The costs of administering the government’s flagship social care fund to manage the spread of coronavirus may outweigh its benefits, a provider leader has warned.
National Care Forum (NCF) executive director Vic Rayner said the latest £546m tranche of the infection control fund (ICF) was spread too thinly, and providers faced excessive requirements to obtain what funding was available to them.
Rayner’s comments, in a post on the NCF website, came after the Department of Health and Social Care announced the grant conditions for the second round of the ICF, covering October 2020 to March 2021.
The fund is paid to councils to pass onto providers to help them manage infections – chiefly by enabling them to pay staff to self-isolate when required and to minimise staff movement between services and service users.
‘Spread so thin’
Three-quarters of the first round of the fund – worth £600m, from late May to the end of September – was reserved for care homes on a per bed basis, which prompted criticisms that not enough was being done to support home care and other providers.
The government’s Social Care Sector Covid-19 Support Taskforce, which reported last month, recommended a further round of the ICF and that specified funding be allocated to the rest of the sector.
In respose, the latest round specifies that 80% of funding is split between care homes and Care Quality Commission-regulated community care providers, on a per user basis.
The move was welcomed by the United Kingdom Homecare Association, however Rayner said that the result of the extended remit, reduced overall funding pot and longer timeframe – six months, as opposed to just over four – meant “it has been spread so thin, and so far that it runs a real risk of achieving very little at a time when it needs to deliver a lot”.
She said that her analysis suggested that a 50-bed care home, with 40-50 staff, would get £35,000-£40,000 over six months, to cover self-isolating staff their normal wages, limiting staff movement, cohorting care workers to specific residents, recruiting additional staff, providing workers with accommodation to stay onsite and ensuring safe visiting to the home.
She said “the gap between the ambition and actuality of funds” was compounded by the level of bureaucracy involved in accessing them, echoing a charge levelled at the first tranche of the fund by Association of Directors of Adult Social Services president James Bullion.
ICF reporting requirements
- Local authorities were paid their first instalment of the fund on 1 October, but will only get the second and final tranche, on 1 December, if they have fully transferred 80% of the first to providers on a per bed or per user basis within 20 days and sent a report to the DHSC on how providers have used the first month’s funding and intend to use further money, by 31 October.
- Councils must then provide the DHSC with monthly reports on the use of the fund by providers in their area.
- The 80% of the funding may only be used on specific measures by care homes or community care providers, to do with ensuring staff are paid their normal wages when self-isolating and minimising staff movement.
- Local authorities may only distribute the 80% of funding to providers who have committed to conforming to the grant conditions and provide certified evidence on a monthly basis that they have done so.
- To access any funding, care homes must complete the national capacity tracker, and home care providers the Care Quality Commission’s home care survey, on a weekly basis.
“So – to receive additional funding of around £6K per month, a home has to provide a monthly report to the local authority, who then aggregate and analyse hundreds of local reports each pertaining to equally small sums, and then provide a monthly report to central government, who presumably then aggregate and analyse around 150 reports to send through to Treasury – who ultimately provide regular reports to public accounts committees,” said Rayner.
“Are we missing the point somewhere here? Accountability and transparency are one thing – but this seeming obsession with counting the beans out and the husks back in would feel disproportionate in planet normal – and therefore feels completely off key in an ongoing pandemic in which care sits in the midst of the maelstrom.”
She added: “I know this funding has been hard fought for – and is desperately needed – so how have we got ourselves into a position where it becomes even reasonable to ask whether the cost of administering this fund outweighs the actual contribution to the cost of delivering on the fund’s ambitions?”
‘Funding must be kept under review’
In a recent interview with Community Care, social care taskforce chair David Pearson said the level of funding under the ICF needed to be kept under review.
“The government has extended the ICF based on the evidence of the first phase,” said Pearson, a former president of the Association of Directors of Adult Social Services. “It sets a platform and we need to be making sure we keep it under review over the winter.”
On the back of the taskforce report, the DHSC published a winter plan for adult social care, to help the sector manage the impact of Covid-19 up until the end of March. Besides extending the ICF, it includes:
- The provision of free personal protective equipment to care homes and home care providers, until March 2021, through the existing PPE portal, which is designed to help services meet the additional PPE demands arising from the pandemic. Free stock will also be provided to councils and local resilience forums – multi-agency partnerships designed to tackle emergencies – for those providers unable to use the portal.
- Providing six weeks’ care and support for those discharged from hospital with needs, and urgent support for those at risk of a hospital admission.
- Developing a scheme in which the Care Quality Commission will designate care homes as safe to receive Covid-positive people from hospital, and requiring councils to provide alternative accommodation for people discharged whose care home cannot accommodate them.
- Providing free flu vaccines to all social care staff in frontline roles, including personal assistants funded by direct payments, personal budgets or personal health budgets.
The taskforce included leaders from across the sector, including ADASS, the Local Government Association, the CQC and Unison, as well as representatives from government departments.
Though its work was time-limited, running from mid-June to late August, Pearson said that the DHSC had asked it to continue advising government on the pandemic, along with eight advisory groups set up to deal with specific issues, including carers, self-directed support, the impact of Covid on people from Black Asian and minority ethnic groups, and the workforce.
In its report, the workforce advisory group called for a rapid review into the pay and conditions of social care staff wtih a view to implementing significant rises before the end of the 2020-21 financial year. Though the DHSC is yet to respond, Pearson said all the recommmendations of the advisory group would be responded to in due course.