The government has given councils discretion on how they spend £60m allocated this month to tackle Omicron’s impact on adult social care, to ensure it is spent quickly.
Setting out further details on the Omicron support fund yesterday, the Department of Health and Social Care said it was minimising reporting requirements though stressed that the money should be spent to deal with the variant’s impact on the sector.
As a result, unlike previous Covid funds, councils will not have to report directly on how the money has been used. The DHSC expects authorities to indicate how they have used the resource when they report next month on their use of the existing infection control and testing fund.
It said the £60m could be used for measures set out for use under the infection control and testing fund, such as enabling providers to pay self-isolating staff their normal wages, fund temporary cover and limit staff movement between settings.
Boosting direct payments
However, the guidance said councils could also use the £60m to fund direct payments where a person’s family or friends are caring for them and enable carers to continue in their roles. Direct payment regulations state that they may only be used to enable a spouse, or a relative from the same household, to care for the recipient if the local authority deems this is necessary.
The fund could also be used to finance improved ventilation for care homes, for example, by purchasing CO2 monitors or air cleaners.
Unlike the infection control and testing fund – the latest tranche of which is worth £388m from October 2021 to March 2022 – councils are not obliged to pass on a specific proportion of the Omicron fund to providers in their area. Where they do, the DHSC said they should “ideally not” pass it onto providers who have not complied with conditions for previous grants without sufficient assurances from the organisation.
‘A national emergency for social care’
The funding comes amid widespread concerns over the impact of Omicron on adult social care, which Association of Directors of Adult Social Services president Stephen Chandler has described as a “national emergency” for the sector.
Speaking just before Christmas, he said: “Even before Covid-19 and Omicron, adult social care was struggling with severe funding and workforce challenges. Staff absences due to the rapid spread of Omicron and the need to self-isolate now mean that there are not enough pairs of hands to provide care for everyone who needs it. Every day we are rationing care in ways that we never have before.
“We are making incredibly difficult decisions about who gets care, how much care they get and who misses out – with obvious concerns that this will lead to people becoming isolated and, ultimately, to the loss of lives.”
Amid the pressures on adult social care, NHS leaders are seeking to clear beds in order to preserve capacity to deal with increased hospital admissions arising from Omicron and other causes.
Last month, NHS England and NHS Improvement wrote to health service leaders setting them a target to reduce by half the number of patients in hospital who did not meet the criteria to remain.
“This will necessitate senior system leaders across the NHS and local authorities meeting daily to ensure sufficient progress is made”, said the letter from NHS chief executive Amanda Pritchard and NHS Improvement equivalent Professor Stephen Powis.
Figures for the week ending 2 January 2022 showed that 90% of patients who had been in hospital for at least three weeks and no longer met the criteria to stay were not being discharged each day.
It is not clear how many of these delays are down to the unavailability of social care. However, the NHS has been urged to focus on discharging those patients who will not require additional support, including social care, when they return home.
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I didn’t think ADASS could mire itself in any more ridicule but to claim “we are making incredibly difficult decisions about who gets care, how much care they get and who misses out” as a consequence of Omicron is just shameful. Rationing of who gets what and who deserves to get something is the bread and butter of adults social work. It has been the de facto practice enforced by local Authority Directors and actually predates the Care Act too. None of us who work for the people populating ADASS are going to sit back and pretend they are being forced to make choices they otherwise wouldn’t make. Because I need my wages, I have colluded with the decisions Directirs choose to make which force people into isolation and “ultimately, to the loss of lives”. Don’t believe me, believe the numerous damnations from the Ombudsman predating the pandemic.
The default position of the Care Act is enforcement of an ideological position on provision of service. The view at the time of the repeal of the Community Care Act was that needs led assessments should be scrapped as the funding would not be available to fund the needs identified essentially making the assessment process pointless. It was replaced with the ideology of the small state,low taxation and the transfer of service from the state to community with the closure of many services such as local authority day care and a transfer to the voluntary sector and to the supposed community of church and volunteers and of course to family. Social workers now have to look at prevention and what families can do for their relatives. Direct payments are only agreed if no suitable alternative free provision is available. Alongside of these reforms local Authorities have been forced by austerity to increase service charges to those deemed to have need of local authority support. It is now common practice in local authorities to enforce the ideology of strength based assessment and Social Workers are instructed how questions should be asked and told that they should never ask what needs people have that are unmet presently. The truth is that Social Workers have zero autonomy to ask people about their perception of what is needed. In many cases even when people meet criteria for direct payments their expected contribution strips them of much of their personal independence payments a case of one hand giving money and the other hand taking it back. It is also true that increasingly assessment recommendations are routinely ignored when presented for funding agreement to senior management.
Every. Word. Is. True.
I don’t know if every word is true when Labour controlled authorities have been enthusiastically cutting services pre-Coalition government austerity. And Rachel Reeves echis Jo Swinton in demonising the very people social workers serve.