The National Care Forum (NCF) has conducted a comprehensive Pulse Survey to provide in-depth analysis of how adult social care providers are operating in a COVID-19 world and the second wave of the pandemic.
The Pulse Survey was completed by care providers operating 1,240 care and support services throughout England, employing 35,124 staff and supporting 28,810 residents/clients. The data looked at the period 1st – 31st October 2020 and used key themes to provide a snapshot of some of the issues affecting care providers, including whole home testing, access and supply of PPE, care home visiting, the care workforce and impact on provider finances.
Key findings from the pulse survey were as follows:
Whole home testing
- There had been very high levels of compliance by NCF respondents who provide residential care homes with COVID-19 whole home testing across services, with 99% of care homes taking part in this programme when eligible.
- There is a low incidence of testing failure with only 2% of tests returned for retest and 1.2% not returned.
- 24% of the providers in the survey received test results within 48 hours, however only 1.3% of supported living services or extra care housing schemes operated by NCF members responding to the survey are getting access to the single round of testing promised by the government.
The NCF are calling on Government to build on the success of the whole home testing initiative in care homes and to widen the rollout of testing across other care settings, to include supported living and extra care housing. Improvements are still needed to increase the speed of getting back test results to make sure testing remains an essential part of the fight against COVID-19.
In response to how the first wave of the COVID-19 pandemic compares to the second wave, Jane Ashcroft CBE, Chief Executive, of Anchor Hanover Group said, ‘The second wave is very different. We’ve got testing. I think we forget in the first wave, just how little information any of us had. We were at the beginning of a pandemic. It is quite difficult to draw comparisons. If you recall, it was all about symptoms in the early days. What we know now about coronavirus is that people can be positive and asymptomatic and that’s been a huge issue in relation to workforce. We’ve talked about PPE, the guidance changed in the early days, whereas now we have a very clear set of PPE requirements, which have been in place for a while and everyone is working to them. I think it will only be a little bit further into the future that there will be some really good analysis looking back. What we see in the Government press briefings, with regards to the number of people tested nationally is positive, that number looks high because of the availability of testing. Sadly, the number of deaths reported by Government have increased, but the numbers are nothing like in the first wave.’
Care home visiting
Despite the guidance on visiting in care homes only being issued a few weeks ago, the survey highlights the commitment of not-for-profit care providers in uniting residents of care homes with their relatives and loved ones.
- NCF respondents reported that 94% of their care home services were actively taking steps to facilitate visits during the period of the survey by using a variety of different initiatives to make visits possible.
- On average, NCF respondents are spending around £4,000 per care home to make visits possible. This is an additional cost that is currently being covered by care providers as the Infection Control Fund is not sufficient to meet the demands currently placed on the fund, according to NCF.
The NCF welcomes the Secretary of State for Health and Social Care’s commitment this week to facilitate family visits in all care homes by Christmas. This is an ambitious goal and one that urgently needs a clear, deliverable timetable with sufficient funding to support care providers to make meaningful visits a reality.
Personal Protective Equipment (PPE)
The supply and access to personal protective equipment (PPE) gives a mixed picture in the Pulse survey results.
- 100% of NCF respondents who are eligible to register on the PPE Portal have registered and were predominately using this method to source PPE.
- The allocation of PPE through the Portal was only meeting an average of 48% of the providers’ COVID-19 PPE needs and responsibilities.
- 9% of respondents were having to purchase additional PPE themselves in order to meet their requirements. Providers are unable to stockpile to create a buffer in the case of an emergency and the zero rate VAT on PPE was removed at the end of October thereby exacerbating the financial pressures of accessing PPE to providers.
Vic Rayner, Executive Director of NCF said, '67% of organisations are not fully able to access their PPE requirements through the portal. There's a big gap between the ambition of the portal and the reality at the moment...Organisations aren't currently being encouraged to go to the PPE portal to cover visitor requirements – it’s been set up around staff usage numbers. There is a potential gap there. The current Infection Control Fund levels are not sufficient. In order to make good this commitment, we will be looking to Government to provide some additional support for homes rapidly.’
The care workforce
- Between the period 1st – 31st October, the average level of vacancies reported by NCF respondents was 10% and the average absence rate was 7%.
- The data also shows that 9% of their staff were currently working in other care or health care settings.
The government consultation on regulating to restrict the movement of staff raises a number of concerns. Care workers are already low paid with limited terms and conditions and any measure that sets to penalise care workers fails to understand the seriousness of the issue, according to NCF. The NCF thinks that, given that the country is experiencing a second wave of COVID -19 and the current vacancy and absence levels reported here and the fact that 9% of staff also work in other care or health settings, proposals to regulate and enforce measures relating to staff movement seem very ill-timed.
Phil Orton MSc FCIPD, Executive Director of Human Resources at Making Space said, ‘The care home sector has always had a need for temporary staff to work in homes. There is the potential that if we restrict the movement of people, we are going to limit the opportunities of certain groups of people, which might impact on overtime. Lots of staff in care homes work on average 25-26 hours a week. Having a more stable workforce with less opportunity for bringing in additional staff will have an impact on available resources that we tap into. We don’t know at the moment how long this restriction will stay in place.’
Vic Rayner, Executive Director National Care Forum said, ‘We didn’t come into this crisis with a well-resourced and well-funded staff. We are asking some of the lowest paid workers to make incredibly difficult decisions which will impact their lives and their families.’
Funding – occupancy
- 95% of respondents thought there would be an impact to their financial performance in the next financial year 2021-2022, with over 80% forecasting a decline in revenue and almost 95% forecasting an increase in costs.
- Furthermore, care home providers had seen a decrease in occupancy to an average of 85% from an industry average of 89% - 90% in 2019.
More information about social care and COVID-19 and the Pulse Survey is available on the National Care Forum website.
Find out which areas of the UK will be taking part in the care home testing pilot initially, and what tests visitors will be offered.