issues re the Social Care Support Fund – we have again raised these, and Scottish Government agreed to communicate to us on these issues on Monday – they finally got back on a range of questions late on Friday – I have posted responses up on the Discussion Board. If you have any more questions which are not answered there please do get in touch with me. https://scottishcare.org/members-area/topic/social-care-fund/#postid-430

Finally, the terms of the Death in Service Scheme have now been published. It has been lamentable that officials have taken so long to get this through, but the new Guidance makes it much clearer that Scottish Government will make a direct payment to those individuals involved and this, I hope, will make it easier both for relatives and for employers over the next few weeks. Seehttps://www.gov.scot/publications/coronavirus-covid-19-social-care-worker-death-in-service-payment

Care Home issues

Again, there has been another week of stability in the data relating to deaths in care homes and the totals have reached what is close to a seasonal norm. We have had four deaths in the latest statistics, but caution needs to be noted in that whilst there has been a drop in the number of care homes with an active outbreak this is still at 119 which is 11% of all care homes.

As you will know visiting started last week – and in some parts of Scotland it was a shambles! It was highly regrettable that what should have been a positive experience became a negative one for so many because of inconsistent planning by Public Health Scotland. I submitted a letter (below) to the C are Home Rapid Action Group and a discussion was held on this. It was clear that Public Health felt stretched with – as they stated over a 1000 care homes – I pointed out that some areas managed well and that there was nothing like a 1000 homes seeking to open. I hope that having stated these positions that measures will be much more consistent as we move through the remaining stages. Certainly, Public Health officials heard the sense of disquiet not only from ourselves but also from Chief Officers. The Scottish Government team have provided additional Visiting information in the form of an FAQ https://scottishcare.org/care-home-visiting-faq/

The Clinical and Professional Advisory group also considered a paper which outlined what was needed to move to stage 3 and stage 4 in terms of visiting. At stage three it is envisaged that one indoor visitor will be allowed per resident in clearly defined circumstances and for a specific limited period of time. It is also envisaged that there will be gradual use of communal space and greater socialisation again with limitations and use of PPE. This is a beginning of a return to something like normal. The decision on this will be taken on the 23rd July with a potential move to the next stage the following week. We have made it clear that we need to do much more planning to ensure that we do not make the mistakes of opening to visitors which we have seen at Stage 2.

The  whole issue of visiting has raised concern as to the extent to which measures taken to protect individuals during lockdown have been proportionate and the extent to which these are being considered as having a detrimental impact on the health and wellbeing of individuals. Personally, I consider that we need urgently to explore how we get this balance right as I am not convinced that Government Guidance has enabled us so to do and to have the flexibility and room for professional judgement that we needed and deserved as a sector. An article in the BBC explores some of these issues. See

https://www.bbc.co.uk/news/uk-53338139

The Care Inspectorate document ‘Guidance for Professional Visitors’ was finally signed off by the CHRAG on Thursday and I hope will be made available soon.

One of the major issues we have been facing over the last few days has been correspondence about Operation Koper, the unfortunately named investigation of deaths in care homes and amongst professionals, instructed by the lord Advocate and being carried out by Police Scotland on behalf of the Procurator Fiscal Service.  Members who have been impacted will have received a letter detailing some 20-30 requirements re information and data. This process has landed in a stretched sector with real insensitivity. On the one hand we all want to ensure that there is public confidence  in the sector and that if possible families and relatives are able to get the reassurance they need that all measures were taken to ensure the health and safety of the relatives whom they have lost. However, the mechanism being used to gather data seems disproportionate to achieving that aim. Providers are being asked to provide care plans from the point of admissions which might be several years. These matters were brought up at the Rapid Action Group and it was decided that the Director of Health and Social Cared would liaise with police Scotland. At the very least we would be looking for an extension to the timeframe and an appreciation that records going back no more than one year would be sufficient rather than to the start of residency. We will keep members informed of any movement on this issue. Again, this is about balance because any organisation contrasting such investigations risks a very negative perception amongst the wider public, however justifiable issues of constraint and resource might be.

Care Inspectorate

I would underline again that the Health and Sport Committee have announced that they are to carry out an Inquiry into the role of the Care Inspectorate during the pandemic. The political comment this week together with a fairly determined campaign from the Daily Record lays bare what is behind much of these movements against the Care Inspectorate. Now we would be the first to highlight the failings in the scrutiny system, but I would again caution that there is a growing political sense that the CI have been too soft on the sector and that their collaboration model needs to revert back to a compliance model of strict instruction and penalty. We have to be alive to the very real threats which such an investigation and its hyperbole might pose whilst at the same time calling out failings where they might have existed.

Testing

After many attempts and much effort, we finally held a meeting of the Social Care and Testing Working Group.,  This met on Monday and going forward Caroline Deane will represent Scottish Care at this group. The meeting was purposeful and attended to a range of questions which Scottish Care had presented. Some issues were outstanding and are to be further explored this coming Monday. These include the ongoing uncertainty over the ‘mandatory;’ nature of tests re the SSSC statement, the ability to carry over data and the various practical issues related to the UK Social Care Portal. A member of UK staff will attend the meeting on Monday. Again, if you have particular ongoing practical concerns please flag these to Caroline by Monday morning before the meeting each week.,

We were also pleased to be joined by Susan Stewart from the Office of the Chief Nurse and then later by Tracy Slater from the Testing Directorate at the Scottish Care Surgery on Tuesday. I hope that members found it useful – this can be located at https://scottishcare.org/covid-19-webinars/ .

I should underline we also had to deal with the story in the media that the HMRC had published that those staff who were tested should be considered as being liable to tax on what they viewed as a benefit in kind. After this was raised in the Commons the chancellor Rishi Sunak  requested that HMRC withdraw this – they have done so for now. It felt like Silly Season had finally come. Of equal concern were stories that by being tested staff endangered their personal and life insurance or mortgage applications. We are pursuing this but are comforted by the response to similar concerns raised by the BMA. See  https://www.bma.org.uk/advice-and-support/covid-19/your-health/covid-19-your-life-insurance

Five Nations research

 Many of you will know of the five Nations Care Group which Scottish Care was a founding member of 11 years ago. The group brings together the Chairs and CEOs of care home and homecare organisations across the UK and Ireland. The Group has been meeting on an occasional basis throughout the pandemic exchanging information and knowledge about each of the ways in which the administrations have addressed the issues of concern. We have commissioned a short and rapid piece of work comparing the pandemic response and identifying lessons learned not least for future events. This is being undertaken by the respected consultant John Kennedy and I had the privilege to be interviewed this week. We hope this will  be a useful piece of work ion our future articulation of our own responses to the way in which the pandemic has been handled in Scotland.

 Care at Home

 The Care Inspectorate has started their process of an Inquiry which in relation to care at home and housing support. As I stated last week we are welcoming this, but I raised at the CHRAG that on its own this was not sufficient. As we move forward I think it is critical that SG established an overarching group to explore Care at Home and Housing Support because to put it simply I do not think that the sector is capable of surviving g the sort of growth in community transmission of Covid or the other peaks of flu and Brexit impacted will keep pushing on this, not least on issues of testing for CAHHS staff.

Care at Home and Housing Support Conference and Awards

 This may not come as a surprise to members, but very much on advice in terms of what is likely to be allowed in regard to mass gatherings indoors – we have decided to postpone the CAHHS Annual Conference and Awards which had been rescheduled for the end of September.  We are instead intending to hold a virtual conference and are excited about the prospect of showcasing some of the amazing work that is being down in homecare despite the obvious challenges of recent times. A small working group has been established to decide the shape of this event – likely to take place in early October. We will get full details of this out as soon as possible together with details of the Awards and the process that will be undertaken to ensure that this is a real – not just a virtual- success.

 Care Futures – Technology Survey
 

The Collective Care Futures project is well under-way, and can I encourage folks to continue to get involved in the sessions being led by Becca and Tara. Equally filling in the online questionnaires will be of huge value to what I would argue is one of the most critical and time sensitive pieces of research and policy work which Scottish Care has undertaken in our history. It is critical we engage and get our voice out there in the clamouring din of those who want to define and decide the future of the sector for us.

Find out more about the Collective Care Future programme: https://scottishcare.org/project/collective-care-future/

Link to survey: https://www.surveymonkey.co.uk/r/carefutures-technology

Care Home Day

There probably has never been a more important time to celebrate the significance and importance of care homes in all their wide diversity than at the present time. That is why Wednesday 15th is such a critical day.

 The aim of the day is to highlight how care homes and their local communities have come together to support residents and staff especially during the Coronavirus pandemic.

We want to be able to celebrate the dedication and professionalism of staff in supporting residents, families and each other throughout this period has been exceptional. 

The day is organised by Scottish Care, supported by the Care Inspectorate and the Scottish Government. On the day we are calling for individuals, care providers and partner organisations to join on social media to share good news stories from their local care homes using the hashtag #carehomeday20.

This is the first time we have had such a wide range of engagement and commitment from other stakeholders including the Government so I do hope – even though it is hard – that members will commit to being engaged on the day.

The theme of Care Home Day is ‘Care Community’. You can help us commemorate the day by sharing any good news stories, resources, projects blogs or an example of an innovative practice which shows:

  • Creating a sense of community within and around care homes
  • Fostering relationships with local communities
  • Health and wellbeing of residents and staff
  • Person-centred care
  • Staff supporting each other and residents
  • The local contributions of care homes, staff and residents to their communities and vice versa
  • Care homes as essential parts of the health and social care community

Details can be found at https://scottishcare.org/care-home-day-2020-15-july/

Communication

Our next Surgery will see the return of Karen Hedge and myself for 45 minutes on Tuesday at 12 noon. Please join us on a range of topics.

May I again draw your attention to the Summer issue of the Bulletin. This will again be in an online format – a downloadable PDF – it is jammed full of excellent articles and information. Please read and share. https://scottishcare.org/summer-bulletin-2020/

And finally,…

My blog last week raised the suggestion of a National Day of Mourning and Remembrance. I followed this up by writing to the First Minister and political Leaders. See https://scottishcare.org/scottish-care-issues-letter-to-the-first-minister/

A motion has been tabled in the Scottish Parliament in the name of Labour’s Monica Lennon and the first Minister when asked directly about this in the Daily Briefing said that it was a matter of when not if.

Once again can I remind you that we continue to light a #candleforcare at 7pm on a Tuesday – along with others to remember and to give thanks.

Many thanks

Donald

11th July 2020

 

Letter to CHRAG re Care Home Visiting 

8th July 2020

Dear colleagues

I thought it would be useful to send you information on how the opening up of care homes to garden visitors has been handled. Whilst in many places this has happened without issue regretfully in too many locations what should have been a positive process has resulted in poor implementation and fractured relationships both with providers and with family members.

We have had feedback from across Scotland and here is a sample. It illustrates the degree to which there is a clear disconnect in the process of Government issuing Guidance (often after extensive consultation and careful articulation) and its varied interpretation/rejection/counter-manding by local officers. This places providers and others in an unacceptable position.

As a Rapid Action Group, we need not only to be aware of this but the immense strain this is putting on a system already stretched to breaking. There is now heightened anxiety of moving to the next stage of something which should be positive.

Kind regards

Dr Donald Macaskill

Chief Executive

Overview of Visiting Risk Assessment Sign off process.

Area 1:

Public Health (PH) requested risk assessments early W/B 29/6/2020, then changed their mind saying they did not need to see them, then changed it again at 6.30pm on Thursday 2nd July 2020, the day before visiting was due to commence!  Most homes who were able to open appeared to do so.

Area 2:

Checklist developed for Oversight Group to sign off – PH did not agree with the checklist in the SG Guidance.  All risk assessments for Area 2 were rejected on Friday 3rd July 2020, insufficient extent of outdoor visiting details even though they were using the national template.  Public Health commented the template was insufficient. No visits took place. Real upset amongst families.

Area 3:

Public Health rejected all RA’s on Friday but agreed following a meeting in late afternoon. Visits happened.

Area 4:

Very well organised.  Monday 29th June 2020 – proposal was presented to safety huddle and agreed they would sign off rather than Public Health.  At the provider meeting, protocol and timeframes were submitted.  Sc local staff pulled together and checked risk assessments prior to submission with the result all went through first time except one which was a good outcome.

Area 5:

Only a few homes in area had not returned risk assessments but it did not seem to prevent visits.  At the beginning of the week designated visitor risk assessments were requested but by Thursday, outside protocol was required.  PH nurse apologised for any confusion. 

Area 6:

Providers told Public Health did not have capacity to sign risk assessments off.  If they were completed and any issues sorted out, they were reviewed at daily huddle.  Public health supplied a tick box asking, have you completed the risk assessment, last covid free day etc.

Area 7:

SC staff member joining reps from care inspectorate and public health to look at risk assessments – visits did happen though.

Area 8:

Planning meeting last Monday.  So far positive feedback around visits, partnership and public health, very supportive.

Area 9:

Public health not willing to be involved but were told they had to.  They then wanted all assessments for indoor visits, risk assessments failed as they were for outdoor visits – PH wanted all stage assessments. It was a bit of a mess.  Mixed bag of visits happening and not happening across the area.

Area 10:

Whole area was a debacle.  Many care homes had to cancel arranged visits. Initially told cannot do as do not have capacity then changed on Friday.

Area 11:

Providers phoned health protection team to see if risk assessment had been approved, (Submitted previous Monday), told to phone back Thursday – shambles!  Telephone call came after 5pm on Thursday giving go ahead but visits had been cancelled due to uncertainty. 

Area 12:

3 additional providers meetings WB 29th June 2020 which included H & S advisor for local authority offering support.  Worked particularly well.  By late Friday afternoon, every care home had been lettered and signed off.

Area 13:

Despite efforts local engagement non-existent. Not many visits, if any went ahead.  PH stated only day they could meet was on Friday – feedback half risk assessments were submitted and returned for further information as did not agree with SG approach.

Area 14:

One provider took a week to find out who was doing sign off in this Area as PH/HP said it was not them, finally got sent out a 6-step process from X on the 2nd. Still no answer on Tuesday 7th despite  having sent it 3 times! Used the templates at the back of the SG Guidance and used their wording but still it is not correct. They are nit picking at wording and meanwhile families are crying down the phone.

 

 

 

Collective Care Future: survey on care practice

Second theme: care practice - share your views and experiences

The first phase of the Collective Care Future programme is now underway, focused on understanding the pandemic experience across many different areas of practice both in care homes and care at home.

If you have experience of working or connecting with care homes or care at home services during COVID-19, we invite you to take part in this survey series to share your experience. We’d love to hear from care providers, front line staff, relatives and loved ones of people supported, individuals in care settings and those working in roles in other sectors or parts of the sector who work alongside care services. You can choose to take part in as many or as few of the surveys as you wish.

This week the survey is focused on the theme of ‘Care Practice’. In this theme we are interested to explore the ways in which the delivery of care and support has changed, across areas such as dementia, palliative and end of life care, assessment and care planning.  It includes ways of delivering care which you may have adopted or been aware of previously and those which you have experienced for the first time during the pandemic.

The survey has 4 sections: Impact on Care Practice, Regulation & Guidance, Outcomes & Priorities, and Future Care Practice.

Access survey here: https://www.surveymonkey.co.uk/r/carefutures-carepractice

If you would like to see the questions in advance to help you complete the survey fully, you can download a PDF of the survey here - download survey questions.

You can also download Word copies of the survey to complete by hand or to distribute to others - download Word survey questions.

We would appreciate your support in circulating the survey as widely as possible across your networks, including to any individuals who access care and support and their families who may like to share their experiences. 

If you don’t feel that you have had direct working experience with the independent care sector during the pandemic but you would like to be involved in the second phase of the programme, please let us know at [email protected] and we will be in contact in due course.

Thank you to those who have participated in the first survey on Technology.  If you haven't done so yet, you can still access the survey at: https://www.surveymonkey.co.uk/r/carefutures-technology

Review of the week  28st June to 4th July

Yesterday saw the opening of care homes to garden and outdoor visits. This has been much welcomed and in typical disappointing reality in many parts of the country the weather was atrocious. It was also a hard day for members in Dumfries and Galloway where following Government advice there was an extension of lockdown conditions. It has been very disappointing that the days running up to the opening have been illustrated by the chaos and lack of co-ordination we have seen in so much of the response to Covid19. In some parts of the country we had some PH officials indicating that they were not going to sign off visitor protocols because they had not been told or did not think it their role, in others they had still not developed these systems hours before the openings and yet in other parts they were managing to turnaround things in a matter of hours!

There has been further information in response to issues members have raised in the last week posted in the form of an FAQ sheet. See https://www.gov.scot/binaries/content/documents/govscot/publications/advice-and-guidance/2020/06/coronavirus-covid-19-adult-care-homes-visiting-guidance/documents/care-home-visiting-faq-3-july-2020/care-home-visiting-faq-3-july-2020/govscot%3Adocument/Coronavirus%2B%2528COvID-19%2529%2Bcare%2Bhome%2Bvisiting%2BFAQ%2B-%2B3%2BJuly%2B2020.pdf

Shanice and colleagues at Scottish Care have developed an infographic which members may find useful. See https://scottishcare.org/stage-2-care-home-visiting-infographic/

The following is a summary of some of the main issues in the week that has passed.

Finance and sustainability

I start each of these updates with a section on finance and sustainability because I realise just how critical these issues are. It is clear to me that there is a growing though far too slow dawning of an awareness on the part of officials that we are in an exceptionally precarious situation. This is not hyperbole I have a very real fear that there will be the loss of care homes and also home care organisations because of failures to disperse the monies allocated through the mobilisation funds. We are now working on a weekly basis with COSLA and the Partnerships to identify specific areas where there are challenges. But we need your intelligence to inform us. In addition, I held with others a very frank and honest meeting with COSLA and SOLACE on Monday. There is a clear disjoint – and this should come as no surprise to readers – between the promise of monies from Scottish Government and the delivery of these to HSCPs and LAs. We have stressed that whilst we are sensitive to that, the fact they manage to sort their own services and staff T&Cs out before coming to us is unacceptable. Nevertheless, we now have a CEO who will act as a go-between between ourselves and local authorities to address specific issues. I hope it will bear some fruit and not just be an attempt to ameliorate.

Positively I am getting intelligence in the last week that finally payments – after weeks of waiting – are beginning to trickle through to providers and that in some parts of the country there has been a conclusion to issues. Let us hope this becomes the norm rather than as it is at the moment the exception.

I also held a meeting with the Cabinet Secretary this week and I included finance and sustainability as one of the key issues to discuss. Care home members will be aware that the settlement this year on the NCHC discussions was extremely challenging. I highlighted to the Cabinet Secretary that we need to seek a settlement  as a matter of urgency to prevent a collapse in the sector and that Scottish Government needed to be around the table with COSLA and ourselves. She indicated she was aware of the financial challenges although she is still convinced that large UK providers are ‘creaming profits’ from the sector! She indicated she would talk to officials to see if it would be appropriate for them to be involved. I again stressed to her that we have to sort out a fee that is sustainable. In terms of care at home and housing support she is again portraying the line that the settlement of contracts should be at LA level and that monies have been made available. The clear reduction in contracts is a matter of grave concern.

In the discussions with her I noted the meeting that I and colleagues held with the Chair of the Fair Work Convention earlier in the week. The stress and emphasis upon fair work terms and conditions is only going to be achievable if there is fair commissioning. We will be presenting a paper to the FW Group and it will make clear that providers are more than open to improved T&Cs including extension of benefits re sickness etc but only when and if we are enabled to do so through an adequate contract in homecare and an adequate NCHC.

I hope in the coming week that COSLA will commit to starting discussions on what happens after the 31stJuly as a matter of urgency.

We have also spent the week dealing with a whole range of very legitimate questions in relation to the Social Care Support Fund – despite asking on Monday for clarification on issues and again on Wednesday and Thursday we have still not had response to many of the issues we have raised. I have collated a set of questions and sent these to SG – if you wish to add to these please do so on the Discussion Board. Again, this is a sign of more inefficiency in that the lead civil servant co-ordinating all this went off on leave two days after the Scheme was published. See the Discussion Board. https://scottishcare.org/members-area/topic/social-care-fund/

Unfortunately the final terms of the Death in Service Scheme have still not been published. We have been told that this will finally be done on Tuesday following sign off from COSLA Leaders. I should underline that there is an expectation for providers if possible to make the payment. If this is not possible there will be an ability to work around this. It is tragic that last weekend we lost another social care worker to the virus and it goes without saying that our thoughts are with all those who in their care and compassion for others have lost their lives.

Care Home issues

Again, there has been another week of stability in the data relating to deaths in care homes and the totals have reached what is close to a seasonal norm.

In my meeting with the Cabinet Secretary I indicated our growing concerns about the physical and psychological health of residents given this prolonged period of lockdown and indeed there growing international evidence that is supporting our very real concerns. See https://ltccovid.org/2020/07/01/detrimental-effects-of-confinement-and-isolation-on-the-cognitive-and-psychological-health-of-people-living-with-dementia-during-covid-19-emerging-evidence/

A Group has been established at Scottish Government as part of the Clinical and Professional Advisory group to explore how we can get AHP and other visitors back into the care homes so that we can improve health and wellbeing. We also need to give consideration to improving the general support of individuals in care homes from both primary and secondary care and for secondary care support in people’s own homes. There is a growing appreciation that we need to both improve the sense of clinical abandonment that many felt at the start of the pandemic and the relatively patchy support from primary care before the  virus hit our sector. I reflected on some of this in my blog last week. See https://scottishcare.org/let-care-flourish-reflections-on-primary-and-social-care/

I had hoped that the Care Inspectorate document ‘Guidance for Professional Visitors’ would have finally been published but further work is required on the testing protocol, part of this – I hope earnestly that this will be out by the time I write another one of these as we continue to have concern about some of the visits.

There continues to be a narrative not least from the trade unions but also from some providers about the benefit of a National Care Service. I have tried to stress that now is the time for reflection rather than knee jerk reaction. I spoke to the Cabinet Secretary directly about this and the extent to which all this is risking a destabilisation of the sector at a critical time. Her response was that she had not determined whether the Adult Social Care Reform Group will continue in its present format, but it was her opinion there was not the bandwidth nor time available to do much about reform before the next Scottish elections. She indicated that there would be no overnight changes despite the rhetoric about a National Care Service – which mirrors what the FM this week and that the sector would be fully involved not just consulted after decisions were made. 

Care Inspectorate

The Health and Sport Committee have announced that they are to carry out an Inquiry into the role of the Care Inspectorate during the pandemic. Now whilst it might seem an opportune moment to tell some home truths about the Inspectorate I personally consider this as a not very subtle attempt by some politicians and others in the system to get their own back at the CI as a means of getting to providers. There is a political sense that the CI have been too soft on the sector and that their collaboration model needs to revert back to a compliance model of strict instruction and penalty. Clearly that is in no one’s interest and we will give an honest reflection of what members have suggested has been a generally positive contribution from the Inspectorate, including holding back some of the worst excesses of clinical colleagues. I know care at home members may have had a diverse view.

 Brexit

I indicated last week that we were getting evidence from some suppliers that they considered there may be shortages as a result of a potential no-deal. Given we are now beyond the stage of any extension we must as a sector, I feel, begin to consider the need to plan for all eventualities. I have had discussions with colleagues about what this might mean in terms of dusting down the work we had done at various stages last year. I suspect there will very soon be requirements to evidence resilience and contingency plans.

One area where we have commented in the week that has passed has been following the publication of a disturbing report relating to the changes which are likely to result as a consequence of the Westminster Government’s decisions re immigration. See https://scottishcare.org/uk-immigration-policy-impact-on-scotland-report-july-update/ This will come as a particular concern both for existing EU workers and for future recruitment. We have started discussions with Citizens Advice Scotland about how they might be able to support individual staff members who are concerned about their status and I will send information out when this is available.

Testing

Perhaps more than any other topic issues are abounding about testing. These are numerous including what I have now termed couriergate – the fact that couriers were turning up late or not at all to collect tests and tests having to be re-done; inconclusive tests; the strain and demand on staff time and resource etc. At long last we have finally secured a weekly working group to explore some of the issues (meeting on Monday) and there is to be published a FAQ of key issues and questions. I am pleased that we will have three of the senior staff from the Testing Directorate including the Depute Chief Nursing Officer attending Tuesday’s Surgery. In addition yesterday further changes to the Social Care Portal have been made in response to feedback from members. Information on this is now on the website. See https://scottishcare.org/new-information-on-the-uk-gov-social-care-testing-portal/

There has also been huge disquiet caused by the notice from the SSSC that if staff refuse to undertake a test that this ‘will’ have an impact upon their registration. After much discussion this has been reduced to ‘may’ and a group at SG has been set up to explore the issues behind this. Clearly we all want individuals to be tested but this is hugely complicated in terms of employment status – it is not simply a matter of re-assigning an individual to other duties where these ‘other duties’ do not exist. It is neither simply a matter of instructing as the individual has the right to assent to any medical intervention which is not part of their own care and treatment but is for preventative reasons. A complex issue which we hope some resolution can be reached upon as a matter of urgency.

Care at Home

The Care Inspectorate have brought a paper to the Rapid Action Group and this has outlined an Inquiry which they are to commence in relation to care at home and housing support. Personally, I consider that this is to be entirely welcomed as some of the actions which we saw on the part of LAs and HSCPs at the start of the pandemic are far from excusable or understandable. Scottish Care will put a formal communication to the Inspectorate as part of their Inquiry and there will also be opportunities during it for individual providers to be consulted and interviewed should they wish. The Care Inspectorate will be communicating details shortly.

In broad terms the Enquiry will explore consideration of:

  • Decision making about and prioritisation of care at home and housing support services to be delivered
  • Monitoring of impact of any changes to care and support packages delivered
  • Engagement and partnership working with providers
  • Contingency planning for potential impact of test and protect strategy
  • Recovery plan for care at home and support services

Care Futures – Technology Survey
 

We’re pleased to announce that the first phase of the Collective Care Future programme is now underway, focused on understanding the pandemic experience across many different areas of practice both in care homes and care at home.

We invite you to take part in this survey series to share your experience. This week the survey is focused on the theme of ‘Technology’. In this theme, we are interested to explore experiences of technology – including digital applications and platforms that you may have used before and those which you have used for the first time during the pandemic.

We would appreciate your support in circulating the survey as widely as possible across your networks, including to any individuals who access care and support and their families who may like to share their experiences. 

Link to survey: https://www.surveymonkey.co.uk/r/carefutures-technology

Find out more about the Collective Care Future programme: https://scottishcare.org/project/collective-care-future/

 Communication

We held one Surgery on Tuesday at 12 and thanks to Caroline Deane our Workforce Lead who joined me at the session. I hope we will be able to have staff from the Testing Directorate alongside us at the forthcoming Surgery this coming week.

Our plans for Care Home Day are now up on the website. See https://scottishcare.org/care-home-day-2020-15-july/

The theme of Care Home Day is ‘Care Community’. You can help us commemorate the day by sharing any good news stories, resources, projects blogs or an example of an innovative practice which shows:

  • Creating a sense of community within and around care homes
  • Fostering relationships with local communities
  • Health and wellbeing of residents and staff
  • Person-centred care
  • Staff supporting each other and residents
  • The local contributions of care homes, staff and residents to their communities and vice versa
  • Care homes as essential parts of the health and social care community

In addition, we are pleased to say that we have held meetings with Scottish Government and the Care Inspectorate to attempt to get national coverage for the day and potentially for work to follow it which is not solely social media related. Please do try to encourage folks to take part in the day. We are at a critical stage for the sector in that we must rebuild public confidence and trust in care homes and the Day offers us an opportunity to star that process.

May I again draw your attention to the Summer issue of the Bulletin. This will again be in an online format – a downloadable PDF – it is jammed full of excellent articles and information. Please read and share. https://scottishcare.org/summer-bulletin-2020/

In addition, we have had two excellent blogs produced this week. The first is by Caroline Deane our Workforce Lead and is a reflection on the importance of capturing the voice and insight of the workforce as we plan for a new care future, see https://scottishcare.org/latest-blog-from-our-workforce-lead/

The second by Jacqui Neil our  Nursing Lead is a reflection on the role of family and informal carers. See https://scottishcare.org/who-cares-for-the-carers-new-nursing-blog-for-june/ Both are a great read so please look at them.

We continue to use the Discussion Boards so please refer to them when you can.

And finally,…

I have become very aware this week through conversation and correspondence that there is a very real and raw sense of grief in the sector around the impacts of the virus and the ongoing emotions that are being felt. We are working with others to address some of this at a practical level and hope to be able to communicate some information in the near future. However, I am personally convinced that we need to hold a National Day of Mourning  and that it is not inappropriate for us to take the lead in calling for this and so have written in those terms in my weekly blog. https://scottishcare.org/we-need-a-national-day-of-mourning-and-remembrance-a-personal-reflection/

Sunday night sees an opportunity to thank all those working in the NHS on the 72nd anniversary of the NHS – there has also been a recognition of social care in this act. Details can be found at https://scottishcare.org/marking-the-72nd-anniversary-of-the-nhs-letter-to-health-and-social-care-staff/

I will also continue to light a #candleforcare at 7pm on a Tuesday – along with others to remember and to give thanks.

Yours aye,

Donald

4th July 2020