ASC Winter Plan 2021-22 – actions for Local Authorities

 

On 3rd November DHSC published their Adult Social Care: Covid 19 winter plan 2021-22. This sets out key elements of national support available for the sector over the winter as well as principal actions for local authorities, NHS organisations and social care providers across all settings. Below is a summary of actions for local authorities drawn from the plan. Please read the plan in its entirety to ensure you understand the national support and any actions for the NHS, ICSs and providers that may have implications for Adult Social Care.

  1. Preventing and controlling the spread of infection in care settings

PPE

Local authorities should:

  • promote use of the PPE portalfor CQC-registered care providers
  • maintain a system for provision of free PPE to non CQC-registered providers, either directly or through the LRF
  • report any shortages of local authority and LRF PPE supplies to DHSC

Testing

Local authorities should:

  • make sure care providers, as far as possible, carry out COVID-19 in line with the guidance on the COVID-19 testing strategy for adult social care
  • provide local support for testing if needed, working with local NHS organisations as required
  • monitor their local COVID-19 testing data to identify and act on emerging concerns as advised by public health authorities, including following up with care settings that are not undertaking regular testing
  • pass on the Infection Control and Testing Fund (ICTF)to care homes and parts of the wider adult social care sector, and report regularly on how this funding is being spent by providers
  • support providers in managing multi-virus testing (including for influenza) where need is identified by the HPT

 

Vaccination

Local authorities should:

  • support communications campaigns encouraging eligible social care workers, unpaid carers and people who receive care to receive a free COVID-19 vaccine, and flu vaccine, as appropriate
  • work with local NHS partners to facilitate and encourage the delivery of COVID-19 vaccines (and flu vaccines where appropriate), in line with the UKHSA HPT standard operating procedures, to social care workers, unpaid carers and residents in care homes
  • provide consolidated information on vaccination uptake via the national Capacity Tracker
  • ensure all care homes in their area are able to meet the new requirement to make vaccination a condition of deployment. They should work with care homes to support them to review and strengthen their contingency plans, as well as reviewing their own contingency plans; clarify the potential impact on services locally; and be able to respond, escalating risks where necessary via LRFs and NHS regional teams
  • ensure any NHS and local authority staff who are visiting a care home for work purposes are fully vaccinated – from 11 November 2021, it will be a requirement for NHS and local authority staff to be fully vaccinated in order to work inside a care home, unless they are exempt

 

Infection prevention and outbreak management

Local authorities should:

  • work with all relevant partners, including UKHSA and local health protection boards, to control local outbreaks in line with the contain framework
  • refer to the IPC best practice examples and case studies published alongside the IPC Champions Network launch – for example, local authorities and providers can collaborate with NHS IPC nurses to ensure robust IPC practices are in place within adult social care settings

 

Visiting

Actions for local authorities

Directors of public health (DPHs) and directors of adult social services (DASSs) have an important role to play in supporting visiting, and in supporting the care home to deliver safe visits into care homes. This may be through a dedicated care home outbreak management team or group, often in partnership with local social care commissioners. The DPH should work with the local DASS in developing and communicating their advice to care homes.

Local authorities should support visiting, recognising its importance for resident welfare – any decision to take a more restrictive approach should be proportionate, targeted and time limited.

In all cases, exemptions to any local restrictions should be made for visits to residents at the end of their lives.

Local restrictions should also respect the role of essential caregivers, including allowing them to visit in most circumstances.

  1. Collaboration across health and care services

Preventing avoidable admissions

Home care staff and social workers should understand how Urgent Community Response services work in their respective area and professional setting to enable speedy referrals if there are concerns about the people they care for who may be struggling at home with their health and approaching a crisis.

Technology and Digital Support

ICSs should engage with local authorities and care providers to consider their requirements for access to digital and technology solutions, using this information to develop a robust case to apply for the Digitising Social Care Fund 

Safe Discharge from NHS settings

Actions for local authorities and NHS organisations:

While we expect demand for the settings to remain low, local authorities should continue to make decisions about the provisions of designated settings so that no local authority area is without a designated setting facility. Therefore, where current arrangements are working well to meet local demand for designated settings, local areas are encouraged to continue to deliver designated settings as they have been.

As set out in the BCF policy framework: 2021 to 2022, areas should agree a joint plan to deliver health, social care, housing and other public services that work together to support improvements in outcomes for people being discharged from hospital, and the implementation of a ‘home first’ approach. Commissioners should ensure that a collaborative approach to commissioning the support for people being discharged from hospital makes the most effective use of social care capacity. Further details are set out in the BCF planning requirements.

Local NHS organisations and local authorities should work together to support discharge from mental health settings, such as to step down beds or longer-term supported housing, or with enhanced social care support in people’s homes (such as help with daily living activities like cooking and shopping or support with tenancies and other home adaptations).

Health and social care staff should always involve family and carers in discharge planning, and provide information and advice on who to contact if the individual’s condition changes, how their needs will be assessed and the follow-up support they will receive.

Upon admission to hospital, all people who are homeless or at risk should be identified and referred to local authority homelessness services as per the government’s hospital discharge and community support policy.

Social Prescribing

Local authorities and NHS organisations should:

  • work closely with SPLWs and VCSE organisations to co-ordinate support for people identified by health and care professionals as most needing support, especially those impacted by health inequalities, autistic people, people with learning disabilities, carers and those with dementia
  • ensure SPLWs have the support and equipment to work remotely and access GP or social care IT systems as needed
  • ensure SPLWs have access to high-quality supervision and support

 

End of Life

NHS organisations and local authorities should:

  • ensure that discussions and decisions on advance care planning, including end of life, take place between the individual (and those people who are important to them where appropriate) and the multidisciplinary care team supporting them. Where a person lacks the capacity to make treatment decisions, a care plan should be developed following, where applicable, the best interest checklistunder the Mental Capacity Act 2005.
  • implement relevant guidance, and circulate, promote and summarise guidance to the relevant providers. This should draw on the wide range of resources that have been made available to the social care sector by health and care system partners and organisations, including those published by:

 

  1. Supporting the people who provide care

 

Unpaid carers and respite care

Local authorities should:

  • make sure carers, and those who organise their own care, know what support is available to them and who to contact if they need help. Local authorities have a duty under the Care Act 2014 to provide or arrange services that meet the social care needs of the local population
  • ensure that carers’ assessments are reviewed and updated to reflect any additional needs of both carers and those in need of social care
  • continue to follow the direct payments guidance, ensuring that they take a flexible approach so that those receiving all forms of direct payments continue to have flexibility in how they receive their care and support
  • continue to work with day and respite service providers to ensure the safe re-opening and extended opening of their services, where appropriate, and continue to support those who require services to ensure identified needs are met in the interim of some services re-opening

 

Supporting the workforce

Recruitment and retention across the adult social care workforce is a significant challenge. We recognise the ongoing hard work by providers and local authorities – working with system partners such as the NHS – to address difficult workforce capacity issues.

The government will continue to work closely with the sector to monitor the situation over the winter period and to consider what further action may be necessary.

Workforce well-being

Local authorities should:

  • maintain, where possible, the additional staff support services that they put in place during the first wave of the pandemic
  • review current occupational health provision with providers in their area and highlight good practice
  • promote wellbeing offers to their staff and allow staff time to access support, as well as promoting to providers in their area

 

Workforce capacity

 

We expect the introduction of vaccination requirements for care home workers from 11 November 2021, and the possible expansion to other social care settings (subject to consultation) to help address reductions in capacity that would otherwise arise due to staff becoming ill from the virus or needing to isolate, though we recognise the potential for staffing issues where affected care home workers chose to leave the sector. We are working with Skills for Care to ensure that resources such as COVID-19 vaccination guidance and best practice are available to support providers and local authorities with capacity and workforce planning, recruitment and wellbeing.

 

Our regional assurance team will continue to work closely with local authorities to support their workforce planning and encourage robust contingency plans. The team also works with funded partners such as Skills for Care to provide guidance and support to local authorities on recruitment and retention issues, including disseminating best practice across the sector. The team, through its close engagement with local authorities, provides valuable intelligence on local workforce pressures to DHSC and government.

Actions for local authorities

Local authorities should:

  • use the workforce recruitment and retention funding to support local authorities and providers to recruit and retain sufficient staff over winter, and support growth in workforce capacity of the existing workforce. This will be subject to conditions that will be published shortly
  • continue to work with local providers, partners and the NHS to take a whole-system approach to promoting careers in adult social care, and support retention of the existing workforce. This could include, for example, running local recruitment campaigns or administering shared wellbeing and occupational health schemes. As set out above, Skills for Care provide resources to help local authorities improve workforce capacity and resilience
  • work with local providers and partners, including the NHS, to ensure they have robust contingency arrangements in place to help manage any staffing shortages through the winter. Contingency plans should set out how workforce capacity pressures will be monitored, what the contingency measures are and what their triggers will be, and which organisations are responsible for implementing them. Plans should describe the point at which the relevant LRF is notified of workforce capacity pressures, and where intervention from other partners may be required. DHSC’s regional assurance team will work with local and national partners to understand the current and potential risks to adult social care delivery and planned mitigations
  • follow the guidance on deploying staff and managing their movement, and support providers in their area to access other initiatives using best practice examples and case studiesof local authority workforce capacity measures, such as the Bringing Back Staff programme
  • support providers in their area to update their adult social care workforce data set (ASC-WDS)records, to help ensure effective local capacity monitoring and planning, and manage data requests to local providers to avoid duplication with the information already being provided through the Capacity Tracker and ASC-WDS
  • where appropriate, consider logistical support to care providers – such as help with cleaning, transport and maintenance – to free up frontline care staff

 

Social work and other professional leadership

Actions for local authorities

DASSs and PSWs should:

  • ensure that their social work teams are applying legislative and strengths-based frameworks, and support partner organisations such as the NHS to do the same. See, for example, the Care Act 2014and Mental Capacity Act 2005
  • continue to ensure social work practice is fully cognisant and acts on the issues of inequality and deprivation, and the impact this has on communities and people’s access to health and social care services
  • ensure they understand and address health inequalities across the sector, and develop actions with partners, where required, considering the implications of the:
    • higher prevalence of COVID-19 in Black, Asian and minority ethnic communities
    • inequalities experienced by people with learning disabilities, autistic adults, people with mental health difficulties and people who provide unpaid care
  • consider a review of their current quality assurance frameworks and governance oversight arrangements to ensure that winter and COVID-19 pressures do not reduce the ability to deliver high-quality practice
  • develop and maintain links with professionals across the health and care system to ensure joined-up services
  • lead local application of the ethical framework for adult social care, ensuring that NHS partners fully understand their responsibilities to apply the ethical principles and values as part of discharge delivery
  • ensure that the application of new models and pathways is offering the best possible outcome for individuals, their families and loved ones, advocating for them, and advising commissioners where these pathways cause a conflict
  • review any systemic safeguarding concerns that have arisen during the pandemic period, and ensure actions are in place to respond to them, enabling readiness for any increased pressures over the winter period
  • support and lead social workers and safeguarding teams to apply statutory safeguarding guidance with a focus on person-led and outcome-focused practice

 

  1. Supporting the system

 

Funding

Local authorities should continue to meet the conditions of the extended ICTF, including ensuring providers in receipt of funding continue to complete the Capacity Tracker, provide timely reports to DHSC on spending of the grant, and repay any unspent amounts by the deadline set out.

Local authorities should:

  • continue to work to understand their local care market; and to support and develop the market accordingly including promoting financial support available
  • continue to work to understand consumer demand and need, and where there are potential stresses in the market
  • make full use of tools developed by the CHIP to identify, understand and assess risks in their local markets, and draw on CHIP support as needed
  • continue to review and update contingency plans for managing service interruptions, including those that arise if a provider is unable to carry on because of business failure
  • try to identify and communicate key issues affecting the industry and the market in their local area, and draw any concerns to the attention of regional and national DHSC representatives

 

CQC’s regulatory model

Local authorities should continue to share information about registered services with CQC and promote best practice.

Local, regional and national oversight and support

Local authorities should:

  • continue to engage with DHSC regional assurance teams and NHS partners, where appropriate, on contingency planning
  • continue current oversight processes, including delivery of care home support plans and engagement with regional feedback loops
  • continue to champion the Capacity Trackerand promote its importance as a source of data to local providers and commissioners
  • establish a weekly joint communication from local DASSs and DPHs to go to all local providers of adult social care, as a matter of course, through the winter months