Health and Social Care – Page 15 – The NEN

Getting help for people at risk from harm

It’s vitally important during these unprecedented times that people know where to turn to if they feel someone is vulnerable in their communities.

We should all be following government guidance to stay at home to limit the spread of Coronavirus – however, being at home can increase tensions and affect mental health, meaning some people in our communities are more vulnerable now.

Children and adults can be at risk of harm, and some people will be experiencing financial difficulties or struggling with addiction – but help is available.

If you think a child or adult is at risk of harm, you should report your concerns so that professionals from social work, police, NHS and the voluntary sector can help.

The Council has already put in place measures to support people staying at home like support from our educational psychologists for families who may be struggling with home learning and wellbeing.

Depute Council Leader Cammy Day said: “Now more than ever in these challenging times we should all be reaching out to anyone we think may be suffering and requires support. Many people may be unaware that there’s a wide range of networks in the city for those in need.

“We’ve all heard of many amazing tales of kindness and selfless acts in Edinburgh during this pandemic. It’s so important we raise awareness among our communities of the help that is out there. So, our appeal is … please if you have concerns about someone then contact the appropriate organisation to get them support – you can make a real difference just by making that vital phone call.

“As a Council we work really closely with partner organisations like the NHS, police and voluntary sector to support the most vulnerable in our society.

“A great example is our All of Us campaign with the NSPCC which encourages people to get in touch if they’re finding it hard to look after children, a family needs some extra help or someone they know could do with more support.

“It’s vital people know who to turn to if they have concerns – don’t hesitate to make your voice heard and change people’s lives for the better.”

You can get help if you’re worried about the safety of a child, neighbour, friend or relative. Call any of these numbers or find out more about how to get in touch on our website https://t.co/Z1EyiNiLfw. If you think there’s immediate danger, call Police Scotland on 999. pic.twitter.com/2gpC72tBqa

— The City of Edinburgh Council (@Edinburgh_CC) May 9, 2020

If you’re concerned about your own safety or someone you know like a relative, friend or neighbour then you should contact Social Care Direct on socialcaredirect@edinburgh.gov.uk or call 0131 200 2324.

If you’re concerned for the immediate safety of a child or adult, phone the police on 999.
If an adult or child needs medical attention with or without COVID-19 symptoms, phone NHS on 111 or if it’s an emergency 999.

There are various forms of support such as Scotland’s Domestic Abuse and Forced Marriage helpline on 0800 027 1234, Edinburgh Women’s Aid on 0131 315 8110 and our All of Us campaign, with NSPCC Scotland.

Greens raise concerns around home-care support

Lothian MSP Alison Johnstone has called on the region’s Health and Social Care Partnerships to urgently address concerns around the reduction in provision of home-care support, which has left many disabled people in an extremely difficult position.

Reports suggest that the Lothian region’s Health and Social Care Partnerships have reduced their visits by 356 in total, leaving many vulnerable people struggling to cope – a matter the Scottish Greens raised in parliament this week.

Alison Johnstone MSP said: “The figures published this week raise major concerns, There is huge disparity around the country, with the City of Edinburgh Health and Social Care Partnership reducing their clients by 240, East Lothian by 44, Midlothian by 24, and West Lothian by 48, while at the same time Angus increased its by 80.

“The Scottish Government confirmed that extra support is available and that if more is needed it will be provided, so our Health and Social Care Partnerships must confirm that they will immediately access this support and restore home care visits.

“I’m extremely concerned about the impact of these changes, which result in some people having their support packages dramatically reduced, and others losing support entirely, with many then forced to rely on family members for personal care, meals and medication.

“The impact on the mental wellbeing of disabled people, particularly in terms of social isolation which can disproportionately affect disabled people, is a huge concern. While its vital that care is restored as quickly as possible, the immediate roll-out of online or remote mental health resources would be really valuable right now.”

https://www.bbc.co.uk/news/uk-scotland-52415302

“Some Promising Signs”: Jeane Freeman updates Holyrood

Statement given by the Cabinet Secretary for Health and Sport Jeane Freeman to Scotland’s Parliament yesterday:

Thank you very much Presiding Officer, and thank you for the opportunity to update the chamber on several key areas around our response to COVID-19, and to say something about our future planning.

Today is International Workers’ Memorial Day, and across Scotland many people observed a minute’s silence to particularly honour health and social care staff who have tragically died during this pandemic. A number of our own colleagues in Scotland have lost their life to COVID-19 and my thoughts, and I know those of members across the chamber, are with their families and loved ones.

In the last 24 hours, 70 deaths have been registered of patients who have been confirmed as having COVID-19 – and that takes the total number of deaths in Scotland, under that measurement, to 1,332.

As always, it is so important to remember that behind each one of those numbers is the loss of someone loved and now much missed and I offer my sincere condolences to their families and friends.

Presiding Officer, notwithstanding all of that, we are starting to see some promising signs that the efforts and the sacrifices that the overwhelming majority of people across Scotland have made are having an impact.

The number of patients in hospital with confirmed or suspected COVID-19 has been broadly stable in recent days, and the number of people in ICU with COVID-19 has shown signs of decline.

We should not read too much into all of this yet – these are early days – but these trends are both welcome and cautiously hopeful.

As of today, 50% of adult care homes have reported an outbreak of suspected COVID-19. Last week I set out a series of additional steps to support those who live and work in our care homes.

These steps increase the clinical support focussed on preventing COVID-19 infection and transmission in care homes. Our NHS Directors of Public Health are now providing enhanced clinical leadership and have contacted every care home in Scotland. They are assessing how each home is managing infection control, staffing, training, physical distancing and testing.

We have provided a direct delivery of PPE to care homes and have worked with local partners to significantly improve the operation of local PPE hubs. Whilst the supply of PPE is primarily the responsibility of care home providers in both the private and the public sector, we will continue to provide both top up and emergency provision to ensure staff have what they need and they and the residents have that protection.

Work is also underway to ensure that all COVID-19 patients being discharged from hospital should provide two negative tests before discharge, and that all new admissions to care homes, and all residents who are symptomatic should be tested and those new admissions should be isolated for 14 days.

Social Care and care home staff continue to be priority key workers for testing and I have written to all care homes reminding them of this and asking them to make sure that as employers they follow through where this testing is required.

As members know we also have over 21,000 returning health and social care staff alongside student nurses, student midwives, AHPs and newly graduated doctors, all willing to apply their skills and experience to the collective effort. Many of them are able to work in both the care and the primary care setting. And, as of today, 185 applicants have been matched into roles in care homes and care at home services, and a further 218 are ready and available. I expect the number of matches to increase rapidly in the coming weeks.

As well as those working in care homes to protect our most vulnerable people, I know there are many carers – both paid and unpaid – who are supporting people to stay in their own homes and they, too, must be protected. So we have extended the provision of PPE to Personal Assistants and unpaid carers.

From the start of this week, the local PPE Hubs for the registered social care sector are receiving enhanced supplies and support so that they can distribute to the whole of the social care sector where normal supply routes have failed.

We have published advice for unpaid carers on the appropriate use of PPE and how to access it, and will be publishing equivalent guidance for Personal Assistants shortly.

I have asked the National Carer Organisations and local carers’ centres to discuss with carers their needs, and help us with directing them to their local Hub where they need PPE.

We will ensure Hub locations are clearly signposted on the Scottish Government website and Health and Social Care Partnerships are working with local carers’ centres to make clear how individuals can get the necessary Personal Protective Equipment.

Throughout this difficult time, it is critical that social care support is maintained to ensure the safety, dignity and human rights of people who already receive that support.

In addition to the funding directed towards social care from the 2020-21 budget, I reached agreement some weeks ago with COSLA that we would meet additional costs incurred because of the impact of the pandemic.

That agreement was specifically reached to ensure that both existing and new demand and need could be met. Alongside this, those additional returning staff I mentioned a moment ago are also available for deployment to these services to ensure staffing resilience.

So it is not acceptable to me that care packages are cut – in some instances by 100%.

I expect the steps I have already taken to be used and if there is more that needs to be done to ensure existing packages are not cut and new demand is met, then I hope that colleagues in the sector know that my door is always open and I expect them to come to me with those additional requirements.

I want to turn now to testing. By 22 April, 17,800 health and social care staff, or symptomatic household members, had been tested. 21 per cent of those tested were social care staff.

By the end of April, all 14 Health Boards should have local testing capacity. In terms of testing capacity, we are on track to reach at least 3,500 tests available per day by the end of this month, making steady progress from the start of this pandemic, where capacity was 350 tests per day, from two labs.

We also continue to work with the UK Government on its testing programme, which is expanding both capacity and access in Scotland.

Four UK Government drive-through testing facilities are already operational, with a fifth due to open in Perth this Thursday.

Five mobile testing units manned by army personnel are going live in Scotland this week, and it is anticipated that a further eight units will be live in Scotland within the next week or two.

This increased capacity in our own NHS labs and through that participation in the four nation testing exercise has ensured that we are able to expand the areas and the groups whoa re being tested. So we have increased availability to key workers beyond the Health and Social Care sector using the categories that we have outlined before, and have today also increased testing to all 70-year-old and over admissions to a hospital setting.

In terms of access to the UK four nation exercise, this is controlled through the queueing system managed by the UK Government and through their digital portal.

I want to touch on now on two other issues before I conclude: research and ongoing changes to healthcare delivery.

The pandemic has required fundamental change to how health and care is accessed and delivered. This has involved a significant reorientation of resources, and the incredible support and efforts of local leaders, planners, clinicians – in fact the entire workforce. The work has included:

preparing to quadruple ICU beds and ensuring there is sufficient hospital bed capacity
significant increases in digital access for health services – with around 60% of GPs now using “Near Me”, and weekly digital consultations increasing from around 300 to over 9,000
the reshaping of primary care to support COVID-19 hubs with 24/7 access
shielding almost 150,000 clinically vulnerable people and focusing multi-disciplinary teams working on anticipatory care planning with them
and expanding mental health support by moving towards a 24/7 NHS24 mental health hub and digital therapies

What is clear is that, in line with our framework for decision making that was published last week, we need to achieve a careful balance in managing our healthcare capacity going forward including our commitment to continue to treat emergency, urgent and maternity cases.

So we will continue to work closely with Health Boards and their partners to ensure there are robust plans in place to safeguard local resilience and responsiveness, whilst we also consider how and when we can increase the business as usual work of our NHS.

The incredible levels of compliance with social restrictions that we’ve seen show a clear willingness on the part of the people of Scotland to think beyond individual health to population health. As we move to introduce the test, trace and isolate measures required, we will need that focus on population health to continue.

Finally, I want to update you on research proposals for COVID-19 that we launched on 25 March.

139 proposals were received from across Scotland’s Universities and Research Institutes.

Following an independent expert review process, 55 projects have been selected for funding.

This has resulted in a Pan-Scotland portfolio of research, with 15 different institutions leading on projects.

In summary, the outcome of the call is a programme of projects meeting the aim of establishing a broad Scottish programme of high quality research on COVID-19 that will be delivered rapidly and inform policy and clinical practice in responding to the pandemic.

Presiding Officer, I continue to be grateful for the tremendous resilience of our health and social care staff, our key workers, and most importantly people all across Scotland.

Together, we are making progress, we are suppressing the virus, we are saving lives and we are showing that we can continue to rise to the challenges of this pandemic.

Thank you.

PPE access extended to all social care providers

Everyone who provides social care will have access to appropriate PPE under new arrangements announced by the Scottish Health Secretary.

From Monday (27 April), local Hubs will distribute PPE supplies to the whole of the social care sector where normal supply routes have not been successful. These hubs will extend their provision to include all social care providers, and unpaid or family carers and personal assistants.

During the coronavirus (COVID-19) pandemic, global supply chains have been put under immense pressure and that is why the Scottish Government has set up supplies of PPE to support the social care sector from the national stock.

Health Secretary Jeane Freeman said: “The Scottish Government values the importance of everyone who is providing social care and we want to ensure they have access to appropriate PPE.

“As we respond to the challenges from global scarcity of PPE, we have worked with partners to agree an improved model that will ensure all social care providers have access to supplies from national NHS stock.

“This has only been possible because of a shared aim to ensure the right PPE gets to the right people at the right time and to keep everyone safe.

“In the coming weeks, we will collectively monitor how this model is operating, identifying challenges quickly and taking action as we deal with the evolving nature of the pandemic.”

Health and Social Care spokesperson for COSLA, Councillor Stuart Currie said: “COSLA welcomes this announcement which will ensure PPE provision for unpaid and family carers and personal assistants.

“Local Government has worked with partners across the sector to develop this model to ensure those who are supporting vulnerable people within their communities and all parts of the workforce have access to the PPE they need.”

PPE on it’s way to care homes across Scotland

Additional supplies of Personal Protective Equipment (PPE) are to be delivered directly to care homes across Scotland to help meet the increased demand caused by the coronavirus (COVID-19) pandemic.

NHS National Services Scotland will prioritise the delivery of stock directly to care homes where the virus is known to be present.

Stock will also continue to be provided to local hubs which supply PPE to other social care workers.

Each location will receive a week’s supply of equipment, including aprons, fluid resistant surgical masks and gloves.

The situation will be reviewed next week based on information supplied by care homes on their own supply of PPE stock.

The National Services Scotland Social Care triage service will continue to provide an emergency service in the case of unexpected short term demand.

Health Secretary Jeane Freeman said: “The dedication of those who work in the care sector is hugely appreciated and ensuring those staff are protected is a priority for me.

“They are doing a remarkable job in very difficult circumstances, and we will support them as they do that.

“We have dedicated teams working on the procurement and distribution of PPE to our health and social care workers.

“I believe that providing additional supplies straight to care homes will ensure all care homes in Scotland have enough PPE to allow them to continue to safely provide care and support to their residents. It should also allow time for care homes to work on sourcing their own stock.

“We are also working closely with COSLA to ensure the existing service provided by the local hubs is working as efficiently as possible.”

Scottish Care Chief Executive Donald Macaskill said: “Scottish Care warmly welcomes the announcement by the Cabinet Secretary that direct distribution of PPE to care services will be introduced.

“This will significantly support the protection of staff, residents and clients and the staff who care for and support them.

“I am grateful for the immediacy of response from Scottish Government and the recognition of the need to take these measures with urgency. All of us are working with determination in challenging circumstances to meet the threat of coronavirus.”

On Thursday, Social care providers and unions warned that a critical lack of protective equipment and testing has allowed coronavirus to “sweep through” social care.

In a joint statement – signed by the Association of Directors of Adult Social Services, UNISON, Unite, GMB and TUC – ministers are told that care workers and residents are still being exposed to unnecessary risk.

The care providers and union leaders warn that staff are being forced to risk their lives with care services struggling to get the equipment they need:  

“Social care is facing a crisis without precedent. Problems with supplies of protective equipment and a lack of testing is causing much anxiety amongst employers, staff, and the families of the people they care for. Many care home residents and care workers have already died.

“People who rely on social care are often more vulnerable to catching and dying from Covid-19. Yet a month into this crisis, many care workers are still working without suitable PPE, despite their heightened risk of exposure to the virus and to spreading it.

“A critical lack of PPE and testing of social care staff and service users is putting them at unnecessary risk of exposure – and means we are almost certainly underestimating how far the virus has spread.

The care providers and union leaders say that without urgent action the virus will continue to devastate the sector:

“When patients with Covid-19 are rapidly discharged from hospitals to care homes to free up NHS beds, it risks spreading the virus to care homes and putting staff and residents in danger.

“We are pleased that the government has at last published its strategy for social care. But it needs to go further and action will be more important than words.

“Amidst growing evidence that Covid-19 is sweeping through social care with devastating results, we call on the Government to step up the fight against Covid-19 by:

Publishing a national procurement and distribution strategy for PPE that includes the social care sector, so that care homes and social care providers aren’t left to source their own PPE amidst global shortages and inflated prices.
Setting a clear deadline for when all care workers, clients, personal assistants and residents who need it will have access to testing.
Stopping the rapid discharging of Covid-19 patients to care homes unless there are key checks about safety
Fully involving the social care workforce and its unions and employers in responding to the crisis.

The care providers and union leaders say ministers must “learn the lessons” from the crisis and provide better funding for social care in the future:

“Carers, local government, providers, regulators and civil servants are working tirelessly to respond to the crisis. But social care has been the poorer cousin of the NHS for too long. This pandemic is showing just how essential this largely female workforce is.

“Social care workers look after us all. Our parents, our grandparents, our partners, siblings and adult disabled children. Their work has long been undervalued, with services underfunded, staff often on the minimum wage or zero hours contracts and 122,000 vacancies in the sector.

“When this dreadful pandemic eases the Government must learn vital lessons about the failings of a social care system based on low pay and insecure work and put in place proper funding and a long-term plan for social care as soon as possible.”

We CARE: Hancock launches care sector action plan

The UK government has published an action plan to support the adult social care sector in England throughout the coronavirus outbreak.

New action plan to reduce outbreaks in care homes, support care staff and providers and maintain independence of those receiving care
Plans to boost access to PPE, ramp up testing for care sector and recruit more staff
Unifying new ‘care’ brand for care workers with NHS-style identity, to ensure recognition and access to benefits during crisis and in response to ask from sector

Better access to testing, millions of additional PPE items, expansions to the workforce and a new brand to further recognise the sector’s contribution to society are at the heart of a new action plan to support the social care sector through the coronavirus outbreak.

The Government has committed to ensuring that all care workers who need a test receive one, and all symptomatic residents in a care home will be tested to prevent outbreaks. Over 4,000 social care workers have already been referred for testing so far.

Everyone going into a care home from hospital will be tested with immediate effect. Currently the first five residents with symptoms are tested to provide confirmation of whether there is an outbreak.

The way PPE is being delivered to care homes is being rapidly overhauled, with homes supported to order PPE quickly, including through direct dispatches via Royal Mail, a 24/7 hotline and a new pilot website.

Secretary of State for Health and Social Care Matt Hancock said:  “We should all be proud of our incredible care sector who are fighting this battle against this virus on the frontline.

“Our care staff come to work day-after-day supporting our most vulnerable in these incredibly challenging times.

“Today we are introducing a new CARE brand that can be worn with pride, and it will signal to everyone that they belong to a strong, united and respected family.”

Over 1.5 million frontline care workers will now be able to unite under one banner to help create an NHS-style single identity to better celebrate and recognise the care sector.

This will be based on the existing CARE badge, which was launched as a unifying symbol of pride for the social care sector by Care England and the National Care Forum.

This will make it simpler for care-givers to access benefits such as priority shopping hours, in the same way as NHS staff and will recognise the integral role social care workers are playing in responding to this outbreak and supporting vulnerable people.

The action plan also outlines plans to expand the social care workforce by tens of thousands through a new recruitment campaign that will highlight the vital role of care staff, backed by a new online learning platform to rapidly upskill new staff.

Social care providers across England have already received an emergency drop of 7 million PPE items, so that every CQC registered care provider received at least 300 face masks to meet immediate needs.

In the coming weeks, a dedicated supply chain will be in place for social care, which will mean social care providers can make orders and have them dispatched directly to them – in line with the NHS and Local Resilience Forums.

Care providers unable to get PPE from their usual suppliers will be supported by a 24/7 hotline and a dedicated, in-house team at the National Supply Disruption Response (NSDR), who can rapidly pack and deliver PPE to providers.

The UK Government is also working with e-commerce experts to pilot a website which will allow care homes to order PPE online, using NHS Supply chains and shipped directly via Royal Mail.

Minister for Care Helen Whately said: ”The care workforce is playing an essential role in the fight against Covid-19, and they deserve the same recognition and support as NHS staff.  

“This virus has brought many challenges to the sector and today we are setting out how we will ensure care staff have all they need to do their jobs safely.

“We are keen to get as many people on the care frontline as possible which is why we’re launching a campaign to attract people to the sector to support the national effort. I urge former social workers, occupational therapists and nurses to return to the sector to join the fight to protect our most vulnerable.”

The plan also gives guidance to help minimise the spread of infection within all care settings. This includes advice on safe discharge from the NHS, including testing prior to discharge and when isolation is recommended.

This follows the announcement by the Health and Social Care Secretary yesterday that all care home residents and social care staff with COVID-19 symptoms will be tested as capacity increases.

Dedicated testing has already begun for frontline staff, including social care workers and in addition to over 20,000 tests for NHS workers and their families.

The Care Quality Commission (CQC) are working in partnership with ADASS and local providers to lead the coordination of regional testing and have already offered testing to 11000 care facilities. All registered care providers will be contacted in the coming days so employers can identify staff eligible for testing in line with PHE guidance and refer them to their local testing centre.

Chief Executive of Care England Professor Martin Green OBE said: “The social care action plan gives us a framework on which we should build the future of social care, as well as showing the important role social care is playing to support people in this current health emergency.”

To attract 20,000 people into social care over the next three months to relieve pressures in the care workforce, in the next few weeks we will re-launch our national recruitment campaign to run across broadcast, digital, and social media.

The campaign will highlight the vital role that the social care workforce is playing right now, during this pandemic, along with the longer-term opportunity of working in care. A new online platform will be developed to streamline the recruitment process for candidates and employers.

Previously registered social workers in England, occupational therapists and nurses are being invited to return to the sector to support the frontline effort. Over 7,000 retired nurses have responded to a call to return to employment – some of whom will be deployed to care settings.

The government has invited former social workers who have left the profession in the last two years to return to employment – with the aim that 8,000 social workers could be supported to return to work if they wish to. Over a thousand individuals have already expressed an interest in returning to social care during the outbreak.

Last month, the government announced £2.9 billion of funding to strengthen care for the vulnerable as part of the government’s commitment to ensure NHS and social care system, and other public services, have all the resources they need during the COVID-19 outbreak.

Joint Chief Social Worker for Adults, Mark Harvey and Fran Leddra said: “The social care workforce supports our families, friends and neighbours in the millions every day.

“They provide care and support to sustain in some of the most important elements of our lives – relationships, companionship, inclusion, meaning and aspiration. They enable people to not only get the best care possible but to also continue to contribute to and be a part of society. Our social care staff are there to make moments such as end of life as respectful and caring as possible, as this becomes more of a reality.

“We have both worked in social care all our lives and everyday find ourselves in awe of the dedication and commitment that care workers, social workers, and occupational therapists amongst many others have always shown and now in responding to COVID-19 and the new challenges that it has brought.

“We are delighted that the new CARE brand will provide much-deserved recognition to the social care workforce, and continue to be grateful to those returning or joining the workforce at this time.”

The new social care action plan has been published on GOV.UK

UK Govt. to offer testing for “everyone who needs one” in social care

All care home residents and social care staff with coronavirus (COVID-19) symptoms will be tested as capacity is built up, the UK government is announcing today.

All symptomatic care residents will be tested for COVID-19 as testing capacity continues to increase
All patients discharged from hospital to be tested before going into care homes as a matter of course
All social care staff who need a test will now have access to one with the Care Quality Commission (CQC) to contact all 30,000 care providers in the coming days to offer tests

Currently the first 5 symptomatic residents in a care home setting are tested to provide confirmation of whether if there is an outbreak.

However, as lab capacity increases every day the government is expanding testing to include all care home residents who develop symptoms.

The safety of residents and staff is a priority and as such, testing will now also be provided to all potential care home residents before they are discharged from hospital.

This will provide reassurance and peace of mind to residents and family members, and will help care providers to take appropriate action to ensure that social care workers and other residents are safe – including implementing isolation procedures for those who test positive.

The measures confirmed today are expected to be outlined further in the government’s COVID-19 social care action plan tomorrow, and will help give residents, their families and those that they care for peace of mind.

Secretary of State for Health and Social Care Matt Hancock said: “I am deeply conscious that people in residential care are among the most vulnerable to coronavirus.

“We are doing everything we can to keep workers, residents and their families safe, and I am determined to ensure that everyone who needs a coronavirus test should be able to have access to one.

“We have already begun testing social care workers and will roll this out nationwide over the coming days. And as we continue to ramp up our testing programme, we will test all current care home residents with coronavirus symptoms and all new care home residents who are discharged from hospital into care.

“Testing is key in our battle against coronavirus, and as part of our plan to prevent the spread and save lives we will ensure that everyone in social care who needs a test can have a test.”

As the rollout continues, the Health Secretary has confirmed that every social care worker who needs a test can now get one.

Dedicated testing has already begun for frontline staff, including social care workers and in addition to over 20,000 tests for NHS workers and their families.

As capacity grows further through the government’s new mega labs, it will prioritise the testing of symptomatic social care workers and anyone in their household who have COVID-19 symptoms.

CQC are leading co-ordination of testing for the care sector, and have already offered 6,000 care facilities the opportunity to test their staff. By the end of the week they will have contacted all 30,000 care providers.

Care providers will identify workers eligible for testing and refer them to their local testing centre.

Tests for social care staff and residents will support the government to achieve its ambition of 100,000 COVID-19 tests a day by end of April.

Remember families who receive care at home, urges charity

A social care charity is appealing to the Scottish Government to remember families who receive care in their own homes, and the carers who provide that care, during the Coronavirus pandemic.

In a letter to Jeanne Freeman, the Cabinet Secretary for Health and Sport, the chief executive of the Scottish Personal Assistant Employers Network (SPAEN), Colin Millar (pictured), calls for action to urgently address what he describes as a “crisis”.

He writes: “We are writing on behalf of SPAEN’s 500 Direct Payment employers and the 1,500 or so others throughout Scotland who have chosen to use a Direct Payment or Option 1 to meet their social care needs.

“We are receiving frequent requests for information, advice, support and calls for SPAEN to raise these continued concerns and matters with the Scottish Government, Scottish Parliament and CoSLA as the body representing the local authority councils distributing these funds to PA employers.

“The experience of Direct Payment users in Scotland is harrowing and deeply concerning.

“They continue to report that they have little or no access to PPE and they are getting no information or updates on when or how this will be resolved.

“They continue to be fearful for themselves, their families and loved ones and their employees, their employees’ families and loved ones, all of whom risk their own health and welfare on a daily basis to provide key social care services to people in their own homes and who are placed at unnecessary risk of transmission of this virus due to a lack of PPE.

“Direct Payment employers want to follow, fully, the Scottish Government’s published guidelines on the use of PPE but they cannot do so without being given access to the vital equipment they need.

“Some callers to local authority councils are being advised to use their ‘current supply chain’ to access this. Many Direct Payment employers will not have a ‘supply chain’, they will be purchasing PPE on an ad hoc basis as and when required and permitted through the Direct Payment agreement.

“The normal suppliers are not able to meet the demand as commissioning is done at a strategic level either through the HSCP or the Scottish Government, resulting in a scarcity of PPE for people who are not supplied via these statutory bodies.

“We are aware that a number of other charities and organisations have made similar representations to the Scottish Government.

“While we do not represent unpaid carers, we have seen a huge increase in contact from these groups who are also deeply concerned that they are unable to access support or PPE.

“While we are in a period of crisis, and this is without doubt such a period, we are calling for a fundamental review into how Direct Payment recipients in Scotland are represented and supported at national and regional level at the earliest opportunity.

“After 20 years’ of representing Personal Assistant Employers across the length and breadth of Scotland, thanks to the support of the Scottish Parliament and contemporary Scottish Governments, this year SPAEN’s services are being retracted, due to funding cuts. This outbreak calls into question the logic behind such a decision and we are calling on the Health & Sport Committee to review this decision at its earliest convenience.

“Without a national body representing PA employers, these and many similar issues will simply not be raised and people electing to exercise their right to use a Direct Payment, as per the current legislation, will be further eroded.

“Ironically, it is in times like these that many people assessed as requiring social care support are seeking Direct Payments as care agencies and local authority run home care services are withdrawn or re-assessed with little or no notice or consultation.

“We’ve had repeated requests from people affected by decisions to remove their existing social care support either through care agencies or local authority home and support services where staff absenteeism has presented significant logistical challenges.

“We have requested and continue to lobby for Direct Payments to be made available to anyone and everyone who has an assessed social care need and specifically as a direct alternative where existing social care arrangements are being withdrawn as a result of Covid-19 or related resource issues.

“Peoples’ social care needs cannot, unfortunately, be abated to accomodate resourcing issues and there has already been assurance from the Cabinet Secretary that no-one should lose the support they’re already assessed as requiring.

“SPAEN represents over 500 individual employers who have equal concerns and responsibilities.

“SPAEN would welcome any invitation to join the discussions being held by the Scottish Government to discuss the current challenges facing all of social care to ensure our membership and the many hundreds of others using Direct Payments are fully and properly represented.”

Care Homes: Time for Action is NOW

What started as a sense of unease about the extent to which care homes are getting the Government help they need is turning rapidly to anger and real alarm (writes Age UK charity director CAROLINE ABRAHAMS).

Some 400,000 older people live in care homes in this country and the vast majority are vulnerable by any definition; most have dementia or other forms of cognitive decline, often in combination with serious long term physical health problems like diabetes and heart disease.

Existing problems

Even before the coronavirus crisis hit there were big worries about financial resilience and the capacity to deliver consistently good care across the care home sector. Although care homes are by no means all the same some problems are common to most: difficulty in recruiting and retaining enough good, trained staff being near or at the top of the list, leading to under-staffing and over reliance on expensive agency workers.

For those care homes that take any State funded clients there have also been big and growing problems making ends meet while delivering decent quality, since the State is an exceptionally mean paymaster, in apparent denial about just how much this costs.

Meanwhile, we have somehow got ourselves into a position in which care homes are operated for the most part by many small private providers on the one hand, and a number of corporate chains on the other, with the owners of the latter often based abroad and involved in complex financial arrangements, as a result of which it can be hard to see where accountability lies and what priority is really being placed on delivering good care to a highly vulnerable group as opposed to turning a buck.

From bad to worse

Then coronavirus arrived. Given how unwell most care home residents already are and the fact they are clustered together, plus the deficits in the care home workforce, it was always going to be very important to make sure everything reasonable was done and done quickly to help care homes keep the virus out and, if and when it got in, fight it effectively so it infected as few older people and staff as possible.

However, a month or so into this crisis now it is becoming apparent that many care home are struggling: in particular, they can’t get enough Personal Protective Equipment (PPE) to keep staff and residents safe and they can’t get tests to see who has got the virus and who hasn’t.

In some cases it seems they are being told that it is their job to provide end of life care for residents who are sadly dying from the virus, without enough back up support from GP and community based palliative care services, and without the possibility of these older people being admitted to hospital.

Where are the funds?

In addition, while local authorities have been given extra funding from central Government to support social care, some care home providers are complaining they are yet to pass it onto them, while meanwhile their costs are rising due to an increased reliance on agency staff due to significant numbers of their usual staff being off sick or self-isolating, plus the rise in the national minimum wage.

That’s not the end of it though: tragically, the need to protect residents led to a ban on families visiting, though recently rescinded in exceptional circumstances such as when someone is dying: however, without there being enough PPE it is hard to see how this can really work. And finally, although it is quite clear that the virus has affected significant numbers of care homes and some residents are sadly dying, we do not know how many because official figures are not being collected.

A let down

In short, it’s a mess and one that means care home residents, their families and staff are all being badly let down. It would not be an exaggeration that some are paying with their lives. Why has this tragedy come about? Probably in part because there is simply not enough PPE and testing period, and what there is has gone to the NHS first, understandably. An additional problem is that the care home sector is so fragmented that delivering any kind of national response is very hard.

In addition, there was seemingly a degree of hesitation over the question of what responsibility the Government actually bears for this sector, given that it is largely privately rather than State owned.

Tragically, it seems all too easy for the care home sector to fall between two stools: neither genuinely in the community on the one hand, nor in the NHS on the other. This is not a new problem: for many years for example, some care homes have found it hard to get good GP support for their residents, despite the latter’s obvious vulnerability – something the NHS was in the process of addressing when the virus hit through its ‘Enhanced Care in Care Homes’ initiative. The fact this was even needed though shows up the strategic problem, which is, at heart, attitudinal as well as structural.

Care homes need support

In the short term it is imperative that the Governments acts now to give care homes the practical – testing and PPE – support they and their staff and residents are entitled to expect.

In some cases it may be appropriate for residents to stay where they are without being admitted in hospital but this should not be a blanket decision, nor should care homes be left to manage without proper GP and community health service support.

Action is needed to ensure the money that is supposed to support care homes actually does reach the front line – and more of it may be needed too. And a system is required to count the numbers who are sadly dying in care homes, to demonstrate they really do matter and to aid planning both now and in future.

Longer term the clear implication is that never again can we leave vulnerable older people, and the workers caring for them, so exposed as they have been to coronavirus. The care home sector – social care more generally – is too fragmented for what is in reality an essential public service on which hundreds of thousands of people depend.

The State’s responsibility must be made clear and this and future governments must accept it – but that’s for tomorrow. Today is first and foremost about saving lives.

CHARITIES wrote to the Secretary of State for Health and Social Care yesterday. Their letter said:

Dear Secretary of State,

We are writing together as charity and care sector leaders on behalf of the hundreds of thousands of our most vulnerable people reliant on social care and the hundreds dying in care homes, supported by an army of incredible, often low paid and undervalued care workers who are not trained to deal with death on this scale.

We appreciate the time you and your Ministers have given us this week in seeking to determine a plan for social care during coronavirus. Like you, our priority is keeping people safe in the face of this terrible pandemic.

We are appalled by the devastation which coronavirus is causing in the care system and we have all been inundated with desperate calls from the people we support, so we are demanding a comprehensive care package to support social care through the pandemic.

As a first step we urgently need testing and protective equipment made available to care homes – as we’re seeing people in them being abandoned to the worst that coronavirus can do. Instead of being allowed hospital care, to see their loved ones and to have the reassurance that testing allows; and for the staff who care for them to have even the most basic of PPE, they are told they cannot go to hospital, routinely asked to sign Do Not Resuscitate orders, and cut off from their families when they need them most.

A lack of protective equipment means staff are putting their own lives at risk while also carrying the virus to highly vulnerable groups. Care professionals that have this equipment are using it in line with the guidelines – there’s just not enough getting through to the frontline. Care England estimates that there have been nearly a thousand deaths already, yet deaths from coronavirus in care homes are not being officially recorded or published, social care is the neglected frontline.

Older people’s lives are not worth less. Care home staff are not second class carers. The Government must step in and make it clear that no-one will be abandoned to this virus simply because of their age, condition or where they live.

A comprehensive care package must include:

PPE equipment readily available to care homes. Without it, all residents’ lives are at risk
Care home staff, and people being discharged from hospital into care homes, given priority testing, alongside critical NHS staff
Support to ensure contact can be maintained between care home residents and their families
Good palliative and end-of-life care for people dying in the care system
A daily update on coronavirus deaths in the care system, just like deaths in the NHS, so that as a society we can understand the scale of the challenge we face.

We know how hard you and your colleagues in Government are working to protect the country from the worst effects of the pandemic. We would like to reiterate our offer to provide support to develop the strategy for social care at this time of crisis. We will continue to do all that we can to make sure families reliant on social care get the protection that they need.

With best wishes,

Kate Lee, CEO Alzheimer’s Society

Matthew Reed, Chief Executive, Marie Curie

Caroline Abrahams, Charity Director, Age UK

Professor Martin Green OBE, Chief Executive, Care England

Deborah Alsina MBE, Chief Executive, Independent Age

Figures released this morning by the Office of National Statistics show that 217 coronavirus related deaths were recorded in care homes in the week ending 3rd April – a tenfold rise on the week before – Ed.