Browse

Agenda item

Overview of Adult Social Care Winter Pressures

A report is attached from the Director of Ageing and Living Well outlining key actions taken by the council to address winter pressures during the COVID-19 pandemic.

Minutes:

Emma Legg, Director for Adult Care, Living and Ageing Well, introduced the report noting that it had been written before Christmas, so the figures had changed. The director reported that there had been unprecedented demand for supported discharge over the past two years. To illustrate this point, she highlighted that in 2019/20 they had purchased 60 care home beds for people needing 24 hours support, once they had been in hospital, but that the current figure stood at 143. There had also been a marked increase in the number of referrals to the reablement service.

 

The director drew attention to the council’s new in-house domiciliary care service Wiltshire Support at Home, stating that it was now delivering more hours of care than anticipated and was allowing them to better support patients as they were being discharged.

 

Concerns were raised about the recent increase in the number of care homes being closed due to Covid-19, 53 at the time of the meeting. However, the director noted that the majority of Covid-19 outbreaks were now community infections found in staff, rather than in the residents themselves. Staffing was an area of particular concern with over 700 provider staff having left their jobs in the last six months.

 

 

During the discussion points included:

 

• In response to a question about the number of patients being readmitted, 27 percent within four weeks of discharge, the director reported that the figures related to the reablement service, where patients tended to have a high degree of need. It was reported that the situation was being monitored and the council was working closely with acute providers.

• When asked about the long-term viability of domiciliary care providers working with the council, the director noted that providers had their own sustainability plans, but they were encouraged to notify the council of issues as early as possible. It was reported that the council’s commissioning and brokerage teams worked closely with providers and through Wiltshire Care Partnership. Mitigation measures were in place and nationally there had been changes to funding packages for discharged patients.

• Given the staffing pressures in the industry, care was taken not to recruit from other providers wherever possible. The director spoke about the importance of promoting care as a career and of using the apprenticeship levy. The reasons for West Wiltshire losing a larger proportion of its workforce than other areas of the county were unclear, but she noted that there were more retail opportunities located in that area.

• It was reported that the Wiltshire Support at Home Service was still new but focused on expanding capacity. Modelling was ongoing to access the impact of the service.

• Members asked about the use of the Shared Lives Programme in supporting hospital discharge.  The director noted that this was being used by some local authorities (LAs) and explained that Wiltshire was keen to liaise with other LAs to learn about their experiences. Work was also being done to review the use of technology, although there was not a one size fits all approach.

• In response to a question about the use of prophylactic natural supplements in supporting immunity, Dr Peter Collins, Chief Medical Officer at Salisbury Foundation Trust, noted that a number of Covid-19 medicines were in development and it was hoped that this would reduce pressure on hospitals over time. Prophylactic treatments would likely be used in subsequent iterations of Covid-19 as the population learned to live with the disease, but the current focus was primarily on measures such as mask wearing and social distancing.

• Chief Executive Officer for the Salisbury NHS Foundation Trust, Stacey Hunter, explained that the care system should be a health model, rather than an ill health model, so lots of work was being done to focus on reducing admissions by aging and living well.

• In response to a question about how help from the voluntary sector was being organised, the chief executive stated that they had rethought their workforce strategy to see to make the most of the resources offered by the voluntary sector.

• Cllr Jane Davies, Cabinet Member for Adult Social Care, SEND, Transition and Inclusion, spoke about the importance of co-working. She explained that the council’s new Prevention and Wellbeing Team would work alongside Community Engagement Managers (CEMs) to assist the community sector.

• Lucy Townsend, Corporate Director of People, reported that a Home from Hospital Service contract was due for tender and they were encouraging bids from the voluntary sector. A further contract for day care opportunities would also be open to voluntary sector bids.

 

Resolved

 

1) To note the contents of the report.

2) To recognise the work of the council in its support of the provider market.

3) To acknowledge and express the committee’s appreciation to care staff and the voluntary sector in their response to the pandemic.

4) To invite a further update within six months, updating on the challenges facing adult social care and its ongoing response.

 

Supporting documents: