NCF releases Pulse Survey results

December 17, 2020

The National Care Forum (NCF) has shared the results of its second Pulse Survey of the adult social care sector, to provide in-depth analysis of how adult social care providers are operating during the second wave of COVID-19.

Working together with market research agency, Information by Design, the survey was completed by NCF members operating 1,456 care and support services throughout England. Participants employed over 47,000 staff and supported almost 51,000 people across a wide range of care services including care homes, community based services, supported living and extra care housing. The data provides a snapshot of some of the key issues over the period 1st-30th November 2020.

Some of the key findings from the NCF Pulse Survey:

COVID-19 testing

  • 99% of those responding reported compliance with whole home testing of staff weekly and residents monthly (98%).
  • There is an indication that there has been an improvement in the speed of COVID-19 test results with almost 57% of tests returned in 48 hours compared to 24% in the last survey looking at the period of 1st-31st October 2020.

Care providers reported the significant cost of administering the tests, with many stating the need for a dedicated staff member to take on this role. When asked if they felt the increase of testing to twice weekly for staff and weekly for residents was achievable, many expressed concerns due to the ongoing pressures on care providers.

Sue Porto, Chief Executive at Brandon Trust said, 'On top of the day-to-day pressures, staff have had to implement infection control practices over a sustained period to keep people safe and there is no end in sight. Staff also bear the brunt of the extra clinical responsibilities, looking after very vulnerable people and people who have tested positive for COVID-19. Our front-line staff are often some of the lowest paid of our workforce and we expect so much. Staff deliver time and time again. We have put extra demands on our operational staff to provide additional data, both in terms of infection control data requirements, but also the capacity tracker.'

The Pulse Survey findings showed that the concept of visitor testing twice weekly was viewed as positive on the wellbeing of residents connecting with their relatives. However, in a busy care home environment, concerns were raised about the impact this will have on direct staff time with residents and provision of care. Previous analysis by NCF has suggested all the additional testing commitments introduced in the Winter Plan could add over 5 million care hours a month to an already stretched sector.

The ongoing dispute over the accuracy and use of lateral flow device (LFD) testing needs to be urgently resolved. The NCF has long held the view that COVID-19 testing is an important tool in the infection prevention and control armoury against COVID-19. LFDs have their place and their value, and are simply one of the measures available, alongside other important precautions such as PPE and social distancing that should be used to comply with best practice infection prevention and control measures.

Oona Goldsworthy, Chief Executive, Brunelcare said, ‘Of the conflicting advice that we are getting through public health, the concerns everyone has are about the efficiency of the lateral flow tests. It's said lateral flow tests only have 50% efficiency. That’s low. We are having to do risk assessments for every single resident, to check what the impact of visiting is going to have on them and the residents. We don’t have any tests yet.’

Rationing of Personal Protective Equipment (PPE)

  • 73% of services reported that the allocation of PPE was not sufficient to meet their COVID-19 responsibilities.
  • Fewer than 1% of services are able to source PPE from the Local Resilience forum or local authority.

Care workforce

The responses in the survey highlight the range of different approaches care providers are using to support their staff.

  • NCF care providers have implemented a wide range of initiatives to support their staffs’ mental health and wellbeing, from setting up counselling and employee assistance programmes, to making available mental health resources and enhanced one-to-one support.
  • Many registered managers are also struggling to maintain resilience during a time of increased pressure and complex decision-making. The significant workload driven by the ongoing need for PPE, COVID-19 testing, a myriad of reporting / data requirements and now the administration of the vaccine places significant pressure on the care workforce which cannot be underestimated.


  • 90% reported that COVID-19 will impact on their financial position at the end of the year.
  • 75% say their revenue is down, and 83% say their costs are up creating greater fragility to an already stretched and underfunded sector.

Community based services

  • Only 38% of community services were able to run fully as normal, with 62% either unable to operate or operating a much smaller proportion of their usual services.
  • 82% of services were supporting fewer people face-to-face and 91% were supporting fewer people overall.
  • 73% were offering a digital alternative and 90% have made other changes to provide support in a COVID world.
  • Local authority funding is down for 48% of services and income from people who pay for their own community services is down by 48%.

Commenting on the Pulse Survey results, Vic Rayner, Executive Director at NCF said, ‘This snapshot gives a vital insight into the pressure pot of social care during COVID-19. Whilst we rightly celebrate the arrival of a vaccine, it is vital that the day-to-day impact of managing during this pandemic is recognised.

‘Values, innovation and resilience have driven the social care response to COVID-19, however, the toll on our amazing workforce, those who receive care, families and loved ones and the sustainability of organisations is immense. Government ignores this at their peril. Warm words and headline grabbing commitments mean nothing without the resource and infrastructure to support meaningful implementation – be that testing, vaccination, PPE or accolades for the workforce.’

Mark Wilson, Director of Engagement, Friends of the Elderly said, ‘Community based services play a really integral role within the care sector...These services not only maintain and improve people’s wellbeing and they provide support to relatives and their main carers, to help give them respite.

‘However, community based services seem to have been missed in the Government guidelines in how we deliver safe day care facilities. This has resulted in us deciding from the care home guidance what we think is suitable for a day care setting. We haven’t had any practical support, like care homes have had.

‘There has also been limited access to funding, PPE, and practical support from local authorities. We will be closing our services again on Christmas Eve. We won’t be open until the beginning of February. We are concerned if family members visit our client group over the five-day Christmas break, because there is a risk that when people re-join the service in January, they could possibly come back asymptomatic and spread COVID-19 across our client group. Because there have been no guidelines for day centres, there is no testing regime in place. We can only access tests for staff and clients if they have been asymptomatic. So, it’s a real problem. Financially, it is difficult.’

Age UK warns progress in resuming care home visiting is stalling and calls on everyone to pull together to make it happen.

Today sees the launch of NCF's Caring in COVID e-book; which celebrates the contribution of care workers during the COVID-19 pandemic. For more information, visit NCF's twitter feed. 

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