There is almost a sense of return to some degree of normality with the tremendous news that we have gone for at least one whole week with no deaths from Covid19. This has been a real fillip to many people and has been received with a very emotional response not least in the care sector which has so taken the brunt of this pandemic.
The following is a summary of some of the main issues in the week that has passed.
Finance and sustainability
At the risk of tempting fate following yet more meetings this week I am getting the sense that there is now a collective desire on the part of central and local Government to get to the bottom of why so much of the sustainability payments are still not out there. This week the Director General of Health and Social Care co-ordinated a meeting with senior local authority, COSLA and HSCP figures which was an honest consideration of some of the specific and strategic challenges. There is still nonsense – so for instance in Glasgow we have been told that less than 50% of providers have applied for additional financial supports. I find it hard to believe that this can be the case, but I would re-iterate again that applications need to be made in order for monies to be delivered. That said we held two meetings this week. Karen, Janice and Jim are leading on this work and the spreadsheet which was put up last week detailing the problem areas is still there. We are seeing progress in some areas such as Borders and Moray but there is a real block in others, e.g. North Ayrshire. Once again we have meetings planned for Monday and Wednesday in the coming week in order to look at the detail of specific issues in particular areas – please send information to us or your Independent Sector Lead – without it we simply cannot change things or advocate on behalf of members.
I held a meeting with the Cabinet Secretary on Thursday afternoon, and I raised the issue of sustainability payments beyond the end of July. You will be aware that the current commitment from COSLA is to this date. She indicated that she was due to meet with COSLA leaders on Friday and that they would discuss what support was needed. She indicated that she needed to be convinced that there was a need. For my part I said that providers are certainly feeling that there was a need, even on the basis of PPE costs alone. We will inform members about any news on this front as soon as possible.
Can I remind everyone that if you have issues around the Social Care Support Fund that you should post these on the Discussion Board where you will find some answers which have already been provided. 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
Again to remind everyone that the terms of the Death in Service Scheme are available at https://www.gov.scot/publications/coronavirus-covid-19-social-care-worker-death-in-service-payment
Care Home issues
As stated above there has been positivity with the decline in deaths and the slow-down in positive tests. There has been suspected Covid-19 cases in 694 adult care homes, 64% of the total. There have been deaths from suspected Covid-19 in 339 adult care homes, 31% of the total.
Last week I indicated a real sense of disappointment about the handling of visiting and these points have been brought to the attention of the Directors of public health. Unfortunately, Jason Leitch the National clinical Director intimated in a tweet that indoors visiting with one person and outdoor visiting with multiple people would commence on the 24th. He somewhat jumped the gun in that any decision will have to be confirmed but scientific advisers. I hope he will rectify this tweet. We have also asked for any change to Phase 3 to commence on the 27th – on a Monday to give people plenty times to get Risk Assessments signed off. In addition, the Guidance for Indoor visiting is still to be finally signed off and will mention a limit of 3 visits outdoors not ‘ multiple.’ We are not off to a good start!
I have also raised directly concerns which members have been expressing about the status of residents who wanted to go out of the care home and visits family, friends or simply to do some shopping. There seems to be a belief in some parts that folks in care homes never go anywhere and are virtual prisoners. Some urgent work is being done on this issue and I hope to have something to communicate at the end of the week.
A paper to restore ‘visiting’ from both clinical professionals such as AHPs, OTs etc and other visitors such as hairdressers, therapists etc has also been prepared and I hope this will come into play at the same time as we move to stage 3 with the wider family visiting.
More positively there has also been a decision taken to set up a small group including with provider representation to look at the issue of IPC in care homes. The constant drumming from myself and others that care homes are not units or hospitals seems to have been recognised and there is an appreciation that acute sector IPC measures need to be adapted. I hope that this group will develop approaches and models which are more sensitive and reflective of the reality that a care home is someone’s home whilst still keeping in balance the need to protect and reduce infection risk.
One of the other issues that we are increasingly aware of are the post-viral impacts of Covid on those who have had the disease. It is now clear that we are dealing with an ‘underlying deep disease’ and one that is a vascular virus as well as a respiratory virus. As growing evidence shows there are profound ongoing impacts related to coronary health, respiration, COPD, falls, diabetes, frailty and dementia. This will have an especial influence on residents ion care homes and many of those being supported in their own homes.
Last week I reported on our concerns about Operation Koper. These remain. The Director General Donna Bell reported a meeting she held with staff from the Lord Advocates Office and Police Scotland. She highlighted our concerns over time and s cope of the information requests from police Scotland. As I feared there is a limited extent to which we can influence these investigations but Donna Bell is now exploring whether it might be possible for me to speak directly to senior investigators to make them aware of the sensitivities and concerns which are being felt in the sector on this particular issues and to see to whether or not we might be able to improve this.
Testing
At least 34,017 individual care home staff were tested in the last few weeks and at least 1,989 individual residents in care homes were tested. However, there were 3,500 staff who refused and some care homes as a whole either refused or did not access the portal. We are going to work with Scottish Government to explore some of the reasons behind this. I am aware of the risk of false positives when there is such low prevalence in the community and issues of the sensitivity of the test and inconclusive results. I am aware that there are reasons of shift patterns, rostering, etc but we need to explore the issues. We are also now part of the Social Care and Testing Working Group. This meets on Monday mornings and is a practical opportunity to bring up issues of concern. Caroline Deane represents Scottish Care at this group and if members have issues please highlight these to Caroline.
Once again there has been no final decision on the ‘mandatory’ nature of the tests following the unhelpful intervention from SSSC – we believe that discussions between various parties on this issue are ongoing at the time I write this.
Care at Home
The Care Inspectorate has started their process of an Inquiry which in relation to care at home and housing support. The issue of wider concerns over care at home and housing support was again brought up by us at the CHRAG and the in-principle decision was taken to extend the membership of CHRAG to include care at home perspectives and to create what are effectively going to be a range of subgroups on Adult Social Care. The process for this has just commenced and we will ensure that there is Scottish Care representation on the various groups. But at long last there is an acceptance that despite the understandable focus on care homes , that adult social care is more than just care homes, and that the risks to the rest of the sector are real and immediate.
Collective Care Futures
The Collective Care Futures project is well under-way, and I continue to encourage folks to get involved in the sessions being led by Becca and Tara. Equally filling in the online questionnaires will be of huge value. It is critical we engage in a week which has seen the Labour Party promoting its idea of a National Care Service.
You can choose to take part by completing the survey series. There are currently 3 surveys available – technology, care practice and partnership – with 3 more to become available in coming weeks. You can take part in as many or as few of the surveys as you wish.
If you or any of your staff/colleagues would prefer to share your experiences in a short online call, on a certain theme or across a range of themes, you can email [email protected] to arrange a convenient time.
Becca and Tara would also be extremely grateful if you could share details of the programme with your networks and contacts, who are also welcome to take part via surveys (hard copies can be downloaded) or in an online call. Please see full details at https://scottishcare.org/project/collective-care-future/
Care Home Day
Care Home Day happened on Wednesday and I would want to thank everyone who shared stories and took part in this day. There was a remarkable degree of buy in by many of our partners in Health Boards, local authorities and Health and Social Care Partnerships. There was a real sense of positivity on the day. This is shown in the remarkable data which has been analysed on the use of the hashtag #carehomeday20.
Total posts: 2,043
Users: 219
Reach: 351,355
Impressions: 1,424,644
Retweet rate: 93.40%
Reached No 2 trending in Scotland
I would want to take this opportunity to express my particular thanks to Shanice Shek and Becca Young for the amazing work they did on the day and prior to it to make this the success it was.
In the midst of all the negativity it was good to – at least on social med9ia – see some positivity and the fact that the Cabinet Secretary recorded a video message and that the first minister mentioned it in the Daily briefing were both positive indicators.
PPE
It may seem strange to raise this as an issue here because in large part there has been considerable stability of supply. However, a number of members have communicated to us a concern that prices are rising and that there are suggestions from suppliers that there may also be shortages. We are starting to map in broad terms the extent to which members might be interested in a situation where NSS offered its services to social care providers at rates which are likely to be highly competitive. We will develop a question on the Discussion Board, and it would be helpful for members to give opinions on such a suggestion.
Communication
Our next Surgery will be this coming Tuesday with again Karen Hedge and myself for 45 minutes at 12 noon. Please join us on a range of topics.
And finally,…
This week I have commented a great deal on the very disappointing news from the home office that they will not make social care a distinct category on the Shortage Occupation List. The loss of the ability of providers to recruit from overseas will have a profound impact on many of our members and we will continue to speak out and campaign on this issue. It is lamentable and bizarre that these restrictions will come in in January at a time when we might be facing a second viral peak, a flu upsurge and the challenge of supply through Brexit.
On a more positive note we are delighted to have welcomed Jim Baird to the team at Scottish Care as the Rights Made Real Human Rights Project worker. Jim comes with many years of experience of working in the field of dementia and we are pleased to have his wealth of experience at such a critical time. We look forward to his insights and contribution over the next few months.
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
18th July 2020
