Agenda item

To receive an overview of the care home and care sector position including an update on the work being undertaken on the local authority Care Home Support Plan.

The Board received a presentation from the Director of Adults’ Health and Care at Hampshire County Council alongside a report with most recent data and developments.

Members received an overview of the key elements and heard that all Hampshire organizations had come together to provide services and support with humanity, compassion, and care.  The speed and voracity of the impact of Covid, even with the response of many organizations and the Voluntary Care Sector (VCS), left the care home sector particularly and significantly affected. 

There have been some lags due to data delays but review of key data has had a significant impact on learning and work is already underway to better understand the causes of excess deaths in care homes.  Each and every death is tragic for loved ones, but also for the care home families that function as such.

From a Hampshire perspective, actions have been taken to provide support for the care sector in meeting key challenges with nearly 4 months in response mode and continuing to fight the pandemic.  Asymptomatic people remain a challenge for a novel virus as well as the transmission profile, PPE supply chain challenges and guidance, clear and present danger, testing for residents and staff, lockdown and closures of communities, effects of not having visits from family and friends, significant emotional, psychological, mental health impacts, concerns for safety of key workers, and protecting and reassuring BAME staff.

Grants for infection prevention and control measures have been taken forward swiftly in order to establish the Care Home Support Board with multiagency support for a response plan and delivery and distribution of funds to every care home setting in Hampshire, including advance payments prior to receiving government funding and a second payment in process now.  Multidisciplinary team meetings, stringent grant conditions and audit have been put into place. 

In response to questions, Members heard:

Routine testing started mid-April and it is possible some deaths towards the beginning were possibly Covid-related but had not been tested. Other factors such as acute capacity for stepdown placement in combination with other challenges contributed to numbers.  There is variability in the data and the average over the period is used.

Excess deaths have included people’s private homes, care homes, and hospitals.  Doctors had the option to add the presence of Covid on death certificates.  There were concerns about some people who didn’t go to the hospital because of media messaging, though hospitals have accepted critical patients through the pandemic period.  The graphs depicted are not up to date to current time, but deaths are lower now, so that curve may reset as some people may have died earlier than anticipated.  The statistical analysis would be very useful though every loss remains tragic for families, friends, and carers.

Ensuring people in care homes have personalised support plans and death plans based on personal and family preferences continues to be part and parcel of the care support plan from a national level of strategy. Digital notes are accessible to paramedics and patient preferences are front and centre of their care.  Providing ethical care and having the care sector moving as one is critical to focus and be responsive around supporting people.  Healthwatch have also joined the group for multiagency care home support arrangements.

Currently, people are being admitted to care homes but in lower numbers and work is taking place by the Hampshire Care Association to reinforce that care homes remain open, safe, and are continuing to provide the highest quality of care.  The relationship between the Primary Care Network (PCN) and care homes remains key.

Members thanked the Director’s leadership and the department and noted that the stories of members of staff in the care sector going above and beyond have been quite moving.  

RESOLVED: 

That the Health and Wellbeing Board--

• Is assured by the work underway to support the care home sector through the development of a care home plan and notes the contents of this report.
• Recognised the impacts upon the care home and wider social care sector and thank all those staff working across the sector for the humanity, compassion and care shown throughout their responses to Covid-19.
• Will receive further updates at future meetings on continuing work to support the care sector.