Agenda item

The Strategic Director Social Care and Education submits a supplementary report to the Winter Plan to the Scrutiny Commission which highlights the specific issues for the Reablement Services operated by Leicester City Council, arising from the Covid-19 pandemic and winter resilience planning.

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 supplementary report to the Winter Plan to the Scrutiny Commission, which highlighted the specific issues for the Reablement Service operated by Leicester City Council, arising from the Covid-19 pandemic and winter resilience planning.

Ruth Lake, Director of Adult Social Care and Safeguarding introduced the report which built on the previous report of winter resilience and included activity data and key quality indicators. The following points were made:

·         The current CQC rating for the registered service was ‘Good’. 

·         National benchmarking information was included following an audit the service participated in over the past two years.

·         Also described was how the Reablement Service fitted within the range of services offered, for example, it provided support for residents to prevent them going into care or hospital unnecessarily and also in returning home after something in their lives had happened, such as an illness or a fall, and a couple of case scenarios were provided in the report as examples.

·         Key impacts of Covid-19 since March were included, and as previously reported activity had been seen to decrease rather than increase, but it was believed it would be slightly different when going into the second wave of the pandemic with the hospital continuing to provide elective surgery where it could, and that was a large pathway through into reablement services, whereas a lot of activity had been curtailed in the first wave of the pandemic.

·         Resilience through the period was testament to staff and managers who had had to adapt, for example, wearing enhanced PPE, working with people known to have Covid-19. It was also an older workforce.

·         In the Winter Plan and Service Continuity Self-Assessment there was one line that referred specifically to reablement. Staff were very watchful and keeping a close eye on issues but were not substantially concerned about the capacity and resilience of the Council’s own Reablement Service going through the winter period, and there was confidence they would fulfil their core function.

·         The Reablement Service was a service of last resort and supporter of other services which were struggling and there was some concern in terms of agency’s expectations that they would be able to assist them with their activity.

Members noted the report. In response to queries raised the following points were noted:

·         The issue in relation to insurers was not an issue specifically for the services, but was whether or not Council’s insurance or insurance providers covered officers going into different settings, for example if some of the Council’s staff had to go in and work in a care home, for example, if the care home was struggling due to loss of staff, or other issues. Guidance had been taken from the Council’s insurers who confirmed staff going into other care settings were covered by the Council’s insurance to do that.

·         The Reablement Service is provided in a people’s own homes by carers, and not a service provided in a care setting. A step-down service is provided, for example, someone may have had to go into a care home setting but were now returning home, the Reablement Team may pick up the care provided and continue to support the person at home.

·         The Council worked closely with the district nursing service and community therapy service but did not directly provide it. Through the Home First offer there were daily meetings to talk about people that needed support from the health and care sector to try and ensure they received that in a coordinated way.

·         Covid-19 was not of itself an issue and was not a determinant in whether a person did or did not receive the service and people would continue to be supported if that was the case.

·         In the very first responses as hospitals were announcing their intention to clear their hospital beds as the country went into lockdown, Adult Social Care reviewed its operational procedures and the view was taken to support people for the shortest amount of time it was appropriate to do before moving them on to another service.

·         The Reablement Service was often described as a six-week service but was there for as long as people would benefit from it, up to six-weeks. It was reported it was often the case that people would be assessed on their reablement journey and some people would move off after days, a couple of weeks or the full six-weeks. Officers would ensure daily rigour about the point where it was found people would no longer benefit anymore from the reablement offer but would be moved on to other ongoing care, which was good practice rather than a Covid necessity

·         In the first wave of the pandemic the service was working with people who had been very poorly and were still affected by Covid19-related issues and were recuperating. It had also become obvious at the time there were some people who were going to require ongoing support for quite some time.

·         During the first wave those not being looked after were people who would normally require short-term support, for example, those who had had elective surgery such as hip operations and would require a therapeutic approach. It was noted that over the next wave there would be a balance of the two.

The Chair noted the contents of the report and praised the work of the staff working in the Reablement Service, often in difficult circumstances, to help people regain choice and independence.

AGREED:

1.    That the Adult Social Care Scrutiny Commission note the report and provide and comments and feedback to the Strategic Director and Executive.