CEO Review of the week 30th August to 5th September

The last few day have been dominated by discussions on the announcement on Wednesday that an independent Review of Adult Social Care will be held over the next four months with a report in January 2021.

The timing of this review might have been expected but is unfortunate in that we are still in the midst of a pandemic and that despite portraying it as one which will be human rights based and therefore inclusive and focussed on the needs of people who use social care – there is little real time for meaningful engagement especially for those who are living under Covid restrictions.

Be that as it may, and inevitably given the politicisation of the debate, Scottish Care has formally welcomed the review and will fully and robustly articulate the position of the independent care sector in our responses.  Our media statement is below this update. The Scottish Care Executive will meet on Tuesday afternoon to discuss what our strategy and the nature of our formal response, and I will also be meeting with the Chair of the Review for an initial meeting on Tuesday lunchtime.

Clearly the Review has brought a degree of uncertainty to an already disturbed landscape. I am comforted by the fact that the former Auditor General is on the Advisory Group as any of the options, including the much talked about National Care Service, will require to be robustly costed

Scottish Care will develop an articulated and formal response over the next few weeks, but I think it would be wrong for members to equate a National Care Service as nationalisation.

For my part I am clear that a national delivery of adult social care has to possess certain characteristics most of which would negate a nationalised model but at least enable a national approach – there is a difference. Some of the characteristics which  I think the Review needs to explore I mention briefly here:

• Care – it has to evidence that social care is distinctive from health care. We cannot simply ape the NHS – they do different things and the last thing anyone needs is the medicalisation of care.
• Citizen focussed – it has to be centred around the needs and wishes of the citizen and not the system, workforce, the acute sector NHS or indeed providers.
• Choice – it has to embed rather than remove the principle of choice, individual control and autonomy which lie at the heart of the self-directed support legislation. Just because the power interests of local authorities have prevented SDS from working does not mean it was wrong.
• Community – it has to be appreciative of the community dimension of care especially homecare as opposed to a national, one-size fits all, generic approach which is top-down.
• Commissioning – it has to address the competitive model which in homecare has driven prices down and in care homes has resulted in a failed Cost of Care Model where local authorities end up spending twice as much for in-house services.
• Costed – it has to offer proposals which are seriously costed rather than hypothetical. It has as part of this come up with some idea as to how a society with an ageing population and a declining workforce is able to pay for its dreams.
• Condition absent – it has to address the inequity that dependent upon one’s diagnosis you either receive care and support free at the point of need or you end up selling your own home to pay for it.
• Charging – it has to address the at present 22 different approaches to social care charging across the country.
• Consistent – there needs to be a clear consistency of regulatory oversight and practice rooted in the National Standards and in a non-clinical approach to care.
• Creativity – it has to leave space for the social care entrepreneurship which has been at the heart of care and which is essential in a digital and technological age.

I could go on but in the next few weeks we will have to address the growing clamour that profit should be removed, capped or restricted; how we protect and advance the diversity of business models including charitable/voluntary, not for profit, employee owned, small family run private and large multinational corporate organisations which constitute our membership; embed what works in the nature of health and social care integration which means citizens have a continuum of care and contact of high quality and consistency; better reward the criticality of the workforce in general and develop the role of nursing and clinical staff in care homes; and finally address the demand for consistent and national terms and conditions that advance Fair Work.

I hope you will join us in the discussion which will be critical in shaping the future of the sector. We will shortly announce virtual member sessions to garner and hear your voice and views.

We hope that in the next week the mechanisms to enable our input into the review will become clearer and we will communicate these as soon as they become apparent.

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

Testing.

Well that was the week that was. Monday started badly with the debacle that was the changes made with little notice to the UK portal and progressively things got worse – despite the Cabinet Secretary’s optimistic rhetoric to the Parliament – by the end.  Yesterday after a week of mounting concern we issued a statement to the media calling on the Scottish Government to take sole responsibility for the effective running of the testing system. We need to protect both our staff and residents and also ensure as winter advances that we are able to enable family visits to really happen. See https://scottishcare.org/scottish-cares-statement-on-covid-19-testing-in-care-homes/

Late last night I spoke to the lead civil servant who informed me that they had started steps to increase NHS capacity with a view to urgently taking most of the tests in-house. A letter to that effect came out overnight and I very much hope that we will see an improved service.

 Homecare Festival. WEDNESDAY 7^TH – FRIDAY 9^TH OCTOBER.

 We have published the programme for our three-day Homecare Festival. We believe we have achieved a good mix of debate, discussion and innovative input withs peakers from across the UK and hope you will all join the event. More details are available at

https://scottishcare.org/cah-conference-2020-2/

The themes are

Wednesday 7^th October: 

Theme 1: Re-shaping Homecare – issues of vision, sustainability and practice 

Thursday 8^th October  

Theme 2: Maximising potential: the critical role of the homecare workforce 

Friday 9^th October: 

Theme 3: Home is where the rights are: homecare and human rights 

We will culminate the week with an Awards Evening on the Friday 9^th October evening at 7.30 pm which will be hosted by Michelle McManus and myself.

Care Home Issues.

The Clinical and Professional Advisory Group met again this week and reflected on Guidance which was later published by the Cabinet Secretary – this relates to the restoration of professional visits and the greater use of communal space. See https://scottishcare.org/coronavirus-covid-19-adult-care-homes-visiting-guidance-3-sept/

The Daily Huddle has now over 900 care homes signed up. This as we have consistently said should be invaluable for giving data and we are working hard to ensure that we have access to this as a priority. 

The group also considered a paper to promote better information for families and also more effective engagement and involvement of families in the work of developing Guidance and implementing it.

We had a robust discussion about how important it was for there to be a proper system of messaging and communications in situations where lockdowns were occurring. This follows the decision – without public communication by NHSGGC to extend the prohibition of visiting indoors to include three other areas of the west of Scotland.

In general terms there was also a discussion about the balance between the rights of individuals and the effective restoration of normality to care homes. I am singularly not convinced we have got this right. Failure to do so risks making care homes unsustainable if families feel it would be better to have their family member delayed in a  hospital where they can at least visit them rather than in a care home where they might not see them for months on end. It was stressed upon the clinicians that something radical needs to happen for Stage 4!

There was no meeting of the Care Home Rapid Action Group as it transitions to becoming the Pandemic response Group which will include homecare issues and services.

Finance and sustainability

To remind members that we published the COSLA and Scottish Government letter detailing their new arrangements on the website last week. See. https://scottishcare.org/?p=12927&preview_id=12927&preview_nonce=3ce8f4b93f&post_format=standard&_thumbnail_id=12232&preview=true 

 

This letter states that:

• Care Home Occupancy Payments will begin to taper with 75% of voids caused by the continued impact of COVID paid in September, 50% in October and 25% in November. These will continue to be paid at 80% of the National Care Home Rate;
• The planned care approach for care and support and community-based services will remain in place until the end of October to allow a transition period;
• Additional costs for personal protective equipment, infection prevention control and staffing related costs, in line with Scottish Government guidance, will continue to be met in line with current arrangements and are subject to ongoing review and engagement with the sector; and
• Social Care Support Fund payments will continue subject to extension of the regulations.

We are still keen to get a sense of what members feel about these payments. Please communicate directly with me or Karen.

Insurance

 I held a very useful meeting with the Director of General Insurance and the Director of Policy at the AIB ( Association of British Insurers). They confirmed for me that there will likely be price rises over the next period of times and a number of brokers were excluding Covid cover for both public indemnity and employer liability insurance. There is a contraction of the market thereby meaning that there will be fewer insurers for social care. They highlighted that it is likely that more insurers will require more detail from policyholders and how important it was that care homes developed a risk management model to show to their insurers. They indicated that reasonable priced cover was there, but people had to shop around. I hope that they will be able to have them attend a webinar in the near future.

 Communication

Next week the Tuesday Surgery will be at the usual time of 11 am and will be hosted by Karen Hedge and Becca Young. I have a long-standing speaking engagement.

Workforce

Many workers and managers have been impacted by bereavement during the pandemic and I would like to draw your attention to a webinar being delivered by our colleagues at NES. ‘Managing Bereavement in the Workplace’  is a free 1hr webinar hosted by NHS Education for Scotland on Tuesday 15^th September at 17:00-18:00. Register here: https://register.gotowebinar.com/register/2951547013865683470

Regulatory Forum,

May I remind you that the next meeting of the Regulatory Forum for Care Homes will be held on Monday 7th September 2020 between 10.30am and 12:30pm.  This meeting will take place via Microsoft Teams, and invites have been sent this week.  Again, if you would like to attend this meeting and have not already done so, please email [email protected]

Workforce Event – 16th September 2020
A Salute to Care Managers: recognising the importance of your own wellbeing

We are delighted to welcome you to join us for our next workforce event ‘A Salute to Care Managers: recognising the importance of your own wellbeing’ which will be held online on Wednesday 16^th September 2020 between 10am and 12pm.

The event will focus on the wellbeing of home care managers and the challenges being faced providing ongoing support for staff and caring for your own personal wellbeing at this time.  We aim to give those participating the opportunity to discuss their own experiences dealing with COVID and to gain feedback from care managers in the social care workforce as to their specific needs in this area.

• Session 1 – NES Psychological 1^st aid module – how this can benefit managers with their own wellbeing and supporting their staff.
• Session 2 – Care provider wellbeing initiative – introduced during COVID, how this has been implemented and the impact on staff wellbeing.
• Session 3 – SSSC manager wellbeing and support – this will be an interactive session for managers to feedback what wellbeing resources / initiatives have been most helpful and effective and where this work can continue to focus to best effect.

If you wish to attend please email [email protected]

This event will take place in two parts.
10am – 12pm Home Care and Housing Support organisations and managers
2 – 4pm Care Home organisations and managers
  

Care Home Festival

Just a reminder for your diaries.

We will be going online with the Care Home Conference and Awards and will be holding a Care Home Festival over three days from Wednesday 25^th November till Friday 27^th November with an Awards Ceremony in the evening of the 27^th. We will be starting the Awards application process at the start of September.

And finally,…

Next Thursday I have been called to give evidence at the House of Commons Scottish Affairs Select Committee on a range of issues relating to the pandemic including workforce, Guidance, testing and the issue of immigration and Brexit – should be a brief discussion!

In keeping the issues of care and the sector at the forefront of the concern of many please join me in lighting a #candleforcare on Tuesday at 7.00pm

Many thanks

Donald

5^th September 2020

 

Media statement on Programme for Government:

Scottish Care welcomes the announcement in the Programme for Government that an Independent Review will be established to explore the options around the future of adult social care in Scotland, including exploring a national care service.

Scottish Care has long argued over many years and under successive administrations that adult social care needed urgent reform and resourcing. Such reform needs to be rooted in the individual human rights of citizens. It fundamentally needs to understand that social care is NOT the same as health care and therefore we cannot just copy the NHS and use it as a template. Critically social care involves life-long services and supports at the heart of which citizens must be able to have control and voice.

Dr Donald Macaskill, CEO of Scottish Care stated:

“ It is sad that it has taken a global pandemic to highlight the faults in our social care system when those who provide and work in care have been talking about under-resourcing, lack of prioritisation and focus for many years.

Nevertheless, I am pleased to see the establishment of the Independent Review and the independent care sector looks forward to working with the Review group. Theirs is not an easy task. If we want to create a care service where people are treated equally, where regardless of your condition and life support needs you are able to get care free at the point of need, where workers are given terms and conditions which value their role then this will result in a massive fiscal outlay for all of society. It is right that we should have this debate and as a society consider the options which will lead us to having a high quality, rights based social care system.”