Labour: Government has ‘weeks’ to protect care homes

14 September 2020

Re: Social care winter plan

Dear Matt,

Coronavirus has taken an unimaginable toll on elderly and disabled people, and their families. There have been almost 27,000 excess deaths in care homes since the start of the pandemic, with at least 15,000 due to Covid-19. Millions of families have taken on new caring responsibilities or are doing even more to support their loved ones than before. These appalling figures should serve as reminder of how quickly the virus spreads amongst those who rely on social care, and the terrible impact on families and care staff.

Reports that infections rates are beginning to rise in care homes once more are a matter of serious concern. With winter and the flu season fast approaching, it is vital that the Government now puts in place a clear winter plan to support social care. The Government must learn the lessons from mistakes that have been made so far, and show users, families and staff that social care will be a top priority in the months ahead.

I have sought to be constructive throughout the course of this pandemic and it is within this spirit that I am outlining the action that I believe needs to be taken to protect care services this winter.

This starts with strong leadership. I once again ask you to appoint a Chief Care Officer to sit alongside the Chief Medical Officer and help provide the national leadership, focus and attention that the sector requires. You should also re-consider disbanding the Social Care Taskforce at such a critical time. All of the reports and recommendations from the taskforce, and its working groups, should be immediately published so we fully understand the lessons that need to be learnt and what the sector needs for the future.

There are 5 specific areas where action is now required:

A guarantee that weekly, rapid testing of care staff will take place
The shambolic handling of covid-19 testing for care staff cannot continue into winter. Care homes were first promised weekly testing for all care staff by July 6th. This was then pushed back to September, and care homes for working age adults have only just been able to order regular testing from last week. Weekly testing for home care staff has not yet been put in place, despite community transmission rising and the R rate now above 1.

Care workers are looking after people who are at especially high risk from Covid-19, so increasing reports of delays in care homes getting tests results back are especially worrying.

Regular and swift testing must be expanded to all care settings and care staff as soon as possible and this should include home care staff and those who work in supported living. It also beggars belief that with CQC inspections rightly restarting, there is no commitment to testing CQC inspectors to stop the very people who are supposed to be helping guarantee the quality of care themselves potentially spreading the virus between care homes.

Ensuring all care workers get the PPE they need
One of the worst problems at the start of the pandemic was the failure to provide care workers with proper PPE. I heard repeated reports from care workers who couldn’t even get basic masks, and were terrified of infecting the people they cared for and their own families.

It is crucial that lessons are learned as care services cannot afford to suffer the same PPE shortages again. Ministers must spell out what steps it has taken to guarantee the supply chain so all care workers routinely get the PPE they need, including care home staff, home care workers, those who work in supported living and the 70,000 Personal Assistants currently employed via Direct Payments.

Families need urgent additional support and must be able to safely resume visits to care homes.
Millions of families have been under huge strain as a result of Covid19, with many separated from their loved ones in care homes or pushed to breaking point because of the strain of their unpaid caring responsibilities.

Action must be taken to ensure families get the support they need during Coronavirus and beyond. As a first step, government must provide local authorities with resources they need to support unpaid family carers, including with proper information, advice and crucially access to respite breaks. A staggering 4.5 million people have taken on new caring responsibilities since the pandemic began. 70 per cent of existing unpaid family carers say they are spending even more time caring – an extra 10 hours on average a week. The physical and mental health consequences of this can no longer be ignored.

I have previously written to you to ask that family members of care home residents be given access to regular testing and PPE, recognising the vital role they play in supporting their relatives. Without family contact, many care home residents have seen their mental and physical health deteriorate, which is particularly true for people with Alzheimer’s or dementia. Guidance from the Department of Health and Social Care should emphasise the value of family visits and that family members should be treated as key workers, with the priority and focus this should bring.

Care homes should be supported by the NHS
At the start of the pandemic many care homes felt completely abandoned, with older people being discharged from hospital without proper testing and staff left to provide care outside of their training or expertise.

Ministers must spell out how they will ensure these mistakes are not made again. It is vital that the NHS has in place a plan to ensure no one with coronavirus is discharged from hospital into a care home this winter, to prevent a repeat of the terrible impact this had in the first months of this crisis.

The Government has promised “Enhanced Healthcare” in all care homes but whilst there are some excellent examples of GPs, district nurses and other clinicians providing support, care providers tell me this remains patchy with many care homes still having nothing beyond a ‘named clinician’. In addition, plans to carry out flu vaccinations for people in social care must be shared with providers at the earliest opportunity, with all care homes residents vaccinated as soon as possible.

Social care must have the additional resources it needs throughout the winter and beyond
It is vital that local authorities and care providers have the resources they need to meet challenges of Covid-19. Social care services were already stretched to the limit, even before the virus struck. Local authorities and care providers have since faced substantial extra costs, and these increased pressures – especially for staffing and PPE – are likely to increase over the winter months.

You will be aware that the ONS has set out clear evidence that care homes which provide proper sick pay and that are less reliant on bank or agency staff have lower levels of Covid19 infections. To protect both care home staff and residents, the Government must ensure that care workers can self-isolate when they are asked to do so.

Ministers must explain why the Adult Social Care Infection Control Fund, currently due to finish at the end of September, is no longer needed since the pandemic has not yet gone away. This Fund has played a key role not just in providing infection control training, but in reducing the use of agency staff moving between homes and spreading the virus.

Alongside an immediate cash injection, social care services desperately need a long-term plan for reform. This issue cannot be kicked into the long grass any longer and I urge you to publish a plan for the future funding and provision of social care by the end of the year, as the Prime Minister promised in January.

Getting on top of challenges face by social care ahead of winter is vital – we cannot afford for action to protect care homes and other services to be as slow and chaotic as it was at the start of this pandemic. I hope you will consider these suggestions in the positive and constructive spirit they are made and would be happy to discuss these in further detail. I look forward to hearing from you soon.

Yours sincerely,

Liz Kendall
Shadow Minister for Social Care