Agenda item

This report provides Members with an overview of MCH’s current position in relation to the COVID-19 pandemic and re-commencement of community health services.

Discussion:

The Director of Operations, Clinical Quality and Nursing at Medway Community Healthcare (MCH) introduced this report which provided Members with an overview of MCH’s current position in relation to the Covid-19 pandemic and re-commencement of community health services.

The following issues were discussed:

• MCH employees – Members expressed their appreciation and thanks for all the MCH employees who had continued to provide an excellent service during the pandemic, noting how valuable it would have been for those isolating to receive a visit from their community nurse.

Concern about staff stress and fatigue was expressed and information was sought about how this was being managed.  The Director of Operations, Clinical Quality and Nursing commented that stress and fatigue had been inevitable given the difficult circumstances staff had found themselves in. A great deal of support and advice was available to staff, including counselling and health and well-being tips. Staff were also good at supporting each other. Staff absences were being monitored and absence rates due to Covid were now 0.99%.  Non-Covid absence rates were not significantly high and were in line with other organisations in the region. However, more pressures were likely to come in the winter.

• Darland House – with regard to the deaths of 21 residents at Darland House, it was queried how this could be prevented during a second wave. The Director of Operations, Clinical Quality and Nursing commented that Darland House was a 40-bed dementia nursing home with highly complex and vulnerable residents. Sadly, a number of deaths had occurred during the very early months of the pandemic where a lack of information and PPE equipment meant that many residents were susceptible to infection. A number of measures were quickly put in place including better separation of residents and staff working in different, non-tactile ways. As a high proportion of the workforce were BAME, more risk assessments had been carried out to better support staff.

An undertaking was given that any significant developments at the home would be communicated to ward councillors.

In terms of how visitors were being managed, Members were advised that visits were by appointment. The process was the same in all the homes run by MCH.

• Physiotherapy service – in response to comments about the cumbersome processes involved in being referred for this service, the Director of Operations, Clinical Quality and Nursing commented this was a national referral system but she would discuss with the Team whether the process locally could be improved.

·      Further Lockdown – whether MCH was prepared for another possible local lockdown was questioned. The Director of Operations, Clinical Quality and Nursing commented that lessons learned from the early days of the pandemic had now been embedded and there was the resilience and confidence to cope with any increase in demand.

• Harmony House – noting the additional 8 beds with potential to increase up to 15, it was queried why 7 beds were not required. The Chief Operating Officer, MCH advised that they were not needed during the outbreak of the pandemic due to the nature of the home and the beds had been converted to community in-patient beds. As there was no need to have all the beds open, it had been agreed to work on one floor only, which was why only 8 beds were needed. The option to open the other beds remained open.

In response to a question about whether Harmony House would return to a dementia unit, Members were advised that it would continue to operate as a community in-patient unit for at least the next 6 months and the possibility of it being also used for respite was being looked at.

• Non-essential services – Members were advised that the majority of non-essential services were now operating at 90-100% of pre-Covid rates. Virtual consultations had helped to reduce waiting lists.

• Elderly shielding population – with reference to the many elderly people now being told they did not need to shield at home, the Director of Operations, Clinical Quality and Nursing was asked what plans were in place to build up their confidence to be able to leave home. Members were advised that staff had kept in contact with shielded patients throughout lockdown and offered advice. In the light of the new advice on shielding, patients would be supported to care for themselves and to build up their confidence to live a normal life. Where staff had been deemed as extremely vulnerable there were risk assessments in place and clear arrangements for them to either work from home or in alternative service areas.

• BAME community and staff – as to what was being done to support BAME staff and the BAME community, the Director of Operations, Clinical Quality and Nursing advised there was a workforce plan to support this vulnerable staff group and MCH worked in partnership to support the BAME community. The Director of Public Health added that the Council had overall responsibility for people who were shielding. Working with its partners, the Council was in a position to support this group where needed during the next phase of the pandemic.  Public Health had carried out a survey to identify challenges facing the BAME community. This community were not more susceptible to becoming infected but were more likely to suffer worse outcomes when infected. The survey results would be used to support people and allay concerns.

Decision:

The Committee agreed to note the report and to receive updates from Medway Community Healthcare every three months.