Letter of support for care homes

Letter from Alison Griffin to Helen Whately MP, Minister of State for Care on support for care homes.

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Dear Helen,

On the 14th May 2020, you sent a letter to local authorities about ‘Support for Care Homes’. We were delighted to receive this, as we have been working closely with our local provider sector, and with the NHS, to provide support and guidance in order to keep the residents of Southend safe. You will be aware that care homes are a matter of particular concern to my authority, as a place that has a relatively high number of care homes and beds (13/151 authorities).

Your letter announced an additional £600 million to support providers through a new Infection Control Fund. The fund will support adult social care providers to reduce the rate of transmission in and between care homes and support wider workforce resilience. We were also pleased to receive the additional grant conditions and guidance on 22nd May 2020.

I would like to raise some concerns about this additional guidance, as set out in LAC which placed significant and stringent restrictions on the use to which providers could place this additional infection control fund funding. The limitations are likely to be particularly difficult for the sector in Southend, where around three quarters of our local providers run only one home, and where the average size of homes is around 20 beds. I would be grateful if your department could review the impact of these requirements prior to issuing tranche 2 funding, and look to a relaxation for small providers.

Your letter required local authorities to review or put in place a Care Home Support Plan and to provide an assessment of care home resilience through the completion and submission of a template and a letter that sets out a short overview of their current activity and forward plan.

This letter provides an overview of Southend-on-Sea’s current activity in relation to preventing infection and preventing the spread of infection at our 95 CQC registered adult care homes, alongside our support to the broader care sector. I have also attached a slide pack (SBC – Care Sector Offer – 20200529) that covers our plans in more detail.

Our local care sector support plan, as outlined, has been reviewed by our Director of Adult Social Service (Tandra Forster), our Director of Public Health (Krishna Ramkhelawon), the Accountable Officer for Southend Clinical Commissioning Group (Anthony McKeever), and our Chief Nurse (Tricia D’Orsi) who are all in agreement with it. In line with the guidance in your letter we plan to make both the template, this letter, and the slide pack public at our Health and Wellbeing Board meeting on 10th June 2020.

Joint work to ensure care market resilience locally, and that support is in place for care providers as set out by the Government in its letter (14th May 2020) – including confirmation of daily arrangements in place to review the local data and information on the state of the market locally.

There is effective joint work in place to ensure market resilience, not just for care homes but also more broadly across the sector. All of Southend’s care providers have been regularly supplied with PPE, infection control guidance and training in the correct use of PPE and managing deterioration in physical conditions, and new measures to evidence resilience across the whole care sector (care homes, domiciliary care, and supported living) are being built into provider’s contingency plans, including financial resilience measures. Close working with our providers has continued throughout the outbreak and a new strategy for all sectors of the care market in Southend is planned post Covid, including the proposal to add domiciliary care and supported living to the national capacity tracker for our area.

Locally, the national capacity tracker is being used to update Southend on the position of our care homes. The tracker is provided by 10:00 a.m. daily to the Council’s Contracts Management Team who review the data. Any care homes who have consistently not updated the tracker are contacted; additionally, any homes flagging as AMBER or RED on the RAG rating are also contacted. More recently a review of the homes consistently flagging as GREEN has also been carried out to ensure the accuracy of the rating they have provided, and to ensure that any emerging challenges are picked up quickly and support to the homes is offered. It is reassuring to know that Southend care homes have seen a relatively low number of deaths in relation to the national figure, and work continues collaboratively with our care providers to ensure that this remains the case.

Your system’s collective level of confidence that these actions are being implemented or plans are in place to urgently implement, briefly setting out any areas where there are concerns and what support you might need. 

We are confident that the actions we have put in place to ensure care home resilience during the pandemic are working well. The attached pack sets these out in detail. The nature of our local care home sector, relatively large and mainly small single home providers, means that we have needed to step up as a local social care and health system to ensure adequate support. I am proud of the work that council staff, our local primary care sector, and our broader health colleagues have put in place to support residents and providers.

A short description of the approach that commissioners (LAs and CCGs) are taking to address short-term financial pressures experienced by care providers, taking into account local market context and pressures. This should include reference to any temporary or longer-term changes to fees paid by commissioners. 

The care market in Southend has been fragile for some time and our level of concern about market resilience in the light of the impact of Covid-19 is high. Some of this concern relates to the short-term financial pressures and some relates to broader structural issues.

We have put in place a series of uplifts and resilience payments for providers. These are set out below. This is in addition to our annual uplift, which for 20/21 was between 3 and 4.5% depending on sector and individual contract.

In addition, the Council wrote to care home providers at the beginning of April and advised that for the next 3 months, they would be paid an additional 10% on top of the scheduled payment they receive from Southend Borough Council for the individuals they are financially responsible for in their home. 2 of these payments have been paid and the third will be paid 27th May 2020.

The approach agreed locally to providing alternative accommodation where this is required, and care arrangements for people who need to be isolated or shielded, where their normal care home does not have capacity to provide this. Costs of providing this accommodation are covered by the £1.3 billion COVID-19 discharge funding via the NHS. 

The large number of small care homes in Southend means that this was a priority for us. On Monday 4th May, Southend Care opened a care unit in partnership with the Council to support older people awaiting a COVID-19 negative test result or who have tested positive for COVID-19. Southend Care is a company wholly owned by the Council, set up to deliver high quality care and support in Southend-on-Sea. The unit remains operational and continues to work with Southend Hospital. Based at Southend Care’s existing premises at Priory House in Southend-on-Sea, the dedicated COVID-19 Care Unit has thirteen fully operational assessment beds for older people who have recently been discharged from hospital following a COVID-19 test and are awaiting a negative test result. Since opening, the unit has provided support to eight individuals. There are currently three people in the unit receiving support. The care unit remains prepared for any increase in cases as lockdown measures are eased.   

The COVID-19 Care Unit is operating in line with national and local guidance on the care of people with suspected or actual COVID-19 status. It is being managed by an on-site team of dedicated carers and people have been looked after in separate rooms. Admission volumes have not exceeded two per day, allowing the unit to effectively manage flow and capacity. The unit has adhered to government guidance on use of PPE by health and social care workers. The unit is supported by district nurses, enhanced care home teams and the Council’s hospital social work team. The Pall Mall Surgery in Leigh-on-Sea, which is currently aligned with Priory House, is servicing the unit. The NHS Southend Clinical Commissioning Group has provided wraparound clinical support.

Local co-ordination for placing returning clinical staff or volunteers into care homes, where care homes request this support. 

Southend has developed a robust arrangement for supporting local people during the Covid 19 outbreak, with several Hubs developed across the borough. To support these Hubs there has been a strong response from our local population to volunteer support to the more vulnerable of our residents. The volunteers will be asked to re-deploy to care homes should there be a request from our providers for further assistance.

Where this is needed, Southend will ensure that the same arrangements are put in place to support volunteers in reducing infection rates, as have been applied to care home staff.

I am grateful to central government for your ongoing support to local government through the Covid-19 crisis and am clear we could not sustain this level of work without this ongoing support. We will continue to work closely with the NHS, with the local care sector, and with the community to ensure that care providers are provided with the support they require to keep residents safe.

Yours sincerely,
Alison Griffin

Care sector support offered submitted to Government on 29 May 2020.

Published: 29th May 2020

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