Minutes:
The Director of Adult Social Care gave an update to Members on work being undertaken across the Adult Social Care department.
The Director of Adult Social Care reiterated the message delivered to the meeting of the Health Scrutiny Sub-Committee the previous week, by Jonathan Lofthouse, Site Chief Executive – PRUH and South Sites – in Bromley, the whole system had worked well to support the community and reduce the impact of the pandemic. This was not taken for granted, but it was good to have recognition from a recent review of the discharge arrangements that they were an exemplar of how the system could work. It had also been recognised that bureaucracy had been reduced and managed efficiently across all partners at such a difficult time.
Away from the department’s role to support the NHS, they were continuing with “business as usual”. People were being supported flexibly, and the numbers of referrals for support had continued to increase, although this was still slightly below the normal level. In addition, the department continued to release a large number of staff to support the COVID workstreams, including support to vulnerable people; test and trace; PPE distribution; and vaccination and testing for staff, care providers and the wider community.
Sadly, there had been a recent increase in the numbers of both staff and service users in care settings who had returned positive COVID-19 tests. In order to manage this and provide support and oversight, daily meetings were being held, and were attended by Public Health, social care commissioners, quality assurance officers and the CCG. These meetings were proving invaluable in terms of spotting where there may be an issue arising, and providing training and support. More recently, this had been linked to the number of vaccinations given so that they could begin to estimate when problems would subside, or where more reassurance and support was required. It was noted that the department were keen to ensure that all staff working within care settings were given the COVID-19 vaccination. However, they were having to undertake work to reassure a number of these staff that this was appropriate, and they were working with the Bromley Care Practice who were rolling out the vaccination programme.
The Director of Adult Social Care informed Members that since the last Committee meeting, the second Infection Control Grant had been distributed. They had also recently been notified that some additional grant monies would shortly be received to support providers with testing, which was a heavy demand on their time. It was highlighted that during this period, the relationship with providers had continued to go from strength to strength, which was a positive outcome of an awful situation, and discussions were more cooperative and supportive.
A positive workshop, hosted by Community Links Bromley, was held on the 16th December 2020 to examine the issues surrounding changes in demand for day centres and day activities. The session allowed time for all agencies to discuss how they could work together to rethink the future of day activities for people in the Borough. An outcome from the session had been the Council committing to working with partners to agree a shared vision for developing a broader day service and community support offer for people, and the practical steps to achieve this. The Director of Adult Social Care noted that a more detailed briefing could be circulated to Members after the meeting.
A Member noted that the Bertha James Centre had closed earlier in the year and queried if sufficient day places were available in the Borough to accommodate all those referred. The Director of Adult Social Care advised that following the closure, alternative placements had been provided to all that required them. During the pandemic, service users had been received support in different ways. The directorate had sent out questionnaires to service users, and their families, to gain feedback on what was important to them in terms of day activities, as prior to the pandemic they had already been seeing a drop in the numbers wishing to attend a physical centre. Members asked to be provided with a summary of this consultation.
In response to a question regarding support for carers, the Director of Adult Social Care noted that requirements varied for the different carer groups. The team were in regular contact with carers who they were aware were under a great deal of stress. This particularly related to carers of adults with learning disabilities, to whom it was difficult to explain the current situation, and why they were unable to attend places as part of their usual routine. Where appropriate, alternative provisions had been offered by the team, such as volunteers or staff to take service users out, rather than to collective settings, or providing support in the home to provide a break for the carers. It was recognised that this period had been particularly difficult for those carers who relied on the services that had been unable to remain open. Additional funding had been awarded through a grant, and going forward would be used to look at what else could be provided to support carers to enable them to continue in their roles. The Director of Adult Social Care stressed that they did not underestimate the impact of the pandemic, particularly on carers who had the individual cared for living with them.
A Member noted that it was positive to hear of this additional grant, and queried if carers, and the organisations that supported them, would be involved in developing the approach used to provide support. The Assistant Director for Integrated Commissioning advised that a grant of around £50k had been secured to provide additional support for carers, particularly those who had been unable to attend day centres in recent months. They would be working with Community Links Bromley to distribute small grants of up to £5k, and would be advertising the following week for small providers to put forward ideas for extending their existing schemes, or new programmes that they could put in place. It was anticipated that these schemes would be up and running within a matter of weeks.
The Director of Adult Social Care advised that overall, staffing levels had remained positive, however they were starting to see more staff who were either unwell with COVID-19, or who were having to self-isolate following close contact with others who had tested positive. The Assistant Director for Strategy, Performance and Corporate Transformation had been leading the asymptomatic testing for staff, which was being well attended and was a testament to her and the staff involved. The department had also been able to access vaccinations for front line staff and had put forward over 500 names to the PRUH for an offer of an appointment. These were now rolling out at pace.
A Member noted that the COVID-19 testing programme was an impressive operation and passed on his congratulations to all those involved in establishing a very efficient service. However, it was queried if a covered area could be identified that could be used as shelter for those waiting outside. The Assistant Director for Strategy, Performance and Corporate Transformation advised that a gazebo was currently on order, and expected to arrive the following week, which would be used to create a covered waiting area. An inside area was not being used, as it made infection control more difficult.
The Director of Adult Social Care extended “a big thank you” to all the staff who had continued to deliver excellent support to the community, whilst also dealing with the personal impacts of the pandemic.
A Member highlighted that oversight of domestic abuse and violence against women had been moved from Public Protection and Enforcement to the Children, Education and Families portfolio. The rationale behind this was queried, as it was considered that it may sit better within Adult Care and Health. The Director of Adult Social Care advised that domestic violence sat within various portfolios across different Local Authorities. A number had it located under Children’s Services to ensure an oversight of the impact on children within a family setting. The Director of Adult Social Care agreed to check this in more detail outside of the meeting, and a response would be provided.
The Member further noted their concerns regarding the long-term impact of COVID-19, in relation to issues such as mental health; domestic abuse; obesity; and drug and alcohol abuse. It was anticipated that the demand for services would increase hugely, and it was queried if work was being undertaken to gauge this impact. The Director of Adult Social Care said the impact of the pandemic on people’s mental health and general wellbeing was recognised. They were keen to look at this as some residents were suffering from Long COVID-19, which would have an impact on their lives for a substantial amount of time. It was noted that the mental health setting would be receiving additional investment.
The Director of Public Health advised that a large amount of work had been undertaken to look at post-COVID health issues, particularly with regard to mental health, and other chronic conditions such as cancer, diabetes and obesity. It was noted that issues, such as cancer screenings being paused, had been discussed at meetings of the Health and Wellbeing Board. Data indicated that there had been a significant impact on drug and alcohol services, with both self-referrals and referrals from GP’s having increased, and the Contained Management Outbreak fund had been used to boost this service. Members were advised that a Mental Health Strategy was being developed jointly with the CCG, and a specific item on mental health services would be presented at the February meeting of the Health and Wellbeing Board. It was highlighted that the Joint Strategic Needs Assessment would be reviewed in terms of how the priority areas had been affected by COVID-19. The Chairman of the Health and Wellbeing Board advised Members that the Council’s ‘Don’t Wait to Lose Weight’ campaign had again been relaunched to try and help mitigate some of the effects of COVID-19. It was noted that around 20% of those who had contracted COVID-19 were still suffering from the serious impact three months on, and it was predicted that the population would be living alongside the virus for at least the next five years.
RESOLVED that the update be noted.