Social care crisis must be addressed, says Royal College of Emergency Medicine

Commenting on the latest Urgent and Emergency Care Daily Situation Report 2021-22 that shows nearly one third of patients who were in hospital for 21 days or more were fit for discharge, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “These data reflect the deepening social care crisis.

“We currently have the highest number of long stay patients (21 days or more) since winter 2017-18. Last week, on average, 6,500 beds were occupied by patients who are fit for discharge, and only one in 10 of these patients were able to be discharged daily (on average). All these patients will want to return home and to their communities, but they are unable to because there isn’t the support to aid them upon their discharge.

“There must be a system-wide effort and focus on discharging patients, but such effort will only translate to meaningful action if the government address and take urgent steps to resource social care. Freeing up these beds would help alleviate system pressures, particularly those on Emergency Departments, and promote vital flow throughout the hospital.”

The latest Urgent and Emergency Care Daily Situation Report 2021-22 for the week 10 – 16 January 2022 show:

  • As a daily average 17,541 patients stayed in hospital for 21 days or more
  • As a daily average 6,495 of these long-stay patients were fit for discharge, this is equal to nearly one in three
  • On average only 656 patients were discharged daily, equal to just one in 10

Joint pledge to ensure essential support for social care prioritised

Support for social care is to be intensified as a national priority alongside the NHS and emergency services, as staffing pressures and increased demand reflect the extent and nature of the spread and effect of Omicron.

As a result of staffing availability due to Covid,  the Scottish Government and COSLA, working with local partners across the public services in Scotland, have agreed a joint approach to maximise social care support to ensure people receive the care they need, dignity and human rights are upheld, and to avoid further pressure falling on the NHS.

Some local public services report that pressure is very significant with some health and social care partnerships being asked to prioritise capacity and identify staff who can be deployed to sustain and maintain support for some of the most vulnerable people in society. This may mean some other services are temporarily paused or reduced to redeploy capacity and expertise.

Deputy First Minister John Swinney said: “In order to protect life preserving services, and protect the vulnerable, local authorities and public services will prioritise what they deliver in the weeks ahead as a result of staffing availability due to Covid.

“That may mean some services being closed for a period or operating on reduced hours or service levels. This will free up resources to make sure we can deliver core, essential services. As soon as demands and resources allow, any affected services will resume normal operation.

“People across public services and critical national infrastructure are working hard to keep essential services going. In a lot of cases they are already being asked to be flexible to cover for absent colleagues.

“I am grateful to everyone who is helping us through this difficult period. The Third Sector has a huge amount to offer while the private sector and employers can contribute, either by releasing staff who can help in this effort,  or by supporting carers leave for family and friends who might need it.

“Local public services are delivering national priorities and programmes such as testing and vaccination programmes, delivering business grants, self-isolation grants and support, and much more.

“They have played a key role throughout the pandemic in supporting vulnerable people and key workers. That partnership between local and national government is, and will remain, essential.”

COSLA President Alison Evison said: “Once again, no matter the ask, councils along with other public services will rise to the challenge in terms of providing an appropriate local response. As the sphere of government closest to our communities across Scotland, once more Local Government will play our part in the Covid response. 

“Where pressures on staffing levels are identified, help and support for those most vulnerable as well as the life and limb services in our communities will be prioritised.  As it has been throughout the pandemic, Health and Social Care and keeping people safe will be front and centre of local prioritisation.”

Scottish Government and Cosla Joint statement  on social care support

Omicron variant: Social care staff urged to get Covid booster

Support available to ensure care workers can get vaccines and boosters

Care home staff and those working in social care are being urged to get the booster vaccine in the fight against the spread of Omicron variant.

Scottish Government financial support is available for adult care providers who incur additional costs if employees are vaccinated in working time – so staff can do so without losing earnings or having to take annual leave.

Health Secretary Humza Yousaf thanked staff for their efforts but said the new Omicron variant of COVID-19 made it more important than ever that care workers get their COVID-19 booster vaccinations, test themselves regularly and maintain infection prevention measures.

Rates of uptake of the booster vaccine are currently lower among social care staff, with 47.7% of frontline social care workers and 54.8% of care home staff having had their booster, than they are in other sectors such as frontline healthcare workers (72%).

Mr Yousaf said: “I want to thank everyone working in social care who has taken up the offer of vaccination, and has had a booster jag. But I want to encourage every single social care worker to get themselves vaccinated.

“Even if you’ve been double-vaccinated, we know your immunity against COVID-19 wanes over time. Getting your booster is even more important with the emergence of the Omicron variant. Please do so as soon as possible.

“I’m very grateful to all our social care workers for their continued resilience and ongoing commitment during what I know continues to be a very difficult time. I know staff are likely to be feeling particularly fatigued after more than 20 months of the pandemic and I want to thank you all for supporting each other and working together as we continue to navigate through this.

“However we know that the rate of take up among those working in care homes and social care is not as high as in other sectors. It is crucial, especially for those working with some of our most vulnerable citizens, that you get your booster if you have not already done so.

“Getting vaccinated is vital in protecting you, those you care for, and your friends and family.”

An online booking portal for health and social care workers can be accessed at: www.nhsinform.scot/campaigns/vaccinations-for-health-and-social-care-workers

Views sought on the best way to introduce ‘Anne’s Law’

The public are to be asked for their views on the best way to support people who live in adult care homes to maintain connections with family and friends.

A five-week consultation is to be held on introducing Anne’s Law – to ensure people who live in adult care homes have rights to be able to have direct contact with people who are important to them in order to support their health and wellbeing.

The Scottish Government is seeking to explore a range of legal and practical considerations in order to make sure  any changes brought in are effective. These include how the new legislation will affect the competing rights and needs of others, including other care home residents and staff.

The consultation follows a commitment made by the Scottish Government in the Fairer, Greener Scotland: Programme for Government 2021-22, which was launched on 7 September, to deliver Anne’s Law. It builds on a  programme of work to enable people living in adult care homes to maintain family and friendship connections.

This includes strengthening the Health and Social Care Standards and a consultation was launched on 16 September seeking views on ways to do this.

Social Care Minister Kevin Stewart said: “Social connections and meaningful activity are important for the wellbeing and quality of life of people living in adult care homes. For many residents, family members or friends also play a vital role in their care, complementing the support provided by care home staff.

“The Scottish Government is committed to bringing in Anne’s Law to  ensure people who live in adult care homes have rights to see and spend time with those who are important to them.

“It is important that we hear views and suggestions on the proposals to achieve this so that we do it in the best possible way.  We want to hear from as many people as possible to help shape the proposals – including people who live in adult care homes, their families and friends, care home providers and staff and a wide range of other stakeholders.”

Anne’s Law is named after Anne Duke who lives in a care home in South Lanarkshire.

Anne’s daughter Natasha Hamilton, from Care Home Relatives Scotland, said: “We are very pleased to hear that the consultation for Anne’s Law is getting underway. The pandemic has caused great suffering for residents and relatives and has really taken its toll on people’s mental and physical wellbeing.

“We have always believed that even during outbreaks, nominated carers such as husbands, wives, parents , sons and daughters should be enabled to spend time with their loved ones just as staff do.

“We sincerely hope legislation can be enacted that recognises the importance of family life for people in care and the need for personal connection and touch.”

 Anne’s Law: proposals for adults living in care homes to maintain family and friendship connections  – Scottish Government – Citizen Space (consult.gov.scot)

Seen something? Say something

National Adult Protection Day 2021

The local body responsible for co-ordinating the safety and well-being of adults in Edinburgh is backing the fourth national Adult Protection Day today (20th February 2021).

Edinburgh’s Adult Protection Committee is hoping to raise awareness of how some adults are harmed or abused. It is encouraging people to act on their gut feeling and say something when they see anything that points to an abusive situation to someone they know or come across.

Harm and abuse can take many forms; physical, psychological, financial, sexual harm, neglect and self-harm but there are usually signs and clues that indicate something out of the ordinary might be happening.

Through the Edinburgh Adult Protection Committee, City of Edinburgh Council, NHS Lothian, Police Scotland and local voluntary sector organisations, are committed to working together to tackle abuse of vulnerable adults.

Jackie Irvine, Chief Social Work Officer at City of Edinburgh Council said: “Everyone has the right to feel safe. However, for some people, a disability, health condition or impairment can prevent them from being able to keep themselves from harm. 

“It’s not always easy to tell if an adult is in trouble, but there are signs and situations to be aware of. For example a person may have unexplained cuts and bruises or refuse to talk about their injuries.

“They may be failing to look after themselves or their property, or are confused where their money has gone, or giving money to people they know for reasons that might concern you. They may constantly be having people – friends or strangers – ‘hanging out’ at their house.”

Anne Neilson, Chair of the Adult Protection Committee added: “We all have a responsibility to look out for people in our communities. If you’re concerned an adult is at risk of harm, or something feels wrong, it’s right to have it checked out. 

“Of course we understand that sometimes members of the public may not want to get involved, intrude  on privacy or  subject another person to unfair accusations. But the process can be simple – you can send an email or anonymous phone call and it will be checked out and any support needed will be given. It may be a false alarm, but there’s no harm in being sure.”

Find out about the types of harm we can help with and if you are worried about an adult at risk of harm you can contact the social work service Social Care Direct on 0131 200 2324

More than half of home care was reduced or stopped completely as a result of pandemic, survey reveals

The impact of the Covid-19 pandemic on home care has been revealed following an online survey by the Scottish Parliament’s Health and Sport Committee.

Published yesterday, the survey found that 54% of recipients of home care saw their care either reduced or stopped completely. In one instance, a respondent reported having their care stopped for more than six months.  Reduction in care was a recurring theme from respondents with families feeling that they were “left to get on with it”.

The survey, which ran during August and September, sought to hear the experiences of both carers and care recipients during the pandemic. Key concerns raised include: 

  • In the event of a second wave, the most important issue for those surveyed was safety. They told us it was vital to have access to appropriate PPE as well as frequent testing, and that carers should receive adequate training in both infection control and social distancing.
  • Additional pressures and a loss of routine led to increased anxiety for unpaid carers, who stressed the need for respite. Respondents felt “mentally exhausted” and “frightened to let staff back into their homes”. 
  • It was agreed that there needs to be greater recognition of unpaid carers who were often “left to pick up the slack”. There were calls for more support and financial help as well as a ‘professionalisation’ of the system, with a move towards a professional career model.
  • A fear of services shutting down again left respondents feeling determined to “not be forgotten about” or “left to manage entirely on [their] own”.  They called for the continuity of care services and care packages to remain in place in the event of future outbreaks.

Speaking as the findings of the survey were published, Committee Convener Lewis Macdonald MSP said: “The first wave of Covid-19 had a devastating impact on the social care sector in Scotland.

“Now that we’re in the midst of a second wave, and continuing national restrictions, it is vital that we hear the voices of home care workers and those receiving care at home across the country. These findings are deeply concerning suggesting over 50% of those receiving care at home saw their care reduced or stopped completely during the pandemic.

“Other concerns raised around mental health, safety, and the prospect of care shutting down again, make it clear that things must improve. 

“The Committee recognises the hard work of carers, paid and unpaid, who have gone above and beyond during this unprecedented challenge and we also want to thank all those who took part in the survey for sharing their experiences in what are still very difficult times.”

Letters: Caring for our older people

Dear Editor

The NHS, in all it’s forms, has been invaluable for people. This is understood: we would all be in deep trouble without it.

It is hard to believe organisations see the provision of health services as a means to make huge profits. One of the biggest dangers for the NHS is countries like the USA.

The importance of the people to own and control the NHS has been a tremendous lesson for all. It is now unthinkable to most that it should be otherwise.

This example of how to benefit society must now be extended to what is called the ‘care sector’. It, too, should be a publicly-owned extension of the NHS, not owned by private cmpanies or a business dependent on grants from local councils.

Every elderly person is exactly that, and must be treated with respect, not as an afterthought on some idea of ‘can we afford the cost?’ We can and must afford it!

The now elderly people need care and attention, love and respect for all they have done for us.

A. Delahoy

Silverknowes Gardens

Almost £3 million more for social care projects

31 projects secure an additional year’s funding

Funding for 31 third sector projects in social care has been extended to March 2022 with the announcement of an additional £2.9 million of Scottish Government backing.

Edinburgh projects include MECOPP, Lothian Centre for Inclusive Living and Thistle Foundation Health and Wellbeing.

Scottish Government’s ‘Support in the Right Direction’ programme was initially funded until March 2021, with funding partner Inspiring Scotland. The programme helps organisations who provide information, advice and advocacy to people accessing and managing their social care across Scotland.

The 12-month extension will enable project staff to continue their vital work helping people and carers navigate their way through the social care system, make the most of the ‘self-directed support’ options available to them, and access the support and care they need in their community.

Cabinet Secretary for Health and Sport Jeane Freeman said: “I am very pleased to be able to extend funding for Inspiring Scotland to manage these projects for an additional 12 months.

“The programme has consistently demonstrated the benefits of ensuring supported people have practical information and advocacy to live their lives.

“Independent advice and advocacy, plus support to make connections in their community, relieves stress and anxiety and helps people and carers maximise their choices and control over their arrangements, which is key to Scotland’s social care system.

“I am grateful to Inspiring Scotland and the individual projects for continuing this vital work and providing additional support to our social care sector.”

Inspiring Scotland Chief Executive Celia Tennant added: “We’re very pleased that all 31 Support in the Right Direction projects will receive funding for a further 12 months.

“This announcement recognises the importance of independent support for people, as part of local health and social care delivery, and provides some stability for these essential charities.”

The Support in the Right Direction programme is managed on behalf of Scottish Government by Inspiring Scotland. 

Click here for Details of the funded projects 

Living Well North Edinburgh update

** Corona Virus Update from Living Well North Edinburgh **

Given the unprecedented situation we are all facing due to the Corona Virus, Living Well will be changing what we do over the coming weeks.

To ensure the health and safety of our visitors and staff we will be closing the building to the public from today – Wednesday 18th March until further notice. This means all group activities run by us will be postponed.

We know that our many members rely on the service we provide. To ensure that we continue to support our members, and play a part in the current network of community support we will running the following from Thursday 19th March:

Monday to Friday

We will be setting a timetable of support groups ran remotely through ZOOM with our support workers. The timetable will be posted to this page and instructions on how to access these services.
We will be reviewing and updating this plan regularly.

The message of being kind has never been more important at this time.
We encourage all our members to reach out and support each other during this time by checking in with neighbours, friends and other members using the various social media outlets.

For up to date advice please check

https://www.nhsinform.scot/…/infection…/coronavirus-covid-19

https://111.nhs.uk/covid-19

Who Cares? Tory concern over hard to fill job vacancies

The Care Inspectorate and Scottish Social Services Council (SSSC) published new figures on the levels of staff vacancies in Scotland’s social care services yesterday.

Edinburgh has the highest percentage, 57%, of services reporting that vacancies are hard to fill and almost half of posts unfilled 49%.

West Lothian, Midlothian and Edinburgh have all shown an increase in the number of vacancy rates with East Lothian dropping slightly to 32%. 

Latest figures show West Lothian had 78 vacancies, 35%, Midlothian had 47 vacancies, 40%, and Edinburgh had the highest number of vacancies in Scotland 334, 49%.

Lothian MSP, Miles Briggs, said: “This report highlights the ongoing challenges of recruitment in Social Care and is another example of SNP Ministers’ terrible record on workforce planning.

“The continued high rate of vacancies for social care makes if very difficult to see improvement to services.

“Issues such as delayed discharge in hospitals and shortages in adult care homes are not going to be fixed until recruitment of staff is resolved.

“Edinburgh and the Lothians have particularly high vacancies for Social Care staff and have higher than average services struggling to fill posts.”

The report comes as the Scottish Government launches a new campaign to promote careers in adult social care ‘There’s More To Care Than Caring’.

The staff vacancies report provides a national overview of vacancy levels and recruitment difficulties reported by care services registered with the Care Inspectorate. It also includes data on the actual number of vacancies services have, which is held by the SSSC.

In the past year, 38% of services reported having vacancies, which is unchanged from the previous year.

However, care homes for adults, care homes for older people, housing support services, care at home services, nurse agencies and residential special schools all had a proportion of services with vacancies significantly above the national average for all care services.

Daycare of children and adoption services were significantly below the national average for all care services reporting vacancies.

At 31 December 2018, the rate of WTE vacancies for all services in Scotland was 5.5%, down from 5.9% in 2017. This was higher than the overall vacancy rate across all establishments in Scotland of 3.1%.

Lorraine Gray, Chief Executive of the SSSC said: “A vital consideration when looking at vacancies in care services is making sure that social care attracts people with the right values, skills and experience to work in the sector.

“We’ve worked with Scottish Government on the adult social care recruitment campaign, launched today, which aims not only to encourage more people to consider a career in care but also emphasises the values you need.

“The social service workforce is growing, there are more than 200,000 people working in the sector, which is almost 8% of all employment in Scotland, so there are lots of opportunities and different types of roles.

“It’s a fulfilling and rewarding career which gives you the opportunity to work towards qualifications as part of a professional workforce making a positive difference to people’s lives.”

Peter Macleod, chief executive of the Care Inspectorate said: “We know that an effective and stable staff team is important for providing the world class care everyone wants to see.

“It allows trusting relationships to be developed between people providing and experiencing care, often supporting positive experiences and outcomes.

“The Care Inspectorate recognises that recruitment and retention into some parts of the social care sector remains a challenge, and we collect significant data about the places and parts of the sector where recruitment problems are more challenging.

“This report has been prepared to provide a national overview of the vacancy levels and recruitment difficulties reported by care services in their Care Inspectorate annual returns.

“We know, of course, that numbers do not tell the whole story. The skills, experiences, and values of social care staff are just as critical as the right number of staff being employed.

“However, going forward we expect to see more innovative solutions embraced by care providers and commissioners, as well as increased partnership working between social care services, local authorities and other key partners to ensure that the underlying issues around filling problem vacancies can be addressed.”

Every care service is asked to complete an annual return every year to provide statistical and other information. The vacancy questions are asked for every care service type apart from childminders, who are typically sole providers.

Staff vacancies in care services 2018