Scottish Care welcomes the first ever Winter Plan for Adult Social Care as an indication that there is now a recognition of the importance of social care for all citizens. We are pleased to see that there is a particular emphasis upon collaboration and look forward to future plans more directly engaging with and involving those with operational and frontline responsibility.
We are pleased to see within the Plan a real sense of value of and an emphasis upon the dedicated and professional social care workforce who not just during COVID-19 but throughout the years have been professional and highly skilled in supporting individuals regardless of locations.
Details of the Winter Plan:
We welcome the additional £7 million allocated to Nurse Directors to enable IPC support and training and want to underline the critical and distinctive nature of IPC in care homes and community settings. We will work closely to ensure that IPC training and models are appropriate to the setting and that we do not simply embed acute hospital and NHS based IPC practice. Such adoption of IPC has not only to be context specific but enhancing of the rights and autonomy of individual care home residents or those who live in their own homes.
The majority of care homes already undertake a daily review of COVID-19 symptoms, and we note this in the Plan and look forward to sharing the clinical experience of care home staff with the Clinical and Professional Advisory Group.
We support the imperative around the flu vaccination whilst urging all stakeholders to learn the lessons of what has at times been an ineffective and haphazard implementation of the vaccination strategy, failing at times to recognise the distinctive realities of care at home and housing support staff and the skills and experience of care home nursing staff. We look forward to closer collaboration as we plan the roll out of the COVID-19 vaccine.
The care home sector is fully supportive of ensuring that visiting guidance is implemented in a manner which maximises safety and reduces risk. Providers recognise and value the truth that family members are intrinsic to the mental and emotional wellbeing of residents. However, there is both an understandable desire on the part of providers to protect residents and a fear about introducing infections. We acknowledge that the introduction of a robust and effective testing system will help to allay the fears of providers of care. This urgently needs to include family members alongside staff, and all those who visit care homes for whatever reason, in a manner which is as timely and effective as possible in terms of testing access and turnaround of test results. As a whole system we need also to address the challenges brought about by emerging difficulties in gaining insurance and indemnity, the stresses and overwork created by Operation Koper, and the capacity of a stretched workforce to support visiting in practical ways.
We note the evidence of staff movement in relation to outbreaks. We recognise the desire to create cohorts of staff regardless of settings. Achieving this outcome will not be easy. Individuals who work in social care are amongst some of the lowest paid within our society and they frequently have multiple jobs not because they want to but because they need to. This is especially true in homecare where we are already noting a drift from full-time employment to part-time working because staff are exhausted by the efforts of the last few months.
Great care needs to be taken that to ensure that restricting the right to employment and requiring individuals to isolate for 14 days between employment does not disproportionately penalise individual workers.
In addition, there has to be a realistic appreciation that there is a limited supply of workers. Before the pandemic providers of care – regardless of sector – struggled to recruit, most especially nursing staff. We have all to work closely at local level to ensure that there is adequacy of workforce supply to ensure safety and quality practice. The roles involved are highly skilled and cannot simply be undertaken by individuals without experience, skill or training.
Further the creation of any legislation which effectively limits employment opportunity within a sector which has struggled to recruit, and which is likely to be negatively impacted by future immigration restrictions, will require to be carefully considered and thought through. The consequences of disproportionate restriction regardless of the robust grounds for their introduction may be hugely damaging.
We note the allocation of £50 million to meet these proposals but want to understand how this figure has been calculated and whether it is sufficient, what it will be used to pay for and how we will collectively compensate workers and organisations faced with additional restrictions on staffing.
Testing remains critical. In addition to our comments above we want as a sector to see urgent and immediate plans as to how care at home and housing support staff will be prioritised for asymptomatic testing. It is now seven months since we called for this to become the norm and we still have not seen this commence.
In the community we welcome the emphasis on ensuring people remain independent and at home for as long as possible. With others we continue to urge the re-introduction of care packages for those who have not been supported for a long period of time. We remain concerned that there needs to be significant improvement in practice around communication and information for homecare providers when an individual with COVID-19 is released from hospital. We continue to be concerned that effective winter care in the community will not be achieved as long as some local authorities continue to insist on 15-minute visits during which personal care and other tasks are required and the staff member has to don and doff PPE in a safe manner. Such restrictive packages of care together with the electronic monitoring of homecare staff should stop. They are hardly illustrative of our shared aim for Fair Work.
We welcome the continuation of the Social Care Support Fund which goes some of the way towards plugging the unfair terms and conditions within publicly commissioned social care contracts.
We are also grateful for the continued commitment to the supply of PPE where providers are unable to access these through business as usual routes, and especially in light of the reprehensible re-introduction of VAT on the 1st November.
We look forward to continuing to work with colleagues in the roll out of digital devices to care homes to improve connection and welcome the commitment of £500k to support this work.
Any Plan is only as effective as the commitment and resource to enable it to be enacted. Social care providers continue to prioritise not just keeping people safe and well but ensuring individuals achieve their fullest potential and live life to the full. We agree with the aims of the Plan and commit to demonstrating integrity to resolve challenges in a supportive and empathetic manner in the months ahead. Its success will be premised on true and meaningful partnership with social care providers at national and local levels.
The Adult Social Care Winter Preparedness Plan 2020-21 is available here.
Find out more about the Plan on the Scottish Government website.