Agenda item

The Strategic Director for Social Care and Education will provide the latest Covid19 and care home mandatory vaccination process updates.

Members of the Commission are recommended to pass any comments to the Strategic Director for Social Care and Education.

The Strategic Director for Social Care and Education provided the Commission with the latest updates.

It was noted that:

·         The National Dashboard provided information on the infection rates and the number of positive cases in care homes.

·         In the week commencing 25 September 2021 there were 18 positive cases, of which 11 were staff members and 7 residents. Most of these were associated with an outbreak in one care home and things were in place for providing the necessary support to the care home at concern.

·         Positive cases in care homes had fallen, and Leicester was currently second lowest positive rate in the region. Over last couple weeks community infections had fallen incredibly one of the best regionally.

It was noted that there remained a significant burden to providers around testing and infection control in care homes and that the DHSC had been supplying additional funding for care providers on a formula basis to cover cost of associated activities.

Although the funding had been due to expire on 30 September, the scheme had at the last minute been extended until the end of March, though the Service were yet to be informed on what would be allocated. Estimates of what could be made available were based on previous rounds of funding. Additionally, guidance on what the funding could be spent on was also not yet available.

VACCINATIONS

Following a national public consultation, the Department for Health and Social Care had laid regulations for full mandatory vaccination for anyone that entered the care home environment in a professional capacity. The change in regulation affected some 500 council staff and the requirement comes into effect on 11 November 2021. It was the legal duty on care homes to check staff vaccination status and the CQC would monitor this as part of their inspections. 

The NHS were maintaining a 12-week gap between the two doses, over 90% staff have had their first dose and 85% have had both doses. The department were working extremely closely with care homes to monitor the number of vaccinated staff and looking at any operational issues and contingency plans that may need to be put in place. This would include working with staff who have not been vaccinated and looking at staff rotas and recruiting new staff where required. The department were concerned with a small number of staff but, Officers were hopeful that, come the deadline date there would be no disruption to the delivery of service.

It was also noted that the Government were considering mandatory vaccination to all staff who work within health and social care and Officers felt that it was likely that this would be announced in the near future. There had been some reports of staff resigning from care homes roles to go to work in the NHS, so this new plan could unravel more problems.

It was suggested that, there were a variety of people who the vaccines were not suitable for and information on clinal exemptions had not yet been published. The DHSC had published guidance for self-certification and they had now issued clinical guidance on whether staff were suitable for vaccines. Those staff who had self-certified would remain exempt until 24 December 2021 or until they had been reviewed by a clinician, whichever was sooner.

As part of the discussions it was noted that:

·         Members of the Commission had concerns with the self-certification and its ambiguity.

·         Hopeful that no one will need to be dismissed as a result of the new guidance.

·         The service had an approach in place where staff would be redeployed when they are not willing to be vaccinated. Support was in place for staff and the service were hopeful these numbers would be small percentage of the workforce.

·         Social care staff vaccination must be a positive and a good thing although some staff had worries and concerns.

·         Confident that the introduction of mandatory vaccinations would not be a major factor in service delivery

Further into the discussions Members of the Commission suggested that the condition of the sector currently was unsurprising, and this was a result of disregard from central government towards Adult Social Care staff. It was suggested that the unfair treatment of care-workers over the years had played a part in workers leaving and finding alternative employment. 

Members of the Commission welcomed the 95% of staff who had had their 1^st dose and queried how the service compared to other authorities. It was suggested that, the vaccination rates were broadly lower than the national average and this impacts on the workforce but in comparison with neighbouring authorities the vaccination rates were similar.

Support was in place for staff for meeting target date and a very small number of staff members had refused the vaccination completely with fertility as the main issue. In general suspicion on the quickly produced vaccination and a lot of misinformation on Social Media also played its role in staff concerns. It was noted that the service had strategies in place to promote staff vaccination, and also to keep those that were exempt safe. There were a number of communications on the web page and provider forums had a constant stream of information that went out. Additionally, the service were facilitating clinical conversations with staff.

Following the query on impact planning from the Healthwatch Leicester representative, it was noted that the service were satisfied with the work that was being done during these challenging times and that the service were working with partners locally and beyond on impact analysis for care homes that could be affected with the potential of reduced staff or care home closures.

Following the Chair’s request for an update on the care homes on the red list, it was noted that, there were 11 care homes at the last meeting, the Head of Commissioning had worked with the care homes to bring this number down to 4 care homes on the red list and the department were working with every care home to bring this number down further by the deadline day. Contingency plans were in place should any care home not meet the requirements by the 11 November 2021 to ensure that the service delivery continued as usual. Officers were hopeful that no service will face major issues and arrangements were in place to ensure all care services were maintained.

AGREED:

1)    That Officers be thanked for their update to the Commission;

2)    That the Members of the Commission be requested to note the information provided; and

3)    That the Covid 19 update remain on the agenda to keep Members of the Commission updated on the latest information in the area.