Adult Social Care Winter Plan 2020-2021 - Derby City Council
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Adult Social Care
Winter Plan
2020-2021
1
Introduction
All Councils are required to have in place an Adult Social Care Winter Plan that covers the local
response to the national plan released by government on the 18th September. In our response to
Winter 2020/21, the Council is setting out in a transparent way the measures being undertaken
during the winter months to support providers of adult social care and to support families and
individuals who have faced significant challenges during the Covid-19 emergency. The social
care sector has shown resilience and dedication in keeping Derby’s residents safe at a time of
great change and uncertainty, and we want the support available during winter to add to the
significant effort that has already been made.
The activities described within this plan are underpinned by the Council’s Your Life Your Choice
Strategy that has been reviewed and refreshed for 2020. The Winter Plan also builds on the Care
Home Support Plan which was published in the summer, but it is broader than support for care
homes and looks across the wider social care sector.
2
The National Winter Plan
The Government published its Adult Social Care Covid-19 Winter Plan 2020-2021 policy paper
on 18 September 2020. The Plan sets out the key elements of national support available for the
social care sector during winter 2020 to 2021, as well as the main actions to be taken by local
authorities, NHS organisations, and social care providers, including those in the voluntary and
community sector.
The Plan sets out provision for free PPE for social care providers through a government portal
with exceptions funded via the local authority and a government £546m Infection Control Fund.
In the Plan, the Government has given the commitment to adult social care providers that it will:
• continue to engage, across the sector, including with local authorities, care providers, people
with care and support needs and carers;
• continue to provide financial support to the sector;
• appoint a chief nurse for social care to the Department of Health and Social Care;
• develop a designation scheme with the Care Quality Commission for premises that are safe
for people leaving hospital who have tested positive for Covid-19 or are awaiting a test result;
• continue to develop and publish relevant guidance;
• ensure sufficient appropriate Covid-19 testing capacity;
• improve the flow of testing data to everyone who needs it;
• provide free PPE for Covid-19 needs in line with current guidance to care homes and
domiciliary care providers, via the PPE portal, until the end of March 2021;
• provide free PPE to local resilience forums (LRFs) who wish to continue PPE distribution, and
to local authorities in other areas, to distribute to social care providers ineligible for supply via
the PPE portal, until the end of March 2021;
• make available for free and promote the flu vaccine to all health and care staff, personal
assistants and unpaid carers;
• publish the new online Adult Social Care Dashboard.
The Winter Plan identifies actions to be undertaken by local authorities under four key themes:
Theme 1: Preventing and controlling the spread of infection in care settings;
Theme 2: Collaboration across health and care services;
Theme 3: Supporting people who receive social care, the workforce, and carers;
Theme 4: Supporting the system.
3Derby’s Winter Plan
Our plan covers the period from October 2020 to March 2021 and addresses the requirements
and future activity for Councils as set out in the national plan. This Plan covers the actions
required for Councils, but we are also working on key elements of the plan that are delivered
with NHS providers and commissioners, and also colleagues in Public Health.
Financial Support for Providers
During the Covid-19 crisis response over the spring and summer of 2020, the Government
provided some additional financial support to the adult social care sector through the Infection
Control Fund (ICF). This has now been extended to cover the period from Autumn until the end
of March 2020.
The ICF aimed to fund measures that improve infection prevention and control for all care
providers, including measures to restrict the movement of staff between care settings. The
Government funding has been principally for care homes, but also for home care organisations
and a smaller proportion for other providers. The Council has worked hard to issue the fund in a
timely way and ensure all required information is submitted back to central government.
Derby was allocated a total £2,831,544 in the first Infection Control Fund round and providers
claimed £2,764,554. The second ICF programme provided £2,688,456 and this is being processed
currently.
In addition, from the Council’s allocated COVID assistance funding which was for all Council
services, a further £625,092 was awarded to providers who asked for support in the early phase
of the pandemic. This paid for emergency PPE, staffing, training and other areas of expenditure
such that enabled providers to continue operating despite the severe disruption during the
national lock down. Whilst for some, their services had to temporarily close, the additional
funding enabled them to be sustained and remodel their services so they could support people
in light of the new COVID safety measures concerning social distances and increased infection,
prevention and control.
4Managing the risks over winter & working with the NHS
As part of the Winter Plan requirements, the Department of Health and Social Care requires
Councils to review their preparedness for service continuity through the winter of 2020/21,
including councils’ assessment of risks, their contingency plans, and their support needs.
Derby City Council completed a self-assessment questionnaire which covered the risks to adult
social care continuity of care arrangements in all settings and for all providers up to the end of
March 2020 and the arrangements to mitigate these risks. This was in addition to existing risk
assessments the Council has been making continually throughout the pandemic – including
engaging with a dedicated risk assessment process with the NHS.
There is a dedicated Joined up Care Derbyshire Winter Plan which that Council has contributed
too, and this sets out the role of community and social care providers in supporting the
pressures that are anticipated on the NHS between December and the end of March. This has
been particularly focused on managing the impact of normal seasonal demands as well as the
impact anticipated by the “second wave” of coronavirus infections in the UK.
The Council has worked very closely with care providers to minimise the risk of services being
significantly disrupted however there remain some key areas of concern that are being kept
under constant review:
• the availability of nursing staff in nursing homes,
• the impact of COVID outbreaks on the heath and well being of individuals – staff and people
receiving care
• the impact on safe staffing levels due to the impact of unpredictable periods of self isolation
that may be required across all types of services
• the financial viability of some residential and nursing care providers due to decreased
occupancy levels or being unable to accept admissions due to COVID risks.
The action plan below sets out the key tasks that we will be undertaken over winter and will be
kept under review so that we can react and respond to the changing nature of the pandemic.
For more information, please contact:
QualityMonitoring.Duty@derby.gov.uk or by telephone – 01332 640791.
5Derby City Council’s Winter Plan – 2020/2021
Theme 1: Preventing and controlling the spread of infection in care settings
Required Action Actions being taken in Derby Actions planned
Continue to implement • Regular communication is • More Regular meetings
relevant guidance and produced for providers, as with providers.
circulate and promote far as possible streamlined
guidance to adult social so providers are not over- • Review our communication
care providers in their area, burdened. approach with providers.
including for visitors. • Review guidance on visitors
• There is a dedicated
provider section on Derby in line with transmission
City Council’s website, rates and involving Public
and a microsite hosted by Health.
Derbyshire County Council
specifically for care homes.
• Supporting and enabling
approach being taken to
care home visitors.
Communicate to social care • Fortnightly conference calls • Supporting the new
providers regarding the are held where providers legislative changes planned
importance of implementing can raise any issues of on restricting the moment
workforce measures to limit concern. of staff between care
COVID-19 infection. settings.
To distribute money from the • The Council has distributed • Ensure as much as possible
Infection Control Fund and over £2.7m since May 2020. of the IPC Fund round 2
submit returns on how the (£2.6m) is distributed by
funding has been used in line March 2021.
with the grant conditions.
6Theme 1: Preventing and controlling the spread of infection in care settings
Required Action Actions being taken in Derby Actions planned
Work with relevant partners • ASC working closely with • Continue to engage with
including Public Health IPC nurses, Public Health Outbreak Control response,
England and local health in terms of supporting supporting care providers
protection boards to control testing programme, and assisting with any
local outbreaks. responding to outbreaks business disruption due to
and hosting Outbreak staff isolating or absence.
Control Meetings for
significant concerns. • Continue to share learning
from outbreaks with
To ensure positive cases are • Daily review of testing all providers and work
identified promptly, make results and collaboration specifically with those
sure care providers, as far as with Public Health team, whom have experienced
possible, carry out testing as Test & Trace and IPC team larger outbreaks.
per the testing strategy. about appropriate action
required. • Involve primary care/
GPs in outbreak control
meetings to ensure
resident’s health and
wellbeing has clinical
oversight during difficult
outbreaks.
Provide PPE for Covid-19 • PPE will be distributed
needs when required, either through the LRF to non-
through the LRF, or directly regulated providers.
to providers.
To support communications • Communications to • Targeted work with home
campaigns encouraging providers has taken place care providers to ensure
eligible staff and people who to promote the flu vaccine. they can support staff to
receive care to receive a free access flu vaccinations, and
flu vaccine. also where uptake in care
homes has been low.
7Theme 2: Collaboration across health and care services
Required Action Actions being taken in Derby Actions planned
The local authority should • Local arrangements • Maintain all existing and
be the lead commissioner are in place to facilitate expanded capacity over
of care packages for those discharges, and the winter.
discharged from hospital. Council is embedded in
the Discharge to Assess • Recruit more Home
Pathways. Capacity for First workers to support
discharge support has been Enhanced Care Pathway for
expanded during Covid. people leaving hospital with
delirium and/ or dementia.
Ensure that there is safe • Designated settings are • Work with providers so
accommodation for people in place that have been that for people who have
who have been discharged approved by the CQC. completed their 14 day
from hospital with a positive isolation period, they can
or inconclusive Covid-19 test return to the normal place
result. of residence safely.
Establish efficient • Agreed plan in place • Ensure affected individuals
processes to manage with local Clinical and families are kept well
Continuing Healthcare Commissioning Group informed of any change to
(CHC) assessments and to to complete all CHC and how their care is funded.
rapidly complete deferred deferred assessments by
assessments. March 2021 are in place.
8Theme 3: Supporting people who receive social care, the workforce, and carers
Required Action Actions being taken in Derby Actions planned
To give a regular assessment • Guidance and support has • Individual support to care
of whether visiting within been provided to providers homes to ensure they can
care homes is likely to be in managing visits safely. enable safe visiting practice
appropriate, within their local in line with the guidance.
authority, or within local
wards, taking into account
the wider risk environment.
if necessary, impose visiting
restrictions if local incidence
rates are rising.
Ensure that people receiving • Communication has been • Continued communication
direct payments, their made directly with Direct with Direct Payment
families and carers are Payment holders with holders where required.
able to meet their care and advice on employment
support needs help. issues during Covid-19, • Continue to phone carers
PPE and how to use their over winter to ensure they
Make sure carers, and those care plan flexibly. have the support they need.
who organise their own • Maintain Shared Lives
care, know what support is • Communication to
encourage uptake of flu arrangements and Bonsall
available to them and who to View whilst ever it is safe to
contact if they need help work vaccination to DP holders
and also Carers. do so.
with services that may
have closed, over the • Working with Citizen Advice • Continue to support day
pandemic, to consider how Mid Mercia to target carers time support providers
they can reopen safely winter. who may need support. so that they can operate
throughout the pandemic
Work with services that may • Telephone calls to Carers to and relieve pressure on
have closed, over the ensure they are coping and family carers.
pandemic, to consider how connected to the Voluntary
they can reopen safely winter. Sector Hub/ Local Area
Coordinators.
• Maintained Shared Lives
care arrangements and
re-opened Bonsall View
residential respite facility.
• Supported day time support
providers to remain open
and make use of outdoor
space and technology to
deliver support.
9Theme 3: Supporting people who receive social care, the workforce, and carers
Required Action Actions being taken in Derby Actions planned
Where people who use • Support is being provided • Continue to telephone
social care services can no to providers to ensure families to review their
longer access the day care services can operate in a situation as the pandemic
or respite services that they Covid secure way. continues.
used before the pandemic,
work with them to identify • Individuals and carers who
alternative arrangements cannot access support are
that meet their identified being contacted to explore
needs. alternative options.
To ensure that their social • Social Work Teams have
work teams are applying been supported to continue
legislative, ethical and to use strength-based
strengths-based frameworks approaches with service
(including those based on users and regular staff
duties under the Care Act and bulletins keep teams
Mental Capacity Act). informed of best practice.
Make sure carers, and those • Information is available on
who organise their own the Council’s website.
care, know what support is
available to them and who to • Citizens Advice Mid Mercia
contact if they need help work and Derby Direct offering
with services that may carers conversations with
have closed, over the anyone in need of support.
pandemic, to consider how • Close working with the
they can reopen safely. Volunteers Hub to connect
carers into local support
and through a team of
dedicated care support
officers.
Support care providers to • Daily updates from the • Extend this approach to
identify Covid positive cases outcome of the weekly care other care providers as the
promptly, to carry out testing home testing are shared testing regime rolls out
in line with the testing and triangulated with PH further e.g home care.
strategy. colleagues and local Test &
Trace.
Actively monitor local testing
data to identify and act on • Significant outbreaks are
emerging concerns, including the subject of an “outbreak
following up with care homes control meeting” involving
that are not undertaking NHS, CQC, IPC and Clinical
regular testing, as per the Leads from Primary care.
guidance.
10Theme 3: Supporting people who receive social care, the workforce, and carers
Required Action Actions being taken in Derby Actions planned
Support communications • letters have gone to Carers • need a further reminder to
campaigns encouraging and DP users, and all other care homes and DP users
eligible staff and people who care providers. in November.
receive care to receive a free
flu vaccine direct providers to
local vaccination venues
work with local NHS partners
to facilitate and encourage
the delivery of flu vaccines to
social care staff and residents
in care homes.
Work closely with social • SPWLs in place within all
prescribing link workers GP practices and continued
to co-ordinate support for throughout the pandemic,
people identified by health working remotely were
and care professionals as required with care
most needing it, especially Coordinators.
those impacted by health
inequalities and autistic
people and people with
learning disabilities.
Ensure that discussions • End of Life guidance made • Continue to ensure that we
and decisions on advanced available at the start of the work with all care providers
care planning, including pandemic that was specific to ensure they are clear
end of life, should take to the ReSPECT approach. on the EOL pathways,
place between the individual MCA issues and their
(and those people who are • Support is being given responsibilities within this.
important to them where by GPs and primary care
appropriate) and the multi- to care homes and other
professional care team patients whom may be
supporting them, applying considered to be towards
best interest considerations the end of life.
where someone lacks
capacity.
11Theme 3: Supporting people who receive social care, the workforce, and carers
Required Action Actions being taken in Derby Actions planned
Only apply the Care Act • A process has been put in • Should the threshold be
easements when absolutely place to allow monitoring met to enact the Care Act
necessary and communicate of the management of Easements the DHSC will
the decision to operate under COVID across the ASC be notified in line with the
easements to all providers, sector for indicators that process.
people who need care and the Care Act Easements
support, carers and local MPs may be required. This is • Should the threshold
in an accessible format. monitored twice weekly in be met to enact the
Senior Management Team Care Act Easements a
meetings. communication plan will be
implemented in line with
the process.
Maintain, where possible, • In place for care homes -
the additional staff support support via hospice sector;
services which they put in General Mental Health
place during the first wave of wellbeing offer available via
the pandemic review current NHS partners.
occupational health provision
with providers in their area • Occupational health
and highlight good practice. provision is in place for
providers to access via NHS
Promote wellbeing offers to partners.
social care staff and allow • Council staff can also
staff time to access support. access the Employee
Assistance Programme
available, Mental Health
First Aiders, and support
from Management and
colleagues.
Continue to review provider • The Council is working in
contingency arrangements partnership with colleagues
to help manage staffing across Derby and
shortages within social care Derbyshire through Joined
provision through the winter. Up Care and dedicated
emergency arrangements
Support providers to access in place for care providers
other initiatives – for example via the NHS.
Bringing Back Staff.
Consider how voluntary
groups can support provision
and link-up care providers
with the voluntary sector
where necessary.
12Theme 3: Supporting people who receive social care, the workforce, and carers
Required Action Actions being taken in Derby Actions planned
Local authorities will • Social care is working • This will be in place where
coordinate local support if closely with the Volunteer required (latest guidance
shielding is reintroduced in Hub and supporting is Shielding is not likely to
a local area. This includes vulnerable people including proactively be introduced).
provision of enhanced care those who are clinically
and support for CEV people extremely vulnerable where
on the shielded persons list. required.
Understand and address • Director of Public Heath • Embed Health inequality
health inequalities across and other NHS leaders interventions into all
the sector and develop have been keeping a focus recovery and planning work
actions with partners, where on the impact of Covid including the NHS Phase 3
required, taking into account on vulnerable groups Plan.
the implications for groups and actions and support
where prevalence is higher. have been targeted where
appropriate.
• Local risk assessment in
place for adult social care
professional roles and
within NHS.
13Theme 4: Supporting the system
Required Action Actions being taken in Derby Actions planned
To continue to champion • Work has taken place with • Continue to review the
the Capacity Tracker providers to help them results from the capacity
and the Care Quality complete the required data tracker and work with all
Commission community care submissions. If an issue of care providers to ensure
survey and promote their concern is flagged in the required data submissions
importance as a source of trackers, providers receive are kept up to date.
data to local providers and a follow up phone call to
commissioners; discuss the issue in more
detail.
To work with local partners • An assessment has been • Regularly reviewing
to engage with the Service made of the local care business continuity plans
Continuity and Care Market market and was submitted with providers in light
Review, and complete a self- as required to government. of changing guidance,
assessment of the health of restrictions, expectations
local market management • The Commissioning team and developments.
and contingency planning has been collating and
leading into winter. reviewing contingency
plans and carrying out
targeted work with each
care provider. This has
been dominated by the
support needed for nursing
and care homes, however
the business continuity
support has extended to all
sectors.
To continue to maintain • There is a dedicated web • The materials on the
the information they have page on the Council’s Council’s web site will be
published on their websites website for care providers regularly reviewed and
about the financial support which is used to provide updated and information
they have offered to their a summary of the latest continue to be cascaded to
local adult social care guidance and useful relevant providers.
market. communications. There is
also a dedicated micro site
specifically for care homes,
hosted by the Count council
but accessible to all homes,
and contributed to by all
statutory partners.
14Theme 4: Supporting the system
Required Action Actions being taken in Derby Actions planned
Establish a weekly joint • Regular letters have gone • Continue to provide
communication from local to care providers in relation communication on new
directors of adult social to the latest updates and developments such as
services and directors of guidance. the roll out of the COVID
public health to go to all vaccine.
local providers of adult social
care, as a matter of course,
through the winter months.
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