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Scrutiny Review Adult Paid Carers - witness evidence - Verbal

Minutes:

Christine Lehmann, Health and Adult Social Care gave a presentation on PPS in Islington to the Committee, during which the following main points were made –

 

PPE in Islington

 

·       1.49 million total PPS items distributed to date

·       £596.76K estimated total cost

·       Approximately £110.59 PPE cost per service user

·       PPE and the BECC have been supplying 20% of Islington’s ASC average required PPE per week based on modelled PPE need

·       A complex and dynamic situation with multiple tiers and supply routes including the London Resilience Forums, North London Central Partnership and national Government through the Department of Health and Social Care

·       Problems with supply February/March and the PPE team brought together and developed a system to engage with providers gathering information in order to support and respond. In April created the reporting, monitoring and ordering process for the whole of the ASC PPE delivery system in partnership with the BECC

·       ASC PPE team made up of colleagues from the ASC contracts team, project management team, Public Health performance/strategists, in-house team, re-deployees across the Council. New communication channels were established to focus on immediate need and a contacts list developed to identify providers outside of commissioned services. First priority was to ensure the safety and continued support of residents and the care staff working with them. Initially the PPE team directly procured from suppliers, transferring to the BECC team with ACS PPE team consulting on quantities and PPE items needed for stock. In May/June engaged with other Councils to ascertain the proportionality of PPE requests from providers, and created dashboard with NCL/4C to report on actual usage and project costs in line with national/regional modelled demand. July onwards local processes embedded, supply beginning to stabilise, 4C is expanding to support the other NCL boroughs based on Islington’s work to date, Department of Health and Social Care PPE portal is launched

·       Providers – 155 services in total – wide range of external and internal services including care agencies, care homes, mental health and learning disabilities teams, occupational health, direct payments recipients and their carers, supported living, in house-bridging and discharge services, self-funders and private based Islington service users. Good supplier and user feedback

·       Despite many challenges able to respond quickly to meet need and develop robust systems

·       It was noted that Islington now had an adequate supply of PPE in event of a second wave of the pandemic. In addition the DPH also had a stock of available supplies

·       Members expressed concern that the Government did not have an adequate supply of PPE in place at the start of the pandemic

·       Noted that two thirds of PPE had been distributed to domiciliary care providers

·       In response to a question it was stated that home care providers had given assurances that they had adequate supplies of PPE for staff, however they could approach the Council in the event of shortages. The relationship with providers was good

 

Update – COVID 19 Adult Social Care response

Stephen Taylor, Health and Adult Social Care was present and made a presentation to the Committee thereon, during which the following main points were made –

 

·       Service highlights – Community service provision, operational social work teams, Safeguarding, Contracts commissioning and brokerage and community response

·       Older People’s Care Homes – there are 8 in Islington and there have been varying issues during the pandemic of outbreaks of COVID. Data shows this has reduced from the large early outbreaks. Similarly, after a sharp increase in deaths in homes, there have been considerably smaller numbers recently. As of 25 August there had been no resident COVID deaths for 12 weeks

·       Domiciliary care – providers have reported relatively low number of residents who have been confirmed COVID positive or who have been COVID symptomatic. Domiciliary care agencies have reported no COVID – related deaths or residents they care for to commissioners. After some initial workforce challenges in the sector staffing levels have stabilised and there is no capacity within the market

 

Katie Logan, Health and Adult Social Care made a presentation to the Committee, during which the following main points were made –

 

·       As at 12 June there had been 37 deaths due to COVID among care home residents across Islington. One death in a supported living setting. Based on self-reported figures from service providers the percentage of service users with COVID peaked in early April between 5-6%. No information at present on deaths in care homes at an individual. However it was noted that there had been one additional care home death between 12 June and the end of August

·       There are not significant differences by borough in the rate of COVID deaths amongst care home residents. Across NCL, there have been an average of 64 deaths per 1000 beds and Islington is not significantly different to the NCL or London average

·       Key messages – In London the risk of death for health and social care workers is elevated compared to the general population, as it is nationally. Across London between 9 March and 25 May, there were 64 reported deaths involving COVID of social care workers. Associated risks have been identified with gender, age and ethnicity and ethnicity and ethnicity is a significant driver or risk to the ASC workforce in Islington, as workers from a black ethnic group represent the largest population of the ASC workforce in Islington – 59%. COVID has resulted in high rates of staff absence across Adult Social Care. Nationally an average of 25% of frontline workers were unable to work during the COVID period. In Islington providers reported the highest rates of staff absence in April and May, at around 14%

·       Islington ASC workforce characteristics – men are disproportionately affected by COVID 19 however 80% of the workforce in Islington is female. 72% of the ASC workforce in Islington is between the ages of 25-54 and 22% is aged 55 or over. The largest proportion of the ASC workforce in Islington is from a black ethnic group, 59% followed by white – 29%

·       In response to a question relating to the Infection Control Fund it was noted that this had enabled care providers to pay care staff full pay who could not work due to self-isolating. There had been 2 deaths of care staff in care homes due to COVID

·       It was noted that with regard to frontline staff, particularly BME staff who were most at risk, some providers were arranging training and the Council had provided risk assessment information and access to resources. An example could be provided to Members

·       Concern was expressed that sickness levels were not high and this may be due to care staff not being able to afford financially to take time off sick, and enquired whether providers were paying full sick pay. In addition as the Infection Control funding is shortly due to end from the Government, there should be lobbying to the Government to continue this funding, It was noted the Council is lobbying the Government on a number of issues and that this would continue

·       It was noted that the ethical care charter should be being applied by all big providers however whilst it did not apply to the smaller agencies consideration would be given to this issue when contracts are reviewed

 

The Chair thanked Katie Logan for her presentation