Minutes:
Update on Covid-19 Response and Recovery – Adult Social Care
The Strategic Director of Adult Care, Housing and Public Health provided a summary of key issues and developments in relation to the pandemic. The present position fell between response and recovery and the next month would be important to see the effects of the easements introduced by the Government on the community and the most vulnerable.
Face-to-face interactions were increasing with precautions taken through social distancing and use of Personal Protective Equipment (PPE) where appropriate but work was done remotely whenever possible, often at people’s own request. In terms of the dip in demand seen at the beginning of the pandemic, this was now going back up. Some readmissions to care homes had occurred but not a significant increase, which was positive and would continue to be monitored. Carer breakdown continued to be a concern and officers were working on this at sub-regional level.
Guidance was anticipated regarding provision of day care opportunities, whether in-house or externally provided. Clarification was also being sought on respite, both in general and with regard to testing.
The process had changed again for re-testing in care homes and would be every 28 days for any person in a 65+ care home and weekly for staff. Any concerns regarding a residential care home could see testing undertaken weekly, which in turn raised concerns about provider ability to manage this. This was a national initiative through the new Care Quality Commission (CQC) portal, whereas before local stratification in terms of risk had been carried out and Rotherham would be closely monitoring this. This was a good example of still being in a state of responding, as matters were not yet stable in terms of the expectations for care homes. It was clarified that testing in care homes was paid for by health through the NHS and the Director of Public Health would also have some access to emergency testing although the detail was awaited.
The Government had formed a Social Care Taskforce comprising a wide range of organisations to have a full oversight of the situation in adult social care.
The Council was waiting for the re-testing regime to be extended to learning disability, mental health and supported living but there was an issue over capacity. If continual testing was undertaken as some people were asymptomatic then in all likelihood more positive test results would ensue.
Recovery was being undertaken slowly together with partners in terms of stepping services back up in a planned way. Some of the new ways of working would be retained as people had liked them and there was collective practice within the directorate to consider all the learning and ways to be agile, including in the contact centre. Various compliments had been received. The service worked closely with the Community Hub which had led to a lot of requests coming through, not just from those shielding, but regarding the food banks. Close monitoring would be needed should a new cohort of people come into adult social care because of the psychological impact of Covid-19; for example, on people’s daily living, motivation and skills, particularly in terms of the reablement service. As the hospital returned to business as normal there would be an impact on adult care with the flow of patients out of hospital and Association of Directors of Social Services (ADASS) had produced helpful guidance that would be considered from the Rotherham perspective. The number of Delayed Transfers of Care (DTOC) had been minimal during the pandemic, as the three-hour turnaround had worked very well and would be looked at going forward. Positively most people had gone home from hospital rather than to a residential or nursing home, with the right level of support.
Cllr Roche, Cabinet Member for Adult Social Care and Health confirmed that work was taking place to try and get day opportunities back but the lack of clear guidance regarding day opportunities and respite around the necessary precautions was unhelpful. For respite, progress was reported regarding the new facility in Conway Crescent at Herringthorpe. Registration had been obtained, virtual tours would be taking place of the premises to enable people to see what it would be like once operational and autism-friendly validation had been achieved following a review by a West Midlands autism organisation.
Members asked about readiness for a second wave in the autumn, especially with the potential for flu and additional winter pressures. Winter planning usually commenced in June and the debrief from last winter had taken place two weeks earlier. The Integrated Care System had held a stress testing event the previous week and Gold Place Group was planning for winter and such an eventuality in addition to the recovery conversation. The project to change from seven to three reablement/intermediate care pathways had been paused but would resume and would be important for the winter in terms of capacity. Learning from the past was important about what would be done differently next time with the benefit of hindsight as well as scenario planning. Emergency planning work was underway with the wider health and social care system and across the Council regarding a potential significant outbreak in the community which would cut across services and schools so potential staff deployment was looked at.
Staff had not gone into Riverside House in full teams as a precautionary measure and this would continue until a vaccine was available. For example, the six locality teams would be one in and one out for each. Reablement had initially been ok but then dipped as staff were off, similarly with hospital staff, so there was learning in how to manage such situations and staff had moved between services in an agile way. How to bring staff back in who had been shielding needed to be considered and staff anxiety was still very high, so there was ongoing work to address this. The pandemic had affected and touched us all, and there was a challenge to maintain staff morale and buoyancy, which was equally important as the system preparation for another surge. A recognition event was being planned for the whole service with the Communications team entitled “People Caring for People”.
South Yorkshire, Derbyshire and Nottinghamshire Joint Health Overview and Scrutiny Committee
It was confirmed that the next meeting would be held on 28 July 2020. One of the items on the agenda would be in regard of Children’s Surgery, which NHS colleagues had indicated they wished to discuss with the Joint Committee. The link to the agenda papers would be shared with Health Select Commission (HSC) members who were requested to email the Chair and Governance Advisor with any issues or questions they wished to be raised at the meeting.