- Meeting of Health & Adult Social Care Select Committee, Thursday, 4th March, 2021 10.00 am (Item 9.)
The Committee will review the key issues facing Adult Social Care, including the service area’s response to Covid, pressures on the workforce, support to carers over the last few months, vaccinations in care homes, support to care providers and an update on the Better Lives Transformation programme.
Ms A Macpherson, Cabinet Member for Adult Social Care
Ms G Quinton, Corporate Director, Adult Social Care and Housing
Ms Gill Quinton, Corporate Director for Adults, Health & Housing, was in attendance for this item and provided the Committee with an update on the following:
· how the service had responded to the pandemic;
· what the current pressures were on the workforce;
· support in place for carers and young carers over the last few months;
· vaccinations in care homes;
· support to care providers;
· the Better Lives Transformation programme.
The service had been at the forefront of the pandemic and staff had been reallocated in order to meet the statutory demands. The Chartridge Ward in Amersham had been for people who were medically fit to be discharged from the Hospital setting but had tested positive for Covid. Since the beginning of January 2021, adult social care had focused on hospital discharges and the safety of the most vulnerable clients.
There was a total of 118 social worker posts with most being covered by employees of the Council. There were 37 social worker vacancies; 15 were currently covered by agency workers and 22 were vacant. The Council was committed to supporting the health and wellbeing of staff and encouraged the workforce to take up a range of support and advice that was available.
Carers and young carers
Carers Bucks was commissioned to support carers in Buckinghamshire and at the end of Quarter 3 2020-21, there were 12,786 registered carers with the service. During the pandemic, Carers Bucks secured funds of £150,000 from the infection control grant which enabled applicants to access PPE and support carers who needed to attend vaccinations or testing. The service continued to provide prompt information, advice and support, and had its delivery reorganized between April – June 2020. From July 2020, the service started delivering monthly virtual support groups for adult carers. Additionally, the carers discretionary budget had been used to fund therapies to assist carers with their own health and wellbeing needs.
Carers Bucks had contacted all of the 1,043 young carers multiple times during the first lockdown and offered support. Assessments were held in a safe environment (schools and colleges) or alternatively via Zoom where this was not possible. Over 40 young carers attended two activity days held during the summer which had been aimed at those most socially isolated. Support had been offered as part of the Reaching Out project to support young carers feeling anxious about returning to society post-lockdown.
Vaccinations in care homes
All care home settings had been contacted regularly to offer vaccinations to residents and staff. Staff had access to the vaccination through care homes, the national portal or hospital hubs. Encouragement of accepting the vaccination was ongoing. At the time of the meeting, 94% of residents and 70% of staff had been vaccinated. Reasons why some had not been vaccinated included vaccination hesitancy and staff themselves having to self-isolate.
Support to care providers
Care providers faced increased pressures including increased operational costs and a reduction in self-funder clients. The Council had supported providers in a number of ways including offering access to additional Government funding and enabling access to Government PPE schemes. Care providers that were at risk of financial difficulties had been identified through either contract monitoring or direct contact. The Council was offering appropriate support to these providers however there was a limited control over financial risks as many providers were self-funders or independent businesses.
Better Lives Strategy
There were three aims of the strategy: Living Independently, Regaining Independence and Living with Support. The Directorate was starting to consider what the next phase of the transformation programme would include but one area would be services and support for carers. The programme had already delivered £10m savings whilst improving the service.
After the update, Members had follow-up questions and were advised that:-
· All vulnerable clients had been contacted at the start of the pandemic to check in and see if they needed assistance. Some clients had requested for the Council to keep in touch with them on an ongoing basis.
· The take up of the council’s mental health services was being monitored. There had been some successes with recruitment to this service but recruiting occupational therapists was challenging. The pay structure had been amended to offer incentives to join the council’s workforce.
· Seeleys had been repurposed for several weeks to take people with low level care needs whilst care home arrangements were put in place. The day care service at Seeleys had continued during the pandemic.
· All staff at care homes wore PPE but the best protection for staff and residents was the vaccination. Local Covid outbreaks were monitored and limits on movement would be put in place if necessary.
· The number of council social workers had increased. Agency rates had dropped significantly in part due to the service recruiting agency workers as Council employees. The budget for agency workers was monitored monthly and the use of agency workers was challenged by the Corporate Director. Although the current agency rate was the lowest it had been for a long time, there were certain benefits to agency staff in some circumstances. CCG funding towards agency staff was scheduled to cease at the end of March 2021.
· The service normally had 15-20 vacancies due to the size of the workforce. The current priority was on having qualified social workers in place. Previously, the ratio between qualified and unqualified was 50/50 but the ambition was to aim towards 70/30.
· The Council was limited on its actions regarding the financial viability of the care home provider market but it had made available additional funding available from the Government. The service was also looking at how it could increase traffic to providers, for instance as an alternative to people being kept in hospital. 125 discharge to assess beds had taken place in care homes which had been a success and would carry on after the pandemic.
· The Council had a memorandum of understanding with other South East local authorities to cooperate on rates paid to staff.
· Citizens Advice may be able to assist residents with queries on universal credit and benefits via 0800 144 8444.
· There were no further PPE Government grants however the demand for PPE would continue.
· Existing contracts stipulated the number of beds which providers needed to offer.
· The measure of success and staff take up of the You Matter programme would come via Oxford Health. Information to access the programme was provided at induction, circulated to all staff monthly and advertised at the Chief Executive’s online staff roadshows. Council staff also had access to 24/7 PAM Assist.
· The service was considering its future integrated partnership strategy and would be discussed at the upcoming Board meeting.
The Committee commended the work carried out by the staff during the pandemic and noted that it was greatly appreciated. The Chairman thanked Ms Quinton for attending and providing the update.