Meeting documents

To receive the report.

The Committee considered a detailed report on the key areas of activity that have been undertaken by Somerset County Council Adult Social Care (ASC), with its partners across health, care providers and the voluntary sector; relating to the care of vulnerable adults and their carers during the pandemic.  The Committee heard that there have been a number of changed requirements and "easements" proposed to the way ASC is delivered by Councils across England. These are contained in the main in the 19th March 2020 Hospital Discharge service requirements documents, and the Coronavirus Act 2020.  Finally, in terms of background papers there is the Covid 19 Adult Social Care Strategy which was summarised in Appendix 3. The key areas covered in the presentation will include: -

·         The new operational model for ASC Discharge from hospital – changes to the joint Hospital Interface Service,

·          Integration and locality working, and

·         Support for commissioned services and providers.

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The planning for worst-case numbers affected by the pandemic resulted in a need to move quickly and with real purpose to work better with health care colleagues.  It was clear that the care sector and care homes would need considerable support to cope with the demands of a pandemic. Somerset has been noted at a national level for the support put in place. This has included a dedicated webpage, guidance, news and information, as well as a dedicated email address so response to any emergency can be quick and effective. Somerset has given a 10% uplift in fees for three months in recognition of the anticipated additional cost of PPE and agency staff. Two new interim Care Homes were identified in Henford Court in Yeovil and Popham House in Wellington. These offered transitional support and care for people leaving hospital following treatment for a Covid 19 infection. The Care Home in Yeovil is operational, and Wellington remains an option should there be a demand.

Community Connect has identified all clients who need shielding. Village Agents and Community Support workers have made contact with most and offered a range of support. The interface with hospitals in Somerset is still the Home First service, and this has ensured a 50% of bed capacity in hospitals.

£1 million a month has been used to support providers of Care across Somerset, and SCC is offering a 7 day a week service, linked to GP surgeries, to support Pathways out-of-hospital care. There is now a better hospital avoidance and discharge service, which will prevent admission in the first place and speed up patients return to home. The is being run from a ‘Discharge Lounge’ to make sure the right support is in place at the right time.

The Committee discussed the current position on reviews of care. The number of overdue reviews has dropped and is on track to be down to about 40. The Committee noted that there will always be some that are recorded as ‘overdue’, but in fact this is because they take longer than the 28 days to complete.

The Committee observed that there has been a reduction in the number of people placed in care homes on a permanent basis but an increase in temporary placements. This was because it took longer for people to recover from Covid-19 infections.

Testing in care homes for Covid-19 infections has increased. The Committee were interested to have some local information on deaths in care homes, as this had become the focus of national interest. The Committee heard that in an average April (based on the last three years’ data) there would be about 66 deaths in care homes across Somerset. This April there have been 98. The Committee understood that not all were Covid-19-related, and it was too early to make simple mathematical deductions from this raw data.

The Committee discussed the report and paid tribute to the staff working so hard across the County to support the care sector during this current pandemic. Feedback to Committee members has been that many care homes feel very supported by SCC. There have been some occasions on which care homes not operated by SCC have felt support was lacking. The Committee were invited to let officers know of specific cases where the support could be better.

There was some discussion around the supply of PPE (Personal Protection Equipment). The Committee welcomed the quantity of equipment being supplied to care homes, but there had been some anecdotal evidence that the quality was not always the best. The Committee were again invited to encourage feedback but was assured that the equipment being distributed was appropriate to the needs of each location and setting and was quality-controlled.

There was a discussion about going beyond the expectations of national Government and then not being able to recover or justify the spend. The Committee agreed that it was essential to provide PPE in advance of the supplies being sourced by the Government. The funding for the two additional nursing homes and some of the PPE costs would come from the CCG. The response was proportional to the need at the time and was reasonable given the request to prepare for ‘worst-case scenario’. The Committee agreed that although the first peak may be in the past, it was not clear what will happen once the lockdown measures are lifted.

The Committee asked about disability and carers services in lockdown. It was confirmed that some of the support is still being offered in a different way and that Carers who had refused support in the early days of lockdown were now beginning to emerge and seek support. Community Connect and Village Agents have changed the way they work but continue to offer support in other ways. The Committee asked about micro-providers and access to PPE. They were assured that they were all included in distribution of supplies, and the pandemic has increased the number of such providers.

The Committee asked about the number of vacancies being advertised by SCC and its contractors, concerned this might be an issue. The vacancies are part of natural churn, and SCC is always advertising in this area, as recruitment is an ongoing activity. The Committee heard that the pandemic has encouraged more people to consider care as a career option.

The Somerset Scrutiny for Policies, Adults and Health Committee:

·         Thanked all the officers and staff who had responded so well to the challenge of the current pandemic.

·         Agreed to encourage those with concerns about supply of PPE or needing support to get in touch with the dedicated e-mail.