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An action plan for social care: urgently and desperately needed

Stay home, protect the NHS, save lives. The mantra echoing across the country these past weeks as we came together to try and prevent the spread of COVID-19. But what about protecting our care services?

 

The role of social care in battling the pandemic has, finally, been recognised by the Government. An action plan was published by the Department of Health and Social Care on 15 April, eleven weeks after the first Coronavirus case was confirmed in the UK. After months of action to try and protect the NHS from folding under the weight of this pandemic, its sister service – social care – is at last getting the attention it desperately needs from the Government.

 

The action plan commits to many measures we have been calling for over the past weeks, including:

  • Confirming that visits to people at the end of life are “important both for the individual and their loved ones and should continue”
  • Stressing that advance care plans, including Do Not Attempt Resuscitation orders, applied in a blanket fashion to any group of people are unacceptable, and that the CQC have been urgently contacting providers where this practice has been brought to their attention
  • The need for an individualised response, where people are affected by dementia or have mental health issues and need additional support
  • Testing to be rolled out to all symptomatic residents in a care home, to residents prior to admission to care homes and to all care workers who need it (and their families)
  • Increased supply of personal protective equipment for care providers
  • Recognising that the social care workforce is on the front line of the pandemic, alongside their NHS colleagues and committing to ensure care staff are safe, supported and valued
  • Clarifying that family members may volunteer to help look after relatives in care, and an expectation that care providers would help facilitate this
  • Confirming the government’s role in monitoring use of Care Act easements to ensure they do not disadvantage older people placed in vulnerable positions
  • Recognising that the regulation of care providers by CQC to ensure safety and quality standards are maintained and improved is as important as ever

 

Implementing the plan

Whilst this is welcome news for the thousands of older people using care services across the country, the action plan does raise some questions. Particularly about the practicalities of how the plan will, or can, be implemented. Some of these questions we’ve already been hearing from callers to the R&RA Helpline, and no doubt will continue to hear over the coming weeks, such as:

  • How will health and care services work together to ensure older people with COVID-19 symptoms who need healthcare, and want to go to hospital, are moved between settings? This is a key concern for many callers to our helpline and clarity on this is needed in the action plan.
  • Where a person needs to be isolated but a care home cannot provide isolation/cohorted care, what kind of “secure alternative appropriate accommodation” will local authorities use? What measures will be in place to ensure that alternative provides a standard of care that meets the resident’s needs?
  • When will we have a full picture of the deaths from COVID-19 occurring outside of hospitals?
  • Will personal protective equipment be available for relatives, to facilitate visits to people in care at the end of life? What about for visits to people with dementia who are in distress? (which is permitted if the person is in hospital)
  • Given the delays in rolling out testing to date, how soon will the system be able to test all the residents who need it, and the 1.5 million care workforce (plus their families)?
  • How will the new staff recruited to fill the gaps in the workforce be adequately trained, particularly where supporting people with complex needs?

 

The care system was already at tipping point before the Coronavirus pandemic. Measures to ‘save the NHS’ over previous weeks have placed more pressure onto the already fragile care workforce. The Government’s action plan needs to be implemented as a matter of urgency. It has already arrived too late for some. We hope it is not too late for the thousands of other older people using care services and the relatives waiting at home for news of their wellbeing.


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