The Association of Directors of Adult Social Services (ADASS) has called for an emergency initiative to bolster the social care workforce after its president warned that the sector risked being overwhelmed by the immense pressures on the NHS and staffing shortages.
With the number of hospital patients with Covid-19 well exceeding April’s first peak, NHS leaders have called for capacity to be found in the social care sector to relieve pressures on the health service. However, social care providers have warned that capacity has been sapped by high levels of staffing absence and additional pressures created by increased coronavirus testing.
In a tweet yesterday, ADASS president James Bullion warned that the “immense pressures” on the NHS could easily overwhelm social care”, having flagged last week the severe impact staff sickness was having on the sector.
Emergency plan needed
ADASS has now called for “an emergency winter workforce initiative” to attract people into the sector, offering pay and reward incentives and guaranteed immediate vaccination, the precursor to a “national care wage” of at least £10.90 an hour, well above the current minimum of £8.72.
ADASS vice-president Stephen Chandler said: “With steeply rising unemployment, this is a once-in-a-lifetime opportunity to attract a new generation into careers in the care sector and ease its chronic recruitment problems at a stroke.”
Against the backdrop of sector vacancies of 112,000 as of last year, provider bodies told Community Care that the latest phase of the pandemic was making matters much worse.
Absence rates up to 35% in some services
The National Care Forum (NCF), which represents not-for-profit providers, said some members were reporting absence rates of between 25% and 35% in their services.
A spokesperson said this was being driven partly by the increased use of rapid lateral flow device testing but also by increased transmission.
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Colin Angel, policy director at United Kingdom Homecare Association, said the introduction of weekly testing of home care staff was having similar results.
“[Staff absence has] no doubt increased as asymptomatic workers can now be identified through weekly testing, which has not been available to the home care workforce until recently,” he said.
He added: “The re-introduction of shielding will inevitably have an impact on the capacity of the home care workforce, as a proportion of care workers are now likely to be required to shield again.”
Looking ahead to the rollout of vaccinations among home care staff, Angel said this risked exacerbating workforce pressures if not accompanied by additional support.
“Care workers are likely to be required to travel some distance for the vaccination, taking time out of the working day,” he said.
Angel also urged careful planning for how people who use home-based care will receive their vaccinations.
“Many people using home care will require their vaccine to be administered at home, they will either require a care worker to be present to enable access and egress to the home, or (in the absence of informal carers to do so) to accompany people to a vaccination centre,” he said.
“Councils and the NHS will need to think about how such a service could be commissioned quickly.
“There cannot be an assumption that care workers will just be able to sit and wait for the vaccination team to turn up.”
Concerns over family carers
There are concerns too for the resilience of family carers, many of whom are exhausted after months of carrying out caring responsibilities with little respite.
In response, ADASS is calling for an extra payment of £50 a week for carers in receipt of carer’s allowance, while the Covid-19 crisis continues, in order to fund respite breaks.
“If we do nothing and leave thousands of family carers to burn out, the costs to the state will be incalculably higher than those of providing a modest sum in extra support,” Chandler added.
Significant lack of Covid-secure homes
Meanwhile, 51 of 151 local authorities are yet to identify at least one Covid-secure home, under the designated setting scheme.
Councils, providers and the NHS are working to identify at least one care home in every local authority area to which people who have tested positive for coronavirus can be discharged to from hospital and cared for, for the remainder of the required isolation period.
The Care Quality Commission (CQC) must first inspect the “designated setting” and ensure it meets the latest infection prevention control standards.
CQC data shows that, as of 29 December, only 42% of London councils had at least one approved setting, with a similarly grim picture in the South West, where less than half of councils are yet to identify a Covid-secure home.
“We’re in discussion with the Department of Health and Social Care (DHSC), and system partners to address issues of capacity across the country, particularly in areas where there is a shortage or lack of designated settings,” the regulator said.
‘Immensely proud’ of care staff
In response to the concerns, a DHSC spokesperson said: “We are immensely proud of all our care workers do and recognise their tireless work on the frontline of this pandemic.
“Since the introduction of the National Living Wage, care worker pay has risen at a faster rate than ever and throughout this pandemic we have made sure care workers are properly supported financially, including ring-fencing over £1.1bn of funding which can be used to pay staff who may need to self-isolate.
“We know there is a need for a long-term solution for social care and are looking at a range of proposals as part of our commitment to bringing forward a plan that puts the sector on a more sustainable footing for the future.”