30th September, 2020

Testing is the key to success of the Adult Social Care Winter Plan

By Phil Hope, former Care Minister and GK Adviser

The Adult Social Winter Care Plan published recently is hugely important as it sets out the national support available for the social care sector for the next six months of the winter and the main actions to be taken by local authorities, NHS organisations and social care providers including the voluntary and community sector (VCSE).

There is a sense that older people have borne the brunt of this pandemic and that care homes earlier this year did not receive the support they needed in terms of protective equipment, staff training, access to testing and infection management to ensure their residents were safely cared for.

The wide-reaching Plan responds directly to many of these concerns and includes much needed additional £500 million for the Infection Control Fund (ICF), free PPE via the PPE portal and local resilience forums, free flu vaccines for all health and care staff, a new Adult Social Care dashboard of critical data, and the welcome appointment of a chief nurse for social care in the Department for Health and Social Care.

The Plan sets out a series of key actions to be taken by local authorities that relate to both self-funded care providers and local authority commissioned services. It requires them to put in place their own local winter plans that address local inequalities and involve the NHS and the VCSE in their development. It expects local authorities to distribute the additional ICF funding as quickly as possible, provide free PPE to all care providers including to personal assistants and ensure care providers carry out Covid-19 testing as set out in the sperate testing strategy.

The Plan also expects care providers to update their business continuity plans with a particular focus on workforce resilience, make use of the additional ICF funding, reduce the movement of staff between care settings, provide relevant data through the Capacity Tracker and ensure symptomatic staff and recipients of care are able to access Covid-19 testing as soon as possible. Care providers are also expected to develop a policy for limited visits in line with local and national PHE guidance.

The requirement that patients being discharged to care homes must be tested prior to discharge from hospital is welcome but it is essential that results are made available. Care homes must not again be put under undue pressure to accept COVID-positive patients from hospital, and must be supported to provide adequate accommodation and isolation facilities for residents returning from hospital. The development of a designation scheme for premises that are safe for people leaving hospital who have tested positive for Covid-19 or are awaiting a test result is of particular importance.

Most, if not all, councils care providers will also have stocked up with months of PPE supplies in advance of the Plan as part of their pandemic planning and the government should make clear that they will be compensated for these costs through the free PPE pledge.

The main concern in the sector is the effectiveness and efficiency of the testing system. The success of the winter plan will fundamentally depend upon ready availability of Covid-19 testing for care home residents and staff. Work to ensure that tests can be turned around rapidly, and the results conveyed to care homes, should be an immediate priority. The failure to provide sufficient testing capacity or deliver rapid results from test samples will make action by care providers to ensure the safety of their residents, staff and volunteers extremely difficult. Test results that take 5-7 days to turn around for example are of no use to care home providers. Many will take a precautionary approach in the absence of reliable data and this could lead to higher costs and increased isolation of care recipients from their families and friends.

For the long term it is unclear when a new settlement for social care will be put in place. System and funding reform is still on the government’s agenda but is on hold whilst the focus for adult social care is for everyone to receive the care they need throughout this pandemic. So, the challenge for social care remains – to be given parity of esteem with the NHS and to receive a very substantial funding increase in order to provide affordable care for many more people who need it.

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