Agenda item

Impact of Covid 19 on residents and staff in Care Homes and the Home Care service

Council and CCG staff will update the commission on PPE, testing, how residents are staying in touch family, friends and with the wider world, and lessons  learnt in protecting vulnerable people. 

 

Unison will provide input on staff PPE and testing provision for Southwark social and  home care staff.

 

A legal briefing on the Coronavirus Act 2020 Care Act easements is to follow.

Minutes:

The chair invited officers and NHS colleagues to update the commission on PPE, testing, how residents are staying in touch with family, friends and with the wider world, and lessons learnt in protecting vulnerable people. 

An overview was provided by:

·  David Quirke-Thornton,  Strategic Director, Children’s & Adults Services

·  Genette Laws, Director of Commissioning , Southwark Council

·  Sam Hepplewhite, Director of Integrated Commissioning, NHS CCG

 

PPE

Officers explained that in the early days of the pandemic assistance to care homes had concentrated on provision of PPE, including supporting homes with the financial costs. Communication had been vital and this was provided via a newsletter– first daily, then weekly. This contained information on changes to guidelines, provision of free parking to care workers in order to avoid public transport, how to get PPE when suppliers fail, and how to use PPE. 

 

Officers emphaised the scale of PPE requirement with 800,000 items needed locally across the sector, which included masks, googles, gloves, aprons, depending on infection.  PPE provisions ordered by homes were on occasions diverted to the NHS.  London Boroughs came together to procure PPE with Ealing taking the lead procuring 2.5 million items. Southwark led distribution for South East London. Officers explained that the council is not the routine supplier of PPE, only emergencies. Initially facemasks were in short supply; now the gloves are scarcer.

 

Media images of PPE showed about full coverings  in hospital settings, whereas the guidelines for PPE provision in care homes was different, and that is what the council was focused on delivering to enable people to receive the care that they needed, which they did receive.

 

Communication between care home residents and family and friends

Communication between care home residents and friends and family had been facilitated with the use of iPads, and also on occasion by standing outside the home to see people, as well as  provision of PPE to relatives and friends so they could visit, in the case of accidents or end of life care.

 

Testing

Government testing stopped and then restarted. The local CCG/ NHS has been helpful in facilitating access and working closely with Public Health,  who have led on testing in care homes, which has now been done for 12 of the 15. There has been a portal to register,  targeting older people’s homes first and now moving on to working age care homes.

 

Lesson learnt

There are strong relationships with providers of care and shared values. The

Ethical Home Care Charter has proved its value; our staff absence was lower than other boroughs. Officers will be prioritizing rolling out the Ethical Care Homes Charter.

 

There was a lack  of understanding in the  Department and Health and Social Care about the  range of home care provision and remit, for example Care Homes are  not for getting people out of hospital, but rather residents homes  and there is a right for people in those homes to chose who comes in. There are 17 CQC registered providers in the borough, not only older people’s residential homes. Care Homes have for too long been a Cinderella service, and there needs to be a focus on that changing.

 

The close working with neighbours has been good and supportive, with boroughs providing mutual aid and effective joint commissioning.

 

 

April Ashley, Unison Branch Secretary.

 

 Unison and other trade unions have campaigned on testing and PPE and liaising directly with care home and home care employees.  Issues have included:

 

·  The PPE guidance constantly changed and Unison considered this changed based on what was available rather than what was needed.

 

·  Some Unison members working in Care Homes did not know what PPE was required as managers did not always convey this to frontline workers clearly.

 

·  Unison challenged care home providers and on occasions said care home workers cannot provide care without adequate PPE; people have a right under the HSE legislation to refuse to work in unsafe conditions.

 

·  Many care home staff are BAME so face a higher risk from Covid 19 infection.

 

·  The clap for care was good, but the emphasis must be on providing PPE.

 

·  Full sick pay is vital otherwise people will come into work when sick as employees need to pay rent and mortgages.

 

·  Unison supports the Ethical Care Home Charter.

 

·  Unison wants to see homes brought back in house; the NHS got prioritised for PPE as a public service.

 

·  Unison are continuing to campaign for testing and contract tracing.

 

The chair invited questions and the following points were made in response:

 

·  Commission members and officers all commended and thanked the home care,  care home workers and social workers for all their work during the Covid 19.

 

·  The Unison Branch Secretary assured members that care homes do now have adequate PPE. At the beginning they did not have enough masks, nor was there enough information from local managers, but this has changed. Testing can be obtained at either drive through centres or at home and Southwark Unison members have not raised any complaints at the moment.

 

·  Officers said that previous figures indicated 55 deaths from Covid 19 in care homes; however this has increased with more out of borough. The most recent figures will be supplied.

 

·  The council encouraged all homes to lockdown as the government advice came in; some homes locked down earlier.

 

·  Homes with a higher proportion of end of life care have been hit harder, whereas other homes with working age residents have had far fewer fatalities, as would be expected.

 

·  Mutual Aid and construction companies have donated voluntary PPE contributions, which has been welcomed and helpful.

 

·  The council provided additional finance to care homes.  The council is expecting passporting grants from central government with conditions attached.

 

·  A legal briefing on the Coronavirus Act 2020 Care Act easements will go to the next meeting.