Reflecting on what the world, the country and the care sector have been through over the last few months has made us all more determined than ever to make sure we have learned everything we can from what we’ve faced, and that we are prepared for any possible second wave.
It is now a case of determination and experience mingled with hope – hope that we do not have a countrywide second wave of COVID-19 and determination that, if we do, our response is informed by our experience of the early months of this year.
It is important to acknowledge the enormous impact and loss that the pandemic has brought for so many people, and that the care sector has borne a huge amount of that loss and grief. We have seen a high number of deaths in care homes and every one of those will have had a devastating impact on people’s families and loved ones, as well as the staff caring for them.
Our NCF members have, from very early on in the pandemic, been keen to share their learning about COVID-19.
How to ensure good infection prevention and control measures are in place, how to ensure sufficient PPE supplies, the essential importance of regular testing, how the virus presents, how to care for people who do catch it, how to support their staff to limit movement between and within homes; the list goes on.
Thinking about how we prepare for the coming winter months, which may bring the risk of both flu and COVID-19, it is vital that we as a sector take a nimble and responsive approach to the lessons learned this year, and think carefully about what we can do differently in the way we provide and deliver care and support to the most vulnerable.
It is also important that we are clear about where our action alone is not enough and where we need support and clear input from government. Some of the key aspects of preparedness are set out below.
Leadership from the sector
To help us capture the lessons learned early on in the pandemic, the National Care Forum is working with Professor Karen Spilsbury and Dr Reena Devi at the University of Leeds to report on the experiences of frontline health and social care practitioners caring for older people with COVID-19.
This research project, Learning by Experience and Supporting the Care Home Sector during the COVID-19 pandemic (LESS COVID-19) is funded by the Dunhill Medical Trust. The findings are due to be published in October and will share, in a clear, practical, accessible report, the key lessons learnt so far by health and care practitioners working on the frontline, in advance of further local outbreaks or a wider resurgence across the country.
Supporting our workforce
Care workers have been the stalwarts of the COVID-19 front line. 24 hours a day, seven days a week, our professional staff have continued to provide care under the most challenging circumstances, and they have done this with resilience and compassion. It is essential that, as a sector, we recognise that the impact of the pandemic may have longer lasting effects on our workforce, and that we support their longer-term health and wellbeing.
We have a clear ask of government in relation to the workforce; recent public polling by the NCF found that the majority of adults in England overwhelmingly believe care workers are undervalued (81%) and should be paid better (80%). It is time to see urgent action from the government to invest in the care sector to enable better reward and recognition for our amazing care workforce.
Testing is another key element of our armoury in preventing and managing COVID-19 in the months ahead. The government has finally recognised the importance of regular routine testing across care settings and care services with the introduction of the whole-home testing programme. However, despite the promises and commitment from government, we have yet to see the effective implementation of regular routine testing for the care sector. The gap between rhetoric and reality remains – it is absolutely critical that this is addressed before we move into the winter.
Our asks of government are that it:
- Fully and effectively implements the whole home testing programme.
- Rapidly increases the testing capacity for social care to cover all care settings, including day services.
- Enables testing for visitors to care settings, as well as Care Quality Commission (CQC) inspectors and visiting health professionals, and other people bringing services into homes, such as hairdressers and musicians.
Good infection prevention and control (IPC)
This not a new concept for the care sector, this is something that we are very experienced in and that we have a long history of managing well – just think about the management of seasonal flu or norovirus. It is important to remind ourselves and those we care for about our existing IPC understanding and expertise.
The significant difference with COVID- 19 is that this is a new virus, one that no one had had experience of managing and one about which we still need to know so much more in terms of how it transmits.
While scientists – the epidemiologists and virologists – are working hard to build our knowledge about how to prevent and manage coronavirus, we have had to work extraordinarily hard to adjust our infection prevention and control measures across the care sector to tackle a virus that seems like the invisible enemy.
One of our responses at NCF has been to create a unique partnership with Quality Compliance Systems (QCS) and Standards Wise International to create a specific IPC Self-Audit Tool to help our members enhance IPC procedures. It uses the latest COVID-19 learnings emerging from infection prevention and control specialists and takes account of the newly-developed CQC inspection methodology. The IPC Audit Tool supports organisations to assess their own practices and prepare evidence for audit which not only meets CQC requirements, but also conforms to international standards.
However, the sector as a whole needs more support. Our asks of government are that it:
- Continues and widens its financial support for infection prevention and control to help us maintain the essential measures we need, the cohorting and zoning measures we have introduced for our staff and those people using services.
- Helps us to ensure we have a robust, reliable, quality supply of PPE for the next six to nine months and have help with the enormous cost of this.
- Commissions more research into the transmission of COVID-19 and into understanding when people who have it (both those with symptoms and without) are most likely to transmit it and how they do that.
Given that we are heading into the flu season, as employers and providers of services, we all have a responsibility to actively promote the uptake of the vaccine, in both the people using care services and in the staff delivering that support.
The sector is working hard to understand the barriers to better uptake and bust some of the myths that deter people from having the vaccine. Our ask from government is that urgent action is taken and clarity provided on their flu vaccination plans and how they plan to support the care sector.
Helping people thrive
The pandemic has highlighted the significant challenges of continuing to enable people who use care and support services to live the best lives they can, despite all the constraints that COVID-19 has brought. It is vital that we strive to do what we can to continue to enable people to thrive as best they can in the new world of COVID-19, but we can only go so far without more support and acknowledgement from government.
What are you doing to prepare for a second wave? What learning can you share and what would you like to see from government? Let us know by commenting on the CMM website and sharing your feedback using the comments section below.