Care and Commiment

Article by David Pearson CBE, Chair – Social Care Sector, COVID-19 Support Task Force
Coronavirus has affected everybody in many ways. No more so than in social care where people working in the sector have juggled responsibilities for families and friends with providing care and support for people who are most at risk from this very dangerous disease.

The acts of care and commitment, having to make rapid changes to working practices in infection control, wearing PPE whilst providing care and support are just some of the ways that people working in the social care sector have gone the extra mile.

This includes challenges for leaders of provider services and I am pleased to have this opportunity to thank you for all that you are doing each and every day in very difficult times.

I agreed to Chair the Social Care Sector COVID19 Taskforce between June and August to also do what I could to help.

All parts of the care sector including Government departments and those with lived experience of social care services worked on the taskforce to help implement the Adult Social Care Action Plan, the Care Home Support Plan and the final report which was submitted at the end of August.
https://www.gov.uk/government/publications/social-care-sector-covid-19-support-taskforce-report-on-first-phase-of-covid-19-pandemic

The commitment and support to complete the work quickly was fantastic.

The report was published on September 18 together with the Adult Social Care Winter Plan based substantially on the 52 recommendations by the taskforce and further advice and recommendations from eight advisory groups. Ministers were regularly kept updated.

The taskforce wanted to ensure that as far as possible the work covered the whole sector and that although the task was to advise government we also advised local authorities, providers, the NHS and CQC and all those who have a role in the delivery and oversight of social care.

The former taskforce has now reconvened as a “stakeholder group”.

The terms of reference are to:

• Advise and give feedback on the implementation of the winter plan.
• Give support to specific work designed to translate policy rapidly into practice.
• Consider national and international evidence to decide what further actions that should be taken by government, local authorities, providers, NHS or CQC.
• Contribute to the communication and dissemination of information, evidence and advice on the application of the plan and other measures.
• In the last few weeks, there has been a great deal of progress from leaders from within the sector on some of the more difficult provisions in the winter plan.

These include:

• The deployment of the Infection Control Fund.
• Providing visiting guidance and the extension of testing so we can all be more confident about enabling and supporting visitation.
• Ensuring people who are COVID-19 positive being discharged from hospitals to care homes are discharged to premises which meet a set of agreed infection control standards.
• The development of regional assurance teams.
• Restricting staff movement in care homes.
• The further extensions of testing within the sector and continuing to ensure that current testing is being fully utilised.
• The distribution of free PPE to the sector.

The virus remains a very big threat to all of us – which is why, as you know, it is very important that everyone follows all the guidance and is extremely careful inside and outside work to keep everyone as safe as possible.

But with positive news emerging around vaccines and therapeutics there is some light at the end of the tunnel.

There is still some further work to do on vaccines to ensure they meet robust standards on safety but the claims they could protect over 90% of people are positive.

The government has bought millions of vaccines in advance and, based on the interim priority advice from the JCVI, care home workers and residents will be among the first to receive it.

When they become available we will not waste any time in getting them to you. You will know that it is a big task because of the number of people who need to be vaccinated.

We are continuing to learn all the time from research both in this country and elsewhere.

From the Vivaldi research commissioned by the government we know that if you have staff movement every day between homes you are more likely to have infections amongst staff than if you don’t.

We also know from this research that outbreaks are less likely in homes where staff receive full pay to isolate with COVID or where they have been exposed to someone with COVID. The expansion of the study is positive news.

The Infection Control Fund is available to support the restriction of movement and whilst understanding the pressures and challenges on providers it is essential that we reduce the risk of infection by implementing everything that we know to work.

From local work on outbreaks there are also some key messages:

• Some people have reported PPE fatigue and the difficulty of fully adhering to both the full time wearing of PPE (particularly face masks) and the appropriate disposal but the most recent international evidence reinforces how important it is to fully wear masks all the time and dispose of all PPE in separate disposal containers. This is because the virus is not only transmitted through coughing but also through speaking.
• The importance of staff maintaining social distancing as they are arriving and leaving and not sharing transport.
• There is some evidence that extra care and support needs to be provided to support residents with dementia who walk with purpose to reduce the risk of transmission of the infection.

The rates of testing among staff have improved significantly (and there have been major efforts nationally to improve testing turnaround times). As you know with high rates of infection in the community this is so important in stopping the spread of an outbreak within homes.

Good practice measures at care homes have also been identified including:

• Strong leadership on strict adherence to infection prevention control (including regular and repeat training and support).
• No staff movement.
• Extended testing regime outside of core staff.
• Additional support provided by parent companies.

I am very aware how important it is to allow care home residents to safely meet their loved ones and of course, as you know we have a difficult balancing act between the risk of COVID transmission and the evidence of harm from the restriction of visiting. We are working with sector representatives on how, with significant extra testing becoming available we can enable every resident to have visitors as safely as possible by Christmas.

Testing is one way of minimising the risk of visiting a care home. If a visitor has a negative test, is wearing appropriate PPE, and following other infection control measures then it will be possible for visitors to have physical contact with their loved one, such as providing personal care, holding hands and a hug.

We learn something every day about the virus and how we can best deal with it, support the workforce and over 18,000 organisations in the social care sector. There are many examples from across the country of innovation and the determination to provide the best care and support possible. Once again, thank you for all that you are doing.

David Pearson CBE

David was the Director of Adult Social Care and Health for 14 years and the Deputy Chief Executive for 10 years with Nottinghamshire County Council. He retired from the County Council in January 2019.

David has wide experience of leadership at a local, national and regional level in care and health and wider public services.

He is a Past President of the Association Directors of Adult Social Services in England and continues to act as an advisor to the government on social care and health reform. He was appointed by the Government in November 2017 to be an independent advisor on the Social Care Green Paper in England.
David took up the role of senior lead on all social care related matters in the NHS for the Covid-19 response from the end of March 2020. This involves working with the sector, NHS and government departments on policy and operational issues. In June 2020 he was appointed by the government to the role of the Chair of the COVID – 19 Social Care Support Taskforce which completed its work at the end of August.

He is also currently the Independent Chair of the Nottingham and Nottinghamshire Integrated Health and Care System. David has led the Nottingham and Nottinghamshire System since the creation of STP’s in 2016. He is a System Partnership Advisor for NHS England. He is also the Chair of the Board of TEC Quality a Community Interest Company whose role is to promote standards of quality and cost effectiveness of technology in health and social care across the UK. He is the Chair of the Advisory Board of the NIHR (National Institute for Health Research) School for Social Care Research.