It has been another busy week affecting both homecare and care home services across Scotland. As I reported in my update last week we saw last Saturday the publication of a letter from the Cabinet Secretary detailing the extension of visiting for care homes including additional numbers for outside visiting (from Monday) and the requirements to enable indoor visiting by one designated individual. The publication of these with so little notice for providers has resulted yet again in a great deal of distress from family members demanding almost immediate access with little or no understanding of the necessary plans and protocols that are required to be in place before indoor visiting can begin. I can assure members that I made the views of the sector and its exhausted staff very clear at a meeting of the Care Home Rapid Action group on Thursday. It is also clear that the Guidance is not as explicit as it should be and having held the Surgery on Tuesday I submitted certain questions which have been answered by the Clinical and Professional Advisory Group and are now available on the Discussion Board. I have asked for a formal FAQ sheet to be produced by the group dealing with these questions and also a range of other questions.
The following is a summary of some of the main issues in the week that has passed.
Finance and sustainability
We continue to gather intelligence on the extent to which sustainability payments are not coming through to providers. It appears to us that the majority of providers who are going to make a request for additional support have done so. It is also clear that we have a range of responses – with some still awaiting their payments from March and April, others paid for May and June and yet others still waiting for their first having received their second payment. I would want to commend Karen and Jim Carle for all the practical work they are doing to address these issues with colleagues from COSLA, CCPS and Scottish government. But yet again we need to get the data from you. So please continue to feed Scottish Care staff with information that will help us address the blocks,
I also held the first talks with Government and local authority colleagues on what will happen after September because as the Cabinet Secretary letter stated there is an intention to taper payments. As an organisation Scottish Care is arguing strongly that there can be no return to the way things are without substantial ongoing fiscal support for a sector which remains extremely fragile. It is likely that we will be involved with other stakeholders in developing an options paper for what will happen after September.
I should also state that this week I have formally requested the commencement of discussions on the National care Home Contract to commence and to take account of thew changes which have impacted upon the sector this year and which are likely to be the case for some considerable time to come.
Care at Home issues
The Health and Sport Committee of the Scottish Parliament has announced that it wishes to hear evidence from those who receive and deliver social care in their own home as part of the wider Social Care inquiry which was from those who provide or have received social care at home as they will be best placed to inform them of changes needed.
Responses will be welcome from the public with a call for those receiving care at home, family members and unpaid carers; staff, managers or owners of care at home services; and personal assistants providing care to share their experiences. Scottish Care will take a full part in submitting a response.
Members will also be aware that the Care Inspectorate has been holding an Inquiry into the role of local authorities and HSCPs in relation to care at home and housing support services during the pandemic. This has now finished and In want to pass on the thanks of the Inspectorate to our members for your engagement and participation in this work. There has been an excellent response from over 300 service providers across Scotland.
Care Inspectorate Consultation.
I am also very grateful to Becca Young who this week completed our response to the Scottish parliament’s Inquiry on the Care Inspectorate during the pandemic. As I said before in our consultation on this response that we are very aware of the desire of certain politicians to get at the sector through the Care Inspectorate. I hope you will find our report reasonable and descriptive of both the strengths and weaknesses of the regulator during this last period of time. See
https://scottishcare.org/wp-content/uploads/2020/08/CI-Inquiry-Aug-20.pdf
PPE.
The UK remobilisation guidance for health and care settings is due to be published next week. This guidance is predominantly about getting back to our previous evidence-based IPC guidance pre-COVID – as detailed in Scotland’s National Infection Prevention and Control Manual (NIPCM) – as health and social care services remobilise and we move to a period of low prevalence/incidence of COVID-19 in the community.
Physical distancing, hand washing and wearing a mask remain the key elements for preventing the spread of COVID-19. In terms of PPE, the guidance will continue to recommend the safest level of PPE to protect health and social care workers in line with contact and droplet precautions, or airborne precautions when an Aerosol Generating Procedure (AGP) is being undertaken.
The guidance will outline key COVID-19 IPC measures such as the use of PPE, extended use of face masks and coverings, physical distancing, and outbreak management, as well as risk assessed care pathway scenarios to help guide the implementation of measures for safe and effective care.
In Scotland, we have also published a range of specific guidance for non-acute settings. Work is underway to update the existing non-acute guidance in Scotland to ensure that it aligns with the new UK remobilisation guidance. We expect that the social care sector will be required to start implementing the UK remobilisation guidance over the coming fortnight once the corresponding non-acute guidance in Scotland has been updated.
Yesterday afternoon (Friday 14th) a letter was issued from the CNO/CMO/NCD to ensure all relevant partners and stakeholders are aware that this guidance is due to be published next week. See https://scottishcare.org/forthcoming-uk-ipc-guidance-for-the-remobilisation-of-health-and-care-services/
We will make sure the new Guidance is carried on the website in the members section.
Homecare Festival. WEDNESDAY 7TH – FRIDAY 9TH OCTOBER.
SAVE THE DATE:
Details are being worked out for our virtual Homecare Festival. This will highlight issues faced by care at home and housing support. There will be various sessions over a three-day period, culminating in an Awards Evening on the Friday 9th October evening.
Fuller details will be made available as soon as possible. We are looking forward to this opportunity to focus upon and celebrate the amazingly creative and compassionate work being undertaken across Scotland by services.
Care Home Issues.
COVID19 deaths in care homes remain low at 2 to the week ending 9th August ( the same as the previous week.)
The Digital Daily Huddle tool is due to start being able to be populated from Monday 14th August. I indicated a real sense of disappointment and frustration felt by man y in the sector by the linking of the tool to the ability to start indoor visiti9ng. This was never meant to be the case and when you consider that there have been real problems with links from NES this has not got things off to a good start. I would still contend that the tool will be of immense benefit in reducing the multiple reporting which is still happening in some areas and has real potential for ensuring more robust data for both individual care homes and also group homes. However, the poor handling of communications and information has not helped, and I have been assured this last week that this will be improved and that there will be a strategic approach to communication and to address the concerns of managers and operators. The webinar of last week is still a useful source of information and can be accessed at https://scottishcare.org/digital-safety-huddle-webinar-recording/
You may remember last week I wrote about the many concerns that had been raised in relation to Operation Koper. I have held discussions with the lead Chief officers from the Health and Social Care Partnerships and will meet senior officers and staff from the crown and Procurator Fiscal Office on Monday afternoon where I hope we can address some of the practical concerns faced by the sector. I will be joined in that meeting by the Deputy Director of the Royal College of Nursing. I will update members next week.
The Care Home Clinical Group signed off guidance which will detail the timeframe and nature of the return of professional visitors such as podiatrists etc together with therapeutic visitors such as hairdressers. This is now with the Cabinet Secretary and I would imagine this will be signed off and result in visits happening after the 24th which is the date by which providers will have submitted their indoor plans for family visits. It is important that the latter comes before the former.
The latest HPS Guidance for residential settings was published on Thursday. It can be accessed here https://hpspubsrepo.blob.core.windows.net/hps-website/nss/3045/documents/1_covid-19-guidance-social-community-residential-care.pdf – Its main changes are as follows:
- Section 2: updates to general measures
- Updated advice regarding self-isolation: extended self-solation to 10 day for symptomatic or positive test
- Section 3: update to advice regarding risk assessment at work
- Section 9: Individuals on overnight leave from the facility
- Section 10: addition of PPE statement
- Section 16: Staff who have contact with a case of COVID-19 at work and staff who recovered from COVID-19
- Section 18: restriction of visitors
- Section 21: addition of prison and detention setting advice Amended appendix 1: HPT email added
Care at Home & Housing Support Awards reopen for entries
This last week we re-launched the Care at Home and Housing Support Awards. This offers the opportunity to recognise all the compassion and hard work from the homecare workforce during the pandemic.
We would like to thank everyone who has already submitted nominations in March. These awards entries have been kept and will still be valid. Should you need to make a change to your entry, please contact [email protected].
Please submit your award entries by Monday 31 August.
Entries can be made either online on our website, or by sending a completed Word version of the nomination form to [email protected].
For more information: https://scottishcare.org/cah-awards-2020/
Testing
Testing has progressed over the past week and it would appear that rates remain high across the country. At least 36,128 care home staff were tested in the week ending 6 August. At least 1,410 individual residents tested.
I spoke to the Cabinet Secretary in my last meeting with her about the potential for the new salvia test which returns results in the hour to 90 minutes not least for visiting into care homes. She has asked the scientific advisers for a view on this mindful of the fact that at the moment the current salvia test is not as robust as the current test.
The group looking at care home issues as they relate to testing is still meeting on a fortnightly basis and is next due to meet in a week’s time. Please communicate your testing questions and issues directly to either me or Caroline Deane.
The latest update on the Testing Guidance appeared also on Thursday 13th. Here it is https://www.hps.scot.nhs.uk/web-resources-container/guidance-on-covid-19-pcr-testing-in-care-homes-and-the-management-of-covid-19-pcr-test-positive-residents-and-staff/
Collective Care Futures
I was pleased to be joined by Becca Young at the latest Surgery and she spent some time talking about the Collective Care Futures project. Please continue to take part by contributing to the Surveys which are still available.
The surveys are available at https://scottishcare.org/project/collective-care-future/
You might also enjoy reading the Emerging Insights sheet on technology which is the first fruit of the project. It can be accessed at
https://scottishcare.org/wp-content/uploads/2020/08/Care-Future-Emerging-Insights-Technology.pdf
Care Tech 3 :
Care Tech 3 will be taking place on the 28 August. A full programme is now available, and tickets priced £12 are now available for purchase.
This is a positive bargain for what looks like a phenomenally engaging programme. The event will feature a range or panel discussion and opportunities to hear the latest developments around technology in social care. There will be a mixture of panel discussions, networking spaces, exhibition and demonstrations. The three panel themes are:
- Technology journeys in care homes and homecare services
- Technology for social connection in social care
- Tech-enabled care in a COVID social care and beyond
Do find out more at https://scottishcare.org/tickets-on-sale-for-care-tech-3-28-august/
Communication
A new issue of the E-newsletter came out yesterday.
Next week the Tuesday Surgery will be at the usual time of 11 am and will be hosted by Karen Hedge and myself.
Nursing
In what has been a very positive week for nursing in social care, including over 35 applicants for the Graduate Programme for Integrated Community Nursing, Jacqui Neil our Nursing Lead was pleased to inform us that we have secured 5 places on the non-medical prescribing course. This will be funded up to £1000, with individual universities setting their own cost per module. This module requires the support of a GP or advanced nurse practitioner who has already completed this and must be confirmed before commencing the course.
This opportunity has the potential to make and shape the future role of care home nursing and therefore requires a high commitment to ensure successful completion. There are 2 cohorts being funded starting September/Oct 2020 and Jan/Feb 2021.
For more details and information on this important opportunity please see https://scottishcare.org/funding-to-prepare-practitioners-for-non-medical-prescribing/
And finally,…
Please join me on Tuesday at 7.00pm in lighting a #candleforcare.
Many thanks
Donald
15th August 2020
