Agenda item

The Strategic Director Social Care and Education submits a report to provide the Scrutiny Commission with an overview of the testing regime for the local residential and nursing care homes in Leicester and to provide a snapshot of the infection rates and number of deaths associated with Covid-19.

The Adult Social Care Scrutiny Commission is recommended to note the content of the report and are invited to provide comment and feedback to the Strategic Director and Executive.

The Strategic Director Social Care and Education submitted a report which provided the Commission with an overview of the testing regime for the local residential and nursing care homes in Leicester and provided a snapshot of the infection rates and number of deaths associated with Covid-19. Members were recommended to note the report and provide and comments and feedback to the Strategic Director and Executive.

Martin Samuels, Strategic Director Social Care and Education, introduced the report. It was reported that Adult Social Care had looked at a range of options in terms of protecting care homes that had become national policy. The report also set out the number of care homes in the city and what types of support were provided and age ranges.

Members were asked to note that in summary, what had been found was a steadily reducing rate of infection in care homes. Details showed that when care homes were first tested in late spring infection rates in staff and residents were at 2.75% and 4.27% respectively and numbers were reported at .5% (staff) and 1% (residents) at the beginning of July.

The Strategic Director took the opportunity to mark the considerable efforts made by staff in care homes and in their home lives, and their hard work was reflected in the mortality rate in care homes, the number of infection rates coming down and the small number of residents who had been hospitalised. It was noted there had been logistical issues in delivering the national scheme and staff were conscious of the impact on the quality of life for residents and cares, for example, people had not been able to visit loved ones.

Tracie Rees, Director of Adult Social Care and Commissioning informed the Scrutiny Commission that the authority contacted care homes at least once a week and an intelligence tracker had been developed by the Council to identify emerging issues and trends. Information and training on infection control had been provided, and homes supported through the testing process. The use of smart phones had also enabled family members to connect with loved ones. Plans were also in place to support initial testing of residents in the 18 supported living schemes in the city. Mass testing had not been progressed with domiciliary care as Public Health had advised that workers could access community testing.

The Chair stated he was pleased to hear there had been no deaths in older people since 21^st July and wanted to thank the staff in care homes and council staff for their commitment and for working hard to reduce infection rates.

In response to Members’ questions and observations, the following points were made:

·         Initially the Ranox testing kits had been put to one side as there were questions regarding their safety, and the subsequent withdrawal of these test kits had led to some delays. Issues had now been resolved. It was reported that issues were starting to arise in terms of the results of tests being provided, with waits of over a week in some cases. This had become a national issue over the last few weeks, with some staff taking another test before results of the previous test were known. Figures shown were for staff who were asymptomatic, as staff with symptoms would be referred to other testing routes.

·         Also, it was reported there were delays in labs, and on occasion some samples going out of date as they were time limited. The Strategic Director sat on the national advisory group and testing group on behalf of the Association of Directors of Adult Social Care Services (ADASS), and issues were being flagged with the national team. Homes were being encouraged to test on a Friday or Saturday when labs seemed to have more capacity.

·         The frequency of testing policy had been introduced at a time when Leicester had a high number of cases. As Leicester when down to low positivity rates, thought would be given to the frequency of testing, but the key question was at what point in the infection rate should proactive testing be stopped, and there was almost a Human Rights issue whether it was appropriate to subject people to an unpleasant testing experience in a situation where it was thought the prevalence of an infection rate was so low they would almost certainly not be positive, and the testing regime was placing a heavy burden on care homes. The decision to end testing would be a national one and advice would be sought from Public Health when needed.

·         The report showed that slightly more than half of staff were tested each week, but it was unclear if it was the same staff members or different staff due to shift patterns, as the national system had no way of identifying this. Although the authority collected data from care homes directly this was only able to establish how many staff were tested, not which staff. It was noted that care homes received no additional funding for testing. If staff were called in for a test on their day off, it was not unreasonable for them to want to be paid. Further analysis would be undertaken on the data being received to find out what proportion of staff were being tested.

·         Emergency PPE was available from the Local Resilience Forum for distributing, but the arrangement was about to stop nationally.

·         With regards to care home culture and infection rate links, the authority mapped homes across the city and good intelligence was gathered. It was reported there was no evidence to link the culture in a home with Covid-19 outbreaks.

·         At 4.8 in the report it was queried why the number of homes reported upon reduced from 135 to 103 in week 32. It was noted that when data was first collected in the lockdown areas it had included part of the county, which then switched in week 32 to reporting on city care homes only.

Councillor Russell, Deputy City Mayor, Social Care and Anti-Poverty gave recognition to the data collected by the authority to enable the reporting of information on infection rates daily. It was noted that the team had been working closely with care homes and had developed positive and constructive relationships but needed to continue to challenge care homes when required to. Councillor Russell want to place on record her thanks to the team who had worked tirelessly with the care homes.

The Chair commented that with all the work done so far, the authority was well prepared for the coming winter months. He asked that it be put on record the thanks and gratitude from the Commission be passed on to all the staff involved in ensuring infection rates were kept low, and the testing regime was strictly adhered to.

The Chair recommended that the report be noted and also recommended that a detailed report be presented to the Commission at a future meeting as stated at 2.5 in the Commission report.

AGREED:

that:

1.    The report and comments by the Scrutiny Commission be noted;

2.    A further detailed report on testing for supported living be presented to a future meeting of the Commission.