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Agenda item

An overview of Care Homes for Older People in Monmouthshire and the impact of COVID-19

Minutes:

The Chief Officer advised that this report requested by the committee was timely and enabled members to be sighted on the key issues facing care homes ahead of any future public inquiry. She introduced the report advising that Monmouthshire has experienced 27 deaths in care homes, which is devastating for the families affected and explained there is a need for caution going forward.  We have data which helps us to understand the picture and context - whilst there has been a decline in current occupancy in care homes, this is not solely due to covid 19. It is important to recognise that some settings are new and are not fully up to their capacity and some have been instructed by the external regulators to reduce numbers whilst taking specific actions. Partnership working has been very important, with care homes needing a lot more contact and support. Personal Protective Equipment (PPE) was a major concern, care settings usually sourcing their own, but with restrictions meaning they could not access it, we had to ensure an effective distribution system. Infection control has also been a major issue, with changing guidance at a rapid pace. In terms of hospital discharge and testing, the procedure has been revised to require a negative test48 hours prior to discharge.  The financial stability of care homes has been affected by fewer admissions and if settings have had a case, they have been restricted on taking in new patients.

 

In terms of what happens next and how we move forward, we are identifying the support providers require to continue in the immediate future. We’ll keep in place procedures that have helped our care homes. We need to better understand the capacity for beds and we must continue to make sure PPE is available. We also must ensure we provide clear guidance on infection control. We are awaiting news from Welsh Government (WG) on the ‘Hardship fund’ and whether these monies will continue post June. In addition, we are working with settings to consider pragmatically how they can take in new patients. 

 

Questions:

 

·         Have there been any challenges in interpreting WG guidance and claiming the hardship funding?

We have given settings as much information as possible on WG guidance and we have assisted them to claim monies to assist them. We have had one claim challenged, which is disappointing, as providers need these monies to survive.

 

·         In terms of PPE, some areas have over capacity of PPE and problems storing it. Have we got the right items and sufficient storage of these for any potential 2nd wave? 

We have a good PPE stock and we have stores in the county which are accessible 24/7 if needed.  The Army gave guidance to WG on delivering what areas needed, rather than supplying simply what was available.   We are in a confident position going forward in terms of PPE.

 

·         How resilient economically is the sector?

In terms of the long term viability, care homes need a greater profile. 2.5% of the population live in a care home, so it’s perhaps not on most people’s radar, but is a major issue as to what the future holds for this sector and for people who need residential care.  We will be able to share an update on Crick Road when we are clearer on the funding.

 

·         To what extent is there a long term recovery method required for these homes to sustain themselves?

That is a key issue for which we don’t have any foresight at the moment.

 

·         Are we sufficiently staffed? Are there any issues recruiting?

We are fortunate that at the moment, we have good staffing levels.

 

·         Are there clear protocols in place to clarify infection control?

Infection control and management of behaviour around social distancing and car sharing is high on our radar. Environmental Health Officers (EHO’s) work closely with Social Care teams to ensure there is clear communication on infection control.  This is not just an issue for care homes but also for domiciliary care and agency workers and it is something that we work on closely across Gwent.

 

·         There has been very little mention of unpaid carers and the health sector. Unpaid carers have suggested in some arenas that they have felt to have been ignored all the way through this process. This surely needs to change.

That is a fair point, but I’d like to reassure you that whilst the focus was initially on hospitals, that was due to the perception that hospitals would be overloaded with coronavirus cases, but that’s not been the case. We have worked closely on hospital discharge with health. We have also done a lot of work with carers on how we can support them, but there aren’t going to be significant changes to the services we can offer them in short term and we really do recognise that these services such as day services are what is really important to them.  We have learnt a lot through this process.   We are constantly engaged with health and we are integrated to some degree locally but regionally, it’s ramped up.  The rush to discharge people from hospital is likely to be a future area for discussion. Any working with health has been massively improved by the speed we have achieved through this crisis and I think we have to balance this against the situation.

 

·         Are the Nightingale hospitals dismantled?

No, these have been retained as far as we know for the winter period to provide for any second wave of the virus. The Grange hospital is ready to open in November if required.

 

Chairs Conclusion:

 

The committee thanks officers for briefing members on the situation. The committee is significantly concerned that the ‘Hardship Fund’ has not yet been confirmed post June and we await further clarification from WG on this matter. As the chair for this final committee meeting, I will send members the email that I have received from Aneurin Bevan University Health Board and your next meeting will be chaired by Councillor Simon Howarth. I thank members for a productive year and all officers for assisting us in our scrutiny activity.

 

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