Seòmar agus comataidhean

On 8 August, the Scottish Government updated its plan and guidance outlining a staged approach to the safe introduction of visiting in care homes during the COVID-19 outbreak. The guidance sets out a 4 stage pathway that care homes can progress through; with each of stage allowing further visiting options for family and friends. From 10 August, 2-3 visitors per resident are permitted outdoors, subject to appropriate physical distancing and Personal Protective Equipment requirements being satisfied. Indoor visits with one designated person for 30 minutes once a week will be permitted once plans have been developed by care homes and approved by the local Director of Public Health ideally by 24 August. Visiting will only be permitted in care homes which are established and declared free of all COVID19 cases by local health protection teams 28 days from last date of positive test result or where appropriate symptoms of any resident or staff member.

In respect of testing visitors, the guidance states that t here may be occasions when the local health protection team decides there is a need to test visitors for COVID-19 in an area or in a particular home. This should be considered as part of local risk assessment processes taking into account the prevalence and incidence of infection in the local community; outbreaks; hotspots which may increase risk of infection among visitors to care homes. The guidance also recommends that that care homes put in place a system to ensure that visitors do not attend with COVID-19 relevant symptoms including asking heath screening questions. This is alongside requirements to physically distance, use of face coverings and where appropriate Personal Protective Equipment (PPE) and strict hand and respiratory hygiene.

The updated guidance can be accessed here: https://www.gov.scot/publications/coronavirus-covid-19-adult-care-homes-visiting-guidance/

Through emergency legislation, we have taken action to address the payment of registration fees for social care workers during this COVID-19 outbreak by extending the period of time a new or returning worker is required to pay their fees, from 6 months to 12 months.

Workers who are required to register with a professional regulator, such as SSSC, are required to pay an annual registration fee and that remains the legal position. By offering an extended period of time in which to register we hope to encourage workers to return to the register during this emergency.

The emergency legislation will remain in place during the current pandemic.

Details can be found on the SSSC’s website www.sssc.uk.com

PPE from the national stock is currently being supplied free of charge to all social care providers as a ‘top up’ service through two routes. These are PPE Hubs in Health and Social Care Partnership areas and a triage helpline to provide supplies in emergency cases, or where the Hubs are unable to meet needs These routes are in place to support providers with their PPE needs if their business as usual supply routes fail. These arrangements were set up as temporary measures in the early stages of the pandemic to ensure social care providers could access the PPE they required, in light of the immense pressure on global supply chains due to COVID-19. A longer term strategy is now being developed to ensure the social care sector continues to have access to safe, sustainable and affordable PPE supply routes.

1. PURPOSE:

The remit of the Care Home Rapid Action Group (CHRAG) is to bring together representatives from across the care home system to monitor data on developments in the sector, enabling a swift reaction to any developing issues.

Specific objectives of the Group are to:

• enhance existing collaborative working across industry leaders;
• identify issues for urgent resolution;
• request and analyse information and data on a range of metrics; and
• identify issues for urgent resolution, making proposals to Scottish Government and the care sector leadership for other national level actions

The Group will not give clinical advice or substitute for the decision making powers of statutory and other bodies, national or local. Instead, the discussion focuses around key developments in the care home sector, and relevant national actions. There is also a Clinical and Professional Advisory Group (CPAG) , which provides a clinical input to CHRAG as required.

CHRAG brings together senior representatives of organisations involved in the delivery of care homes provision primarily to address the immediate and pressing issues caused by the Covid-19 pandemic. Whilst covid-related issues have been the immediate priority of the Group, CHRAG also has a remit to horizon scan, identifying challenges and opportunities affecting the sector as a whole and dealing with each collectively as appropriate.

2. CHAIR:

The meeting is chaired by Donna Bell, Director of Mental Health & Social Care. The Group reports routinely to myself.

3. OBJECTIVES:

CHRAG has set out a number of objectives to be delivered

• Ensured that requirements for multi-professional leadership arrangements including daily huddles as per the enhanced oversight arrangements set out by myself on 17 May are in place.
• Testing – I announced on 1 June that all care homes staff would be tested on a weekly basis. With input from all members of the group/all aspects of the sector, CHRAG has overseen the implementation of this testing programme for all care home staff which has led to over 34,000 staff members being tested week commencing 17 July.
• PPE & IPC – the Group has ensured effective infection prevention and control measures are in place and addressed concerns regarding access to and costs for PPE as well as use of specific aspects of protective equipment.
• Data Analysis – analysis and deeper understanding of the number of cases, deaths and the geographic spread of covid outbreaks has formed and important and integral part of the work of the Group. To do so that Group has worked with Scottish Government Analysts, SAGE, the UK Government scientific advisory group, regulatory bodies and academics. The Group also reviews a weekly local analysis from Directors of Public Health. More recently the development of an automated safety huddle tool has been progressed as an approach to reducing duplication of data provision from care homes and providing greater oversight and reassurance at a local and national level.
• Visiting Strategy – The Group has collaborated over the development of a strategy for professionals visiting care homes, for assurance and inspection purposes which was rolled out in tandem with recent re-opening of visiting for families and aims to reduce duplication, sharing essential data and establishing visiting protocols. It has also commissioned CPAG to develop guidance on visiting by other health and wellbeing professionals as their continuing care for residents is able to be progressed.
• Comms Strategy – the CHRAG comms strategy aims to restore professional and public faith in care homes and has manifested itself to date, in the recent sectoral collaboration on Care Homes Day, which took place mostly on line on 15 July. Trending on Twitter as the second top story.

4. MEMBERSHIP: is regularly reviewed to ensure fair representation from across the sector and currently includes the following organisations:

I refer the member to the answer to question S5W-30330 on 28 July 2020. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx

The Care Inspectorate Scottish Government grant in aid allocation for 2020-21 amounts to £23.742m. We have agreed a settlement for additional funding of £1.1m in 2020-21 to meet budget pressures relating to regrading of inspectors and a team manager review. Additional funding of £0.370m has been agreed to facilitate the role of Healthcare Improvement Scotland secondees in supporting the Care Inspectorate’s inspection programme during the Covid-19 emergency period.

The Care Inspectorate are inspecting services in line with public health advice in order to carry out their role safely and to limit the transmission of COVID-19. Unannounced on-site inspections are currently focused on adult care homes with an intelligence led, risk based and targeted approach. The inspection programme is regularly reviewed to take account of public health guidance and further inspections will commence when it is appropriate to do so.

Entitlement to financial support such as the Best Start Grant and School Clothing Grant provide a vital contribution to households with eligible children. We are also prioritising the delivery of the Scottish Child Payment for children under 6. Our aim is to now start taking applications for this by the end of 2020 with payments being made from 2021. This significant new benefit will provide £10 per week for each eligible child, providing vital support to low income families.

The Scottish Government’s Tackling Child Poverty Delivery Plan, ‘Every Child, Every Chance’, also sets out the wide range of actions which we are taking to increase household incomes and reduce essential costs. These include supporting parents to work and earn more with investment in employability services, including Fair Start Scotland and the Parental Employability Support Fund; providing advice to help maximise incomes through investment in the Money Talk Team service; and making housing more safe, warm and affordable for families by increasing our investment in the Affordable Housing Supply Programme and by setting statutory targets to reduce fuel poverty.

Visiting guidance in health and social care settings recognises that visits to those nearing the end of life are deemed essential and as such we would expect those working in clinical settings to accommodate such visits where it is safe to do so. It is important to note that the guidance relating to visiting patients in end of life situations, both in hospitals and care homes does not restrict visits to family members from the same household. This provision has been in place since restricted visiting was introduced.

However, in light of the continued progress being made in suppressing the virus, we have recently relaxed the visiting restrictions previously in place across hospitals and care homes. New visiting guidance was released for care homes and hospitals on the 28th and 30th June respectively, which will allow visits in these care settings to resume safely and in a series of phases.

For convenience this guidance can be found here under the Health, Care and Social Work section.

The Scottish Government has provided an additional £12.6 million in funding to continue the provision of food to families eligible for free school meals during the course of the school summer holidays.

We recognise that direct cash payments will work well for many families and we have written to local authorities suggesting they consider using cash payments as one of a range of options when deciding on methods for alternative provision to free school meals during the current summer holidays.

Whilst we know there are many advantages to issuing cash payments, such as giving recipients the flexibility to shop with their preferred retailer, it is also important that we continue to afford local authorities the flexibility they need to respond to the individual needs within their local communities and to ensure that no-one is left disadvantaged by a one size fits all approach.