On March 27 a desperate plea from the struggling social care sector to Matt Hancock made clear that weeks after the endless stream of inane assurances from ministers, there was still an “urgent need” for Government to move faster in making PPE available for the adult social care sector.
The Local Government Association and the Association of Directors of Social Services wrote jointly to express their concerns:
“Sufficient supplies that are of acceptable quality are needed immediately. Councils and their provider partners also need concrete assurances about ongoing supplies for the days and weeks ahead.
“Despite welcome recognition from Government of the importance of PPE, we continue to receive daily reports from colleagues that essential supplies are not getting through to the social care frontline. Furthermore, national reporting that equipment has been delivered to providers on the CQC registered list does not tally with colleagues’ experience on the ground.”
The LGA/ADASS letter went on to emphasise the dangers to another neglected group of care workers and their clients, the thousands of people who work in non-regulated services, such as personal assistants:
“The advice they are being given is to contact their local council. To be absolutely clear, councils do not have stocks of PPE equipment to distribute.”
The letter went on to demand among other things that the government should: “make adequate supplies of PPE available through Local Resilience Forums (LRFs) to ensure: councils can quickly address any local social care supply chain issues; and LRFs have capacity to deal with supply problems for other key frontline workers, such as the police, mental health colleagues and homeless outreach workers.”
It followed a letter the day before from the Care Provider Alliance, which made similar points, warning that “Lack of personal protective equipment for care staff remains a pressing problem. … Without the full set of PPE, providers are having to make very difficult decisions about whether or not they stay open for admissions, as they will not want to put existing residents and staff at risk from lack of necessary and required equipment.”
The CPA also warned that no care home or home care staff had yet been tested, and that without testing of patients transferred from hospitals, “admissions to care homes from hospitals need to go into isolation as there is no way of knowing whether they are going to infect others, putting additional pressure on resources and the workforce.”
A few days later, with little evidence of any of the urgently requested changes having been delivered, the Guardian reported care home bosses were at their wits’ end, and threatening to resign over new government guidelines that state they have to accept residents who have coronavirus.
“The guidance also says hospitals will not routinely test residents entering care homes, meaning managers will not know if returning residents are infectious but asymptomatic.”
Indeed the Guidance says (p4)
“As part of the national effort, the care sector also plays a vital role in accepting patients as they are discharged from hospital – both because recuperation is better in non-acute settings, and because hospitals need to have enough beds to treat acutely sick patients. Residents may also be admitted to a care home from a home setting.
“Some of these patients may have COVID-19, whether symptomatic or asymptomatic. All of these patients can be safely cared for in a care home if this guidance is followed.”
The Guardian quoted one care home boss, who argued “They’re just expecting us to cope without giving us any support at all. Our first responsibility is to the residents we currently have.”
The guidance, which appears to have been written by people who have never been to a care home, blandly asserts (page 5) that “Care home providers should follow Social distancing measures for everyone in the care home, wherever possible, and the Shielding guidance for the extremely vulnerable group.”
And while care homes are expected to take random, potentially infected, patients from hospitals, the guidelines require them to exclude family and friends “except next of kin in exceptional situations such as end of life.”
Four days later Shaun Lintern wrote a stinging report in the Independent warning that “Britain faces a care crisis that could overwhelm the NHS”.
“Across the country, care providers say they have been pushed to the brink of closure because some local councils are refusing to release emergency funding made available by the government, while many face staff shortages, a lack of equipment and too few nurses to care for extra patients being discharged by the NHS.”
His article also raised the need for additional funding to cover the increased costs of the care home providers – and the refusal of councils such as Birmingham, Dorset, Worcestershire and Knowsley to offer any extra financial support above the rates agreed in February, which one provider said “do not even cover the rise in the national minimum wage”.
Meanwhile social care workers in UNISON, again concerned that their needs and problems were being ignored by government and barely covered in the media launched a petition which flagged up the problems they have as low-paid workers with mainly private sector employers whose record of concern for staff is pretty dreadful:
“The Government have made some commitments, but they do not adequately address concerns about resources and support getting to frontline staff and public services.
“Many of us on low wages cannot get access to statutory sick pay, and some private social care companies are ignoring the Government’s advice to pay staff if they have to self isolate, which could put lives at risk.
“More far-reaching intervention and enforcement is required to protect the workforce and allow us to deliver vital care.
“It is absolutely essential that care workers have necessary equipment to protect patients and are able to self-isolate or take time off work if we become ill. The threat of losing pay means that many of us may have to choose between feeding our children, defaulting on rent payments or attending work whilst ill.”
It appears that much of this pleading has so far been in vain. On April 9 as this article is prepared, a grinning photo of Social Care Minister Helen Whately adorns a complacent weekly government circular to the social care sector. She ignores the funding issues altogether – and happily admits problems remain accessing PPE:
“I know there is also the challenge of making sure staff have the Personal Protective Equipment (PPE) they need and are confident about using it when appropriate. We understand that in some cases the PPE the sector needs to provide vital care for patients has been delayed or is not available and we would like to thank you for your patience.
“We are working around the clock to give the social care sector the equipment and support they need to tackle this outbreak. We secured one-off, direct deliveries of 300 facemasks to all CQC Registered Home Care, Care Home, and Hospice Providers …
“…we have also agreed a one-off drop of PPE to Local Resilience Forums to help respond to urgent local spikes in need and current blockages in the supply chain. We expect most of these drops to have taken place early this week.”
Also on April 9 the Care Provider Alliance issued a further, anguished plea for adequate funding and government measures to ensure that councils pass on the cash to the care homes and home care companies:
“the proposed funding arrangements are inadequate and there is no guarantee that individual councils will follow the guidance. We do not believe that there is a system in place to ensure that £1.6bn of public funds reaches front-line services.
“In addition, the guidance fails to address the question of how support can be provided to providers who are not currently funded via local authority contracts.”
“Failure to recognise the very real increases in operating costs as a result of COVID-19 risks a substantial failure and collapse of care providers with a significant impact on people, councils and the NHS.”
It remains to be seen whether ministers will catch up with the situation before a major collapse of major outbreaks of Covid-19 take a terrible toll of premature death in care homes they have so studiously ignored.
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