Despite the darkening days there seems to have been a societal change towards a more optimistic anticipation of the future. The news of positive response from the Pfizer, Moderna and Oxford vaccines have offered many the hope that we will finally get some return to a degree of normality in the autumn and winter of 2021. That said a great deal of focus in the week that has passed had been directed towards the decisions of the Scottish Government to move a significant part of the population into Tier 4 restrictions.
The following is a summary of some of the main issues in the week that has passed.
Vaccine
There has been a great deal of activity in relation to vaccinations. The priority as outlined by the Cabinet secretary anticipates that care home residents and acre home staff, followed by those over the age of 80 and health and social care staff will be prioritised in the first Phase of the roll out of the vaccination programme. This will be a major logistical exercise involving all partners and stakeholders in health and social care, public services and indeed the military. I am pleased that there has been engagement with Scottish Care, and we have been inputting the not always positive experience of the flu vaccination programme as it has been extended these last few months. I think one of the issues is that we have on the one hand politicians and scientists wanting to talk up the positivity of the vaccine and its game-changing status and then we have the operational realities on the other hand. It has become clear that there are still significant operational issues to be ironed out about the Pfizer vaccine – it requires ultra-low temperature storage; it requires a restricted number of changes in temperature; it comes in package sizes which may not be reducible etc. So, until we get the answers to these questions and many more, we really cannot say how this will be operationalised including whether it will be possible to prioritise care home residents the majority of whom are unable to move from their location to large testing centres. As soon as things become clearer for both staff and residents/citizens over 80 we will be communicating the answers! I met the Cabinet Secretary yesterday and I indicated top her that there was an urgent need to ensure that communications on the vaccine addressed the growing concerns of some staff in particular who fear they might be used as ‘guinea pigs’ for a novel vaccine. Officials are aware of this and I hope they will work closely with the care sector to address concerns and maximise uptake. I know that there are a couple of Health Boards that have given the impression that vaccinations will be starting in the first or second week of December – my response to that is not a hope in …
Care home issues
We know in terms of care homes that the number of deaths keeps rising albeit at a slower pace than in previous weeks. Sadly, in the week up till the 18th November the numbers of those in care homes who have died from Covid19 or suspected Covid has jumped to 84 individuals up from 74 the week before and this now accounted for 24% of all care home deaths in that week. The only positive is this is 2 % less than the previous week. Against this is the fact that in the same week we had a total of 159 care homes with an active outbreak, up from 148 and 135 in the previous two weeks. So as long as outbreaks continue, we have cause for concern.
The data published by both the Care Inspectorate and National Records Scotland also provides a breakdown on the number of cases per sector. This shows that in private sector care homes there were 166 cases of Covid per 1,000; in voluntary and charitable care homes the figure was 146 and in statutory and public care homes the figure was 178. So, despite the relative smaller number of statutory care homes the prevalence of the virus per 1000 is higher.
Visiting once again remains a significant issue of concern with a growing number of stories of a negative nature in both the print, visual and social media.
The Government intends to publish a paper on testing and the Cabinet Secretary will announce both dates and targets on Wednesday the coming week. I have impressed upon her the urgency of testing for care home family members and for care at home and housing support staff. The statement to be issued on Wednesday will cover both these categories and the testing of professionals who enter care homes. At this stage it looks as if they will adopt the use of rapid flow tests for care home family members. The extent and degree and speed of this is what remains uncertain. It would clearly be beneficial for all concerned if this was expedited as urgently – and safely as possible – especially as there is a great deal of pressure around access and visiting for Christmas.
Christmas has been a bit of a theme of the past week. I have now heard from various sources that some Public Health officials are banning Christmas decorations, cards, gifts and trees. This is utter nonsense and needs to be called out. I hope that the Clinical and professional Advisory group will publish a short page guidance for Christmas next week. This will make it clear that none of the aforementioned are banned. However, it will also make it clear what is required in terms of the 72 hours wait for presents etc, the importance of having decorations and tress which are not subject to touch and located in an area where there is limited access etc.
Whilst on the issue of visiting it is also important to underline and address that it is possible for any individual to visit a care home during the Tier 4 and Tier 3 restrictions and in light of the travel restrictions. A letter clarifying the nature of visiting as it relates to the tiers has been sent to folks by the Cabinet Secretary. See https://scottishcare.org/strategic-framework-for-scotland-and-visiting-in-adult-care-homes/
In addition, further work is being undertaken on the 28 days exclusion once an outbreak has occurred or someone is tested positive. I know that this has led to situations like the one I heard about this week where a care home had been open for 7 hours before a new ‘outbreak’ occurred. This is wholly unsustainable not least with the rise in respiratory conditions over the winter. I am pleased that SAGE and clinical advisors are now seriously considering reducing the exclusion period to 14 days. I have made it clear that the sooner this happens – if it happens – the better!
Lastly it is hoped that further guidance will be issued which describes the move towards the use of local data at a care home level to support care homes and public health officials to make local decisions thereby enabling local visiting.
I can also report that after the discussions which Caroline and I held with Scottish Government officials to explore the issues of management exhaustion and the need to give additional support, that the Cabinet Secretary has agreed to a range of proposals which we put forward to support managers and to do so by providing additional funding of £4.5million. This will be announced next week.
The Adult Social Care Winter Plan.
Members will be aware of the Adult Social Care Winter Plan. http://www.gov.scot/publications/adult-social-care-winter-preparedness-plan-2020-21/.. We remain concerned about the implications of this Plan for staffing and are continuing to hold discussions and take part in planning around these issues.
Many of you will have attended the Winter Plan webinar that occurred a couple of weeks ago. A report has been developed on this session and other engagement. Please see this and an attendant Winter Plan template at https://scottishcare.org/winter-plan/
Care at Home and Housing Support
A second meeting of a Short-Term Working Group on care at home and housing support issues was held in the week that has passed. A whole range of issues have been identified and work is progressing as noted elsewhere on testing, sustainability, appropriate Guidance on use of PPE, staff recruitment and retention. Scottish Care is closely involved in all these areas of work.
National Care Review Submission
To remind you if you have not read it that Scottish Care’s submission to the Independent Review of Adult Social Care is now available on the website. As stated earlier this is an ‘ideas-focused’ paper entitled ‘What If and Why Not? Making the Future of Social Care A Reality’, and it presents a positive yet actionable future perspective to encourage dialogue and debate on what the future could and should look like.
Please read the paper at https://scottishcare.org/submission-to-the-independent-review-of-adult-social-care/and if you would like to discuss the paper further, please contact Becca Young or Dr Tara French at [email protected]
Care Futures Programme
Closely related to the above are the emerging insights on each of the theme areas explored during the Care Futures programme. You can read the emerging insights on the themes to date on the Care Futures webpage. https://scottishcare.org/project/collective-care-future/
The second phase of the programme will begin in Autumn 2020. Based on the emerging insights in phase one, Becca and Tara will develop scenario briefs and curate communities of interest (‘Creative Care Collectives’) to explore the future of the independent care sector.
For more information about how you can be involved in phase two, please email [email protected]
Finance and sustainability
Karen has been leading on significant engagement with colleagues at Scottish government and COSLA on proposals on what should replace the current sustainability arrangements. Some of you in your role as members of the National Committee and Executive were invited to a short notice meeting to discuss these. The final papers have been sent to the Cabinet Secretary and COSLA political leadership and we hope we might be able to announce some decisions next week. A huge thanks to Karen for leading on this important work.
Last Wednesday the Scottish Care negotiating team met with COSLA and Scotland Excel for the first time to open discussions on the National Care Home Contract for 2021-2022. We stated our position on a number of issues and it was agreed to advance work on some of these in off table discussions before our next stated meeting which will be on the 11th December.
Insurance
I am very aware that a great number of you have been faced with significant increases in the cost of premiums, requirement to undergo extensive risk assessments, and difficulties in acquiring either new brokers or new companies willing to take on your business. I raised these issues with the Cabinet Secretary yesterday and she agreed to raise this with Matt Hancock from the UK Government and other health ministers from the devolved administrations at their weekly meeting next week. I hope a collective ministerial approach may be able to influence the insurance sector. She has also agreed to engage with the Scottish Finance Secretary, Ms Forbes, on this issue.
Communication
The Surgery this coming week will be held at the usual time, Tuesday at 11am and Karen and I will host.
Can I also point out that the Webinar next week will be led by one of our preferred suppliers Citation. This will be on the 26 November at 2pm. The hour-long session will offer practical top tips on how to proactively support your employees’ wellbeing. This includes the importance of developing strong foundations in HR, Employment Law and Health and Safety.
Save the Date – Homecare Day
We are pleased to announce that this year’s Homecare Day will take place on Wednesday 9 December.
#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.
Legal Survey
As many of you know Scottish Care recently established a Legal Panel. This Panel consists of 5 leading law firms who we have adjudged to be particularly familiar with the care sector. Karen and I have been meeting these individual companies.
We have also launched a Legal Survey to support their understanding and this work.
All you have to do is answer a very short survey which will take you less than 5 minutes.
We will also be holding a Legal Webinar Panel happening on Friday December 11th. Each of the five law firms will have a specialist to speak to your concerns based on the results of this survey. They will also answer your legal questions in real-time in the webinar so make sure to fill out the survey and come on the day.
For more information on the Scottish Care Legal Resources Select Group please go to our website: https://scottishcare.org/legal-resources-select/
Access the survey on: https://www.surveymonkey.co.uk/r/3JBV8CV
Care Home Conference: 19-21 January 2021
We have decided to alter the dates of the conference to bring it forward a week so that it does not conflict with the likely publication of the National Care Review and so that it is now a Tuesday through to a Thursday. The Awards will still be on the same date of the 22nd January.
Digital Inclusion Programme for Care homes.
Many of you will have seen the announcement by the first Minister in the Daily briefing last Monday of a £1million fund for care homes.
The Digital Inclusion: Connecting Residents in Scotland’s Care Homes project aims to ensure that all of Scotland’s care homes have access to digital devices, connectivity and support to help their residents enjoy the benefits of online access. This programme of work is outlined in the Adult social care – winter preparedness plan: 2020 to 2021 and the Digital Approaches in Care Homes Action Plan 2020-21.
The Digital Inclusion: Connecting Residents in Scotland’s Care Homes is an initiative whereby all of Scotland’s care homes are eligible for a free digital package, to help residents use digital devices to support their health, wellbeing and to connect with family and friends.
At the time of writing the digital package consists of a combination of the following (depending on care home requirements):
- An iPad
- Wifi dongle
- Data package for 4G connection
- Staff skills development opportunities
It is the intention to broaden the choice of digital devices in the spring of 2021. However, they have encouraged care homes to apply at their earliest convenience, so that the benefits can be felt by residents as soon as possible.
The First Minister said in launching this new initiative: “The iPads are not intended to be a substitute for personal visits to care homes…However, this funding will give care home residents an additional way of keeping in touch with family and friends, and of receiving expert clinical advice.”
The application form and further information is available on tec.scot/care-homes/care-home application.
Workforce issues.
Caroline Deane has issued another full Workforce Matters update which can be accessed at https://mailchi.mp/scottishcare/workforce-matters-ebulletin-october-13231971?e=8b93fe8b46
Can I take the chance to highlight two things from this: –
The two regulatory forums have proven to be critical ways of engaging with members on key workforce issues. They uniquely bring together key regulatory stakeholders with the chance of practically addressing current issues of concern.
It has been decided to hold the Homecare Regulatory Forum on a weekly to ensure that the appropriate level of focus and support is being given to the homecare workforce. The focus is on the challenges facing home care and the concerns around the impact of COVID, particularly in the coming winter months. Notes from the meeting and subsequent actions will be shared with Scottish Care members on request. This meets every Tuesday 2-3.30pm
The next Care Home Regulatory Forum will be on the 9th December 10.30 am to 12.30pm.
Please contact Caroline Deane if you have not attended these meetings before and are keen to do so or if you are interested in the discussion held at the meetings but have been unable to attend at [email protected].
EU Exit – Stay in Scotland Toolkit Launch
Many providers will have staff members who may need to apply for the UK Government’s EU Settlement Scheme by 30 June 2021 in order to continue living, working and studying in the UK after that date. We have put up on the website additional information for you and colleagues.
https://scottishcare.org/eu-exit-stay-in-scotland-toolkit-launch/
And finally,…
Just another weekly reminder of the ongoing lighting of 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. Please join me.
Many thanks
Donald
21st November 2020
