The week started with a piece of research and reporting in the Sunday Mail about the experience of care at home and housing support staff in relation to testing. This research indicated that over half of staff working in the community had not been tested during the pandemic. Scottish Care has consistently called for care at home staff to be tested and we have re-iterated this to the media in the week that has passed. This is found at https://scottishcare.org/media-statement-on-care-at-home-testing/
The following is a summary of some of the main issues in the week that has passed.
Testing.
We continue to have real problems with testing of staff and the length of time – between 2 days and 10 days – for which tests are taking to be returned. Scottish Government both through the FM and Cab Sec have publicly stated these delays are unacceptable, have been in communication and dialogue with the UK Government and are broadly seeking to develop a system where care home tests can be primarily undertaken by NHS Scotland labs. The hope is that all care home testing will eventually be local which will ease the pressure as we move into winter. But we are not there by a long stretch. Whilst all this is happening we have very real concerns that this will impact on the delivery of safe care, will demoralise staff and makes care at home and housing support testing look even less likely,. All of this at the start of an autumn and winter period which heralds such uncertainty. We have been continuously told in the week that has passed that things are getting better – this is simply not our experience on the ground.
Caroline attended the Social Care Testing meeting with others and key points are:
- At the moment health boards are identifying their capacity to move testing to them.
- SG has purchased testing equipment and is setting up NHS Regional Hub Testing Centres and the tests for care homes will use this system, logistics of this currently being worked out.
- Group is looking for feedback into what has previously worked well and what has not so this can be built into the new system.
- Looking to get this up and running in 6 – 8 weeks.
- DHSC mitigation during that period to improve system as much as possible.
- Looking to urgently transfer approximately 8000 tests back to NHS boards.
- Each board has different arrangements in place, and they are trying to do this including logistics and IT with minimum disruption to care homes as possible.
- A proposed high-level model will be coming out to stakeholders for comment.
- Currently establishing governance and sub-groups around logistics, portals and links to NHS labs.
- The shifting of tests to NHS local boards as the interim mitigation until hubs can be put into place will focus on larger care homes to ensure highest numbers can be transferred as easily as possible.
A number of sub-groups will be established which will include provider representation to ensure ongoing practice input and feedback from the sector.
On an unrelated but important issue – you will be aware of the new Protect Scotland test and trace app – this has now been downloaded by over a million and it will be a critical tool in the weeks and months ahead to protect our staff and communities. Please encourage folks to download it. See https://scottishcare.org/test-protect-protect-scotland-app-launch/
Homecare Festival. WEDNESDAY 7TH – FRIDAY 9TH OCTOBER.
Tickets are now on sale for this absolutely critical care at home and housing support event. The sector has been through and is still enduring some really challenging times and it will be important that we all get around this event to put the sector into the light and to raise the profile of a whole number of issues. I think the programme is great with a good mix of debate, discussion and innovative input with speakers from across the UK and hope you will all join the event. More details are available at https://scottishcare.org/cah-conference-2020-2/
Please support it by buying tickets.
National Care Review
As indicated in my update last week the National Review chaired by Derek Feeley wishes to engage with the sector. As part of this we have arranged two webinar sessions for members to meet Mr Feeley and share thoughts, views etc. these have been arranged as follows:
Wednesday 30th September 1.00-2.00 Care at home and housing support members
Friday 2nd October 11.30-12.30 Care home members
Sign in details will be posted on the members area of the website nearer the time.
General Covid Care Issues.
It is quite clear that we are on the edge of a second wave or a peak in the first which may result in new restrictions and certainly increased risk to the care sector.
Thursday saw the second meeting of the Pandemic Response Group at Scottish Government
The group spent a great deal of this meeting looking at winter resilience plans and I argued that there was a real patchy engagement with providers across the country within some areas HSCPs involving providers closely and in others not at all. There are too man y plans and not enough co-ordination. It was agreed that we need to involve providers urgently in this which includes second waver planning but also preparation for potential Brexit shortages. In will keep members updates on the issues raised.
Another major chunk of time was taken by receiving feedback from Dr Jenni Burton, Dr Scott Heald and Fiona Mackenzie from Public Health Scotland on the research they have been undertaking on the admission of individuals from hospitals into care homes in the March-May period. This was the same presentation as offered to members during the webinar held on the morning of the 17th. It was agreed that there will be real sensitivity when the Report is published at noon on the 30th September. We will work with other stakeholders to see that we can manage any media interest both at local and national level when this report is published.
The Clinical and Professional Advisory Group met again, and a lot of the time was again focussed on the need to think urgently about re-shaping the guidance to take account of the growing clamour and anger from family members re access to care homes. Readers will no doubt be aware of the demonstration at the Scottish Parliament by the group Care Home Families on Wednesday 16th and their support in Parliament. Indeed, the Lib Dem Leader Willie Rennie spoke on these issues at First Ministers Questions. The Cabinet Secretary has agreed to meet the group together with officials and there has been a decision to explore Guidance again. I hope at the end of the process there will be greater delegation of decisions to local level with appropriate protocols in place, It is simply not tenable that in areas with virtual no community presence of Covid19 that there remain significant restrictions. I get a real sense that clinicians have now been convinced that the psychological and physical harms being brought about by continued isolation and separation from family are no longer tenable. However, the critical role of protection remains paramount.
It is also noteworthy that the number of care homes where there is an outbreak has increased by 12 to 90 from the previous week. The vast majority of these are as a result of staff being tested positive. We have no evidence to date of significant growth in the number of care home residents who have tested positive, In England at the time of writing I believe there are a total of 1800 care home residents who are currently Covid19 positive. We clearly want to avoid the same escalation in Scotland. Given the nature of the growth of cases in the community this is perhaps not surprising. In media comment this week I have tried to underline the critical importance of everyone taking responsibility for their cations as the link between community and care home outbreaks is self-evident.
The Care Home Daily Huddle tool seems to have onboarded most care homes but there remain issues of completion with 86% of returns most days and especially issues relating to the completion of the testing elements – the latter being changed to make this easier. and as we move into winter to try and get a better and more proportionate illustration of what safe visiting will be especially in situations of lockdown. I have been assured that the clinical staff will be presenting new suggestions to politicians. I remain concerned, however, that there is a lack of appreciation that the impact of restricting visiting is having on the sustainability of the care home sector as well as the mental health of those who are resident and their families.
Finance and sustainability
We received the alarming news that one HSCP has restricted sustainability funding to a provider who scored a 2 during the Care Inspectorate’s recent Q7 inspection. This is very much against the COSLA Principles and we will be taking appropriate action, but it would be good to know if this is a wider issue. Please get in touch with Karen or Swaran on this matter.
Once again issues of concern have been raised with us by members and also the media in relation to escalating insurance costs. It would appear that this is primarily impacting on care homes but is now becoming a challenge for care at home and housing support providers. Please see below for our statement.
Communication
Next week the Tuesday Surgery will be at the usual time of 11 am and will be hosted by Karen Hedge and myself.
Bulletin
Can I remind you that the quarterly Bulletin is online. It is jam packed with articles and information which we hope will be of interest. Because copies are not available in physical format we are aware some folks may not get the access which they used to, so we are very reliant on our members to spread the pdf. Thank you. See https://scottishcare.org/autumn-bulletin-2020/
Workforce
On Wednesday the Workforce event A Salute to Care Managers: recognising the importance of your own wellbeing was be held. I managed to drop into the afternoon session, but I am aware that the event was exceptionally well attended with some 80 folks across the day. I found the sessions I heard to be both practical and exceptionally moving in their description of the role of the manager during Covid but also full of real practical hints for health and wellbeing. I want to on behalf of everyone say a huge thanks to Caroline our Workforce lead who put together such an engaging programme and organised the whole event. Thank you.
Care Home Event
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 Event over three days from Wednesday 25th November till Friday 27th November with an Awards Ceremony in the evening of the 27th. We will be starting the Awards application process at the start of September.
And finally,…
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
19th September 2020
Scottish Care’s statement on insurance concerns
Scottish Care has recently held talks with the insurance sector as a result of concerns being raised by our members. These primarily relate to a reduction in the number of companies willing to provide public and employee liability insurance for the care home sector.
We appreciate that the insurance sector has been affected by Covid-19 and has suffered a negative financial impact, but we hope that this will not result in exorbitant price rises for the social care sector in Scotland.
We have become aware that there are a number of insurers who are not willing to take on new clients which is making it very challenging for our members to shop around and get the best deal for their organisations.
We continue to monitor the situation closely because we are very concerned that there are very real risks to the survival and sustainability of the care sector.
CEO Dr Donald Macaskill said:
“It is very important in these challenging and hard times during the pandemic that the insurance sector supports care homes as they have traditionally always done. Care providers need to provide assurance to both residents and staff that they are adequately protected by insurance and I hope that the insurance sector will work closely with ourselves and care homes to get the real picture of what life is like. Yes, there have been really challenging times but our journey back to what is closer to normal will not be helped if the insurance sector pulls the rug from underneath the care sector.”
