Agenda item

To consider a report of the Executive Director Core Services and the Executive Director Adults & Communities regarding the impact of COVID-19 on Adult Social Care and Care Homes in Barnsley (Item 4a attached) and the Barnsley Care Home Plan Letter (Item 4b attached).

The following witnesses were welcomed to the meeting:

·         Wendy Lowder, Executive Director Adults and Communities, BMBC

·         Sharon Graham, Head of Service – Commissioning, BMBC

·         Julie Chapman, Service Director – Adult Social Care and Health, BMBC

·         Cllr Jenny Platts, Cabinet Spokesperson – Adults & Communities, BMBC

·         Emma White, Health & Wellbeing Principal, Adults & Communities, BMBC

·         Jane Sivakumar, Chief Nurse, Barnsley CCG

·         Gill Stansfield, Deputy District Director General Community, SWYPFT

A report was received to inform the Committee of the local authority’s recent submission to government outlining Barnsley’s system wide offer to care homes as part of the response to COVID 19.

It was noted Barnsley care homes support over 1,800 residents across 72 homes. A large number of homes are occupied by elderly residents who are classed as vulnerable to COVID 19, as such the need to wrap those homes with support is essential in response to the COVID 19 outbreak.

It was recognised that the Council and partner agencies have worked flat out over the past few months to keep the borough’s care homes as safe as possible, as well as themselves.

The collective heart felt sympathies of all present were expressed to the families who have lost loved ones because of the crisis.

A presentation was received to provide an update on how adult social care has been impacted in the wider sense. This provided further details in respect of:

·         the social work offer

·         directly provided services

·         adult joint commissioning

·         data and governance

·         the workforce

·         infection prevention control

·         community support

·         finances

The Chair thanked the officers for their report and presentation. Members carefully considered the information and provided challenge through detailed questioning. In the ensuing discussion the following points were raised:

It was noted the Care Home Plan references 72 care homes and queried whether this number represents all care homes or just those specialising in elderly care. It was confirmed this is all care homes in the borough, and that the same level of support is offered to all.

It was questioned whether the salary uplift (discussed at BMBC Cabinet before the COVID pandemic) was now in place. It was confirmed this is in the process of being implemented in partnership with the various care home providers and is being worked through subject to consultation and agreement.

Regarding infection prevention control; assurances were sought that all available grants are being received. It was confirmed this is the case and that 75% of the grant is being used to support care homes, whilst the remainder is being used on a flexible basis in discussion with the care home providers. The remaining 25% has been issued to home case providers.

It was questioned whether potential seasonal variations were being planned for, particularly as we approach the winter months. The meeting was informed of what plans are in place for COVID and other conditions such a flu. It was noted flu vaccinations this year will be critical to help protect the health service and measure will be put in place to ensure as many people are vaccinated as possible, with the potential lowering of the age recommendation also an option. It was acknowledged it is difficult to predict when winter will start and therefore when to plan for.

It was questioned whether any care homes are not participating in testing programmes or providing data. It was reported there are some understandable instances of homes having been worried about the stress of testing asymptomatic individuals.

Regarding the gathering of data, it was reported that COVID had seen massive leaps forward in respect of data gathering and sharing and efforts will be made to ensure new processes benefit us going forward. It was noted a new data dashboard will be developed.

It was asked whether family members visiting care home residents had been tested. It was confirmed this hadn’t been undertaken and noted homes closed their doors quite quickly to visitors. It was noted new guidance is being introduced regarding the safest means of relatives visiting residents.

Regarding the permitting of family visits, it was noted a lot of work had been done to deploy equipment to facilitate virtual visiting, but each home would need to risk assess their environment to ensure visiting could recommence safely. It was suggested some homes may have the structural capability to utilise external doors to create safe environments.

It was questioned what additional measures are being put in place to support people with dementia and other needs who perhaps rely on external ‘pampering’. It was noted these have stopped as a consequence of lockdown but many instances have been reported of staff providing additional support to residents to deliver these types of non-medical services. Officers reported on some amazing examples of creativity coming from the homes and the need to recognise the efforts of staff.

The meeting considered the economic impacts of COVID and the danger we are nationally approaching a tipping point which will see private providers no longer able to generate a profit and leave the market. It was noted there have been a number of national, regional and local studies commissioned to investigate the risks and quantify the financial shortfall in the sector. A recent study by the LGA & ADASS identified that nationally  the home care / care homes & supported living sector were facing additional costs amounting to an estimated £1bn for extra staffing, £4bn for PPE equipment and £700m for increased cleaning. It was recognised there may be further societal changes of attitude to care homes that will need to be factored into the financial forecasts for the sector.

The health of the adult social care finances of the borough was questioned. It was noted that at the last time of reporting this showed spend to be within the annual budget allocated , however, this precedes COVID and finances are likely to be reassessed  as the full  picture becomes known.  

The meeting discussed reported instances of some homes failing to provide an expected standard of care, both before and during the pandemic. It was acknowledged that whilst the vast majority of homes have responded brilliantly to new challenges some have been challenged. . It was confirmed that those homes which 'require improvement' under the Care Quality Commission ratings will continue to be worked with through quality assurance and improvement processes.

The meeting discussed the role Members can play in lobbying for fair financial settlements. It was requested that a briefing note be produced to help inform those debates.

Members placed on record their thanks to the officers and all health and social care sector staff engaged with supporting our care homes at this difficult time, and requested this be conveyed back to everyone.

It was suggested there is hope that a benefit of the COVID pandemic will be improved working relationships between all health care sectors.

RESOLVED that:

(i)      Officers be thanked for their attendance and contribution at the meeting;

(ii)     The Committee’s thanks be extended to officers and all health and social care sector staff in responding to the pandemic;

(iii)    Members support the promotion of the uptake of the flu vaccination across all our communities when the time comes as this will be critical in protecting individuals and services;

(iv)    A briefing note be produced on Adult Social Care costings so Members can utilise this to lobby for fair financial settlements.

The Chair thanked everyone for their attendance