Agenda item

This report highlights how domiciliary care and community services responded to the difficulties that the Covid19 pandemic brought in relation to these services.  It aims to highlight the capacity of the Homecare Framework Providers’ ability to maintain their continuity of care during this difficult period.

The report includes a summary of how the Covid19 virus impacted on Direct Payment and day services.

Discussion:

The Director introduced a report which highlighted how the domiciliary care and community services had responded to the difficulties that the Covid 19 pandemic brought, including the capacity of the Homecare Framework Providers’ ability to maintain their continuity of care during this difficult period.

The Director undertook to convey the Committee’s thanks to the teams involved.

The following issues were discussed:

·       Healthwatch report – with reference to the Healthwatch report setting out the outcomes of the social media campaign to support hidden carers, it was noted that some of the responses about asking for and receiving help were very negative. How the Council intended to respond to these experiences was queried as well as what more could be done to support and listen to carers in a more structured way.

Officers responded that the Healthwatch report had highlighted a number of issues, particularly around the extent of hidden carers, and the recommendations and issues raised in the report were being examined to see how they could be embedded.

·       Carers - the point was made that carers provided a professional service and should be paid accordingly. The Director commented that carers remained key to supporting some very vulnerable clients and intervened in their lives with sensitivity and dignity. There was also a low level of safeguarding concerns. The Association of Directors of Social Services continued to lobby the Government for the sector to be adequately paid. A government review of adult social care was expected which could potentially lead to a better reflection of the value they provided.

·       Testing domiciliary care workers – in terms of what was being done to test this group, the Director of Public Health advised that domiciliary care providers and staff working in extra care and those in supported accommodation were starting to be tested. How to test people in receipt of care was under review. The Council was bidding for lateral flow testing devices and was looking how to roll this out across high risk groups, which may include the care sector.

·       PPE -  the point was made that the use of PPE by carers appeared to be inconsistent. Whether the pooled budget set up to provide PPE would continue was questioned and Members were advised that PPE in the second Covid wave would be provided free of charge. In addition, the Council had been clear with providers what was expected in terms of training for staff and use of PPE.

·       Free travel for domiciliary care workers – reference was made to how these staff had continued to work with many having to rely on public transport during the pandemic. Whether they could receive free travel on buses in Medway during the second wave as some in other areas had during the first wave was queried. The Director of Public Health undertook to look into a suggestion that carers be provided with free travel on buses.

·       Digital App for Mental Health Assessments -the Director clarified that the aim of the App was to provide easier access to a Section 12 doctor so mental health professionals could carry out a joint assessment.

·       Basket of hours approach – it was clarified that home care had traditionally been commissioned in terms of a total number of hours. The basket of hours approach meant that a weekly number of hours was commissioned to best meet an individual’s needs and this allowed care to be tailored.

·       Staff welfare – how the Council ensured that care staff were being treated properly by their employer was queried. The Director commented on the importance of effective monitoring to ensure staff were being treated well by their employers, a role shared with the Care Quality Commission and Healthwatch.

Reference was also made to the significant impact on the mental health of carers when dealing with clients who were distressed because they could not see close family members. Officers advised that a difficult balance had to be struck between maintaining a safe environment and acting in a humane manner. The Council had written to all care homes on what they needed to do to facilitate access to family members where a relative in a home was nearing the end of their life. Some homes had been innovative in making adjustments to allow visits to safely take place and funding for this could be available from the Infection Control Fund.

Often social care staff were visiting clients digitally from their own homes and having to deal with distressing situations. The Council had provided a lot of support to help staff with the pressures this could cause. The resilience of care staff was key and while sickness absence levels had not increased there was more that could be done.

·       Domestic abuse – the point was made that the report made no mention of domestic abuse in spite of the possible increase in homes where some care services had not operated during the lockdown. Whether there were procedures in place for carers to be able to recognise and report this was questioned. The Director commented that some households had experienced high degrees of pressure during the lockdown and he considered that there was hidden harm yet to come to the surface.

·       The role of the voluntary and community sector – the Director agreed with comments made about the importance role of the sector in helping the Council deliver its care responsibilities and how the Council would never be able to afford to pay for the vast amount of unpaid care in the system.

Decision:

The Committee agreed to note the report.