Agenda item

To receive a report from the Executive Director – People. The report is not attached to this agenda and will be circulated “to follow”.

(Report No.251) To follow

Councillor Alev Cazimoglu (Cabinet Member for Health and Social Care) introduced the report of the Executive Director – Resources (No.251) detailing the support being provided to Care Homes in Enfield.

NOTED

1.            That every death as a result of Covid-19 was a tragedy and the impact on the adult social care sector, both for residents and staff, had been significant. The range of social care staff was highlighted, both in care homes and in supporting vulnerable residents in the community and their own homes. Members expressed their sincere thanks and appreciation of the valuable work that continued to be carried out by front line care staff and the voluntary sector who risked their lives on a daily basis in order to provide the care needed by the Borough’s most vulnerable residents. The Council was doing all that it could to protect and support the staff and residents during this crisis, including through the funding of PPE; adequate staffing; and testing availability.

2.            That the report detailed the support being provided to Care Homes in Enfield, which had the 3^rd highest number of care homes of any London Borough. The provision of a time limited grant payment to each of the Borough’s individual care homes (residential and nursing) providers was proposed, as detailed in the report. This would cover a period up to three months and provide a 5% uplift on all current placement spot purchased for this period, as set out in the decisions below.

3.            Members expressed their sincere gratitude to the front-line staff who had continued to provide essential services in such difficult circumstances.

4.            That a discussion followed including points of clarification and questions by Members.

5.            Members reiterated their appreciation of the staff involved in the adult social care sector and their ongoing work and support of vulnerable residents. In response to a question on the short and long-term risks should the 5% uplift not be provided, the Council’s duties under the Care Act 2014 for direct responsibility for the Care Home Market Management was highlighted, as set out in the report. It was essential to maintain the sustainability of the care home sector and service provision both in the short and long-term.

6.            That Enfield had a significant care home sector and supported living schemes. The impact faced by the sector through the number of deaths in care homes, staff absences, and additional costs such as PPE provision was explained to Members in detail. It was noted that tragically the loss of life being experienced was four times higher than normal expectations. The significant financial and human cost was recognised. The Council, with other North Central London Councils, was seeking to provide the additional support as outlined in the report.

7.            In addition to the financial uplift proposed, the Council was also providing support through the financial provision for PPE, the extension of the Council’s employee assistance programme to the staff employed by the adult care sector, as set out in the report. The Council would continue to work with care providers, support them in whatever ways possible and fully communicate and engage with them as the situation continued to evolve and develop. It was acknowledged that more significant interventions could be required in the future.

8.            The large care sector in Enfield was reiterated, as highlighted in the report, and the importance of maintaining the viability of the sector in the Borough was recognised. Officers had been asked to ensure that that a joined-up approach was implemented, with a comprehensive and corporate response to the identified risks and required interventions being developed. The Council had sought to support the adult care sector through the provision to grants to secure PPE, which many had struggled to access due to the national shortage, and, seeking to ensure that adequate testing was available to all care homes and staff.

9.            That there were approximately 5,000 care workers in the Borough and a further 6,000 front line key workers. The response of the NHS and care sector to the Covid-19 pandemic had been magnificent and humbling. Incredible efforts and sacrifices had been made and many individuals had sadly lost their lives. The loss of life in care homes was unprecedented. The impact on both front line workers and families throughout the Borough was significant and would have long-term consequences.

10.         In addition to the work of care homes in the Borough, Members highlighted the other valuable work being carried out for example, in seeking innovative ways of supporting vulnerable adults in their own homes while they could not access normal services such as day centres. Service provision was being adapted as much as possible to meet continuing needs and to protect the most vulnerable.

11.         Members expressed their appreciation to all involved including the Cabinet Member for Health and Social Care and Officers for their continuing hard work. Members acknowledged also the significant efforts of Councillor Caliskan as Leader of the Council in raising the national prominence of the issues highlighted and in seeking adequate funding and support from the Government. Members supported the recommendations set out in the report as reflected in the decisions below.

Alternative Options Considered: NOTED, that the principles had been considered and agreed by all councils across the North Central London (NCL). The Council’s options were to enhance this payment or if not, to run the risk of residential and nursing homes becoming financially unstable and closing. Additionally, not paying the same rate as other NCL Councils.

Other alternatives had already been employed. The Council had provided, in kind, support through the provision of personal protective equipment (PPE) free of charge to all providers who need it as well as other types of support. Our local community health provider, Barnet, Enfield and Haringey Mental Health Trust also provided clinical support through qualified nursing/medical staff to cover an gaps in cover that homes might have due to staff absence.

DECISION: The Cabinet agreed to

1.            Note the distressing and disproportionate impact that Covid-19 had had on our Care Home residents, their relatives and staff.

2.            Note the extent of the support provided to the Care Home Sector.

3.            Note the potential future considerations and requirements for rescue of care providers that had been significantly impacted by Covid-19.

4.            Agree the additional time limited grant payment to each of our individual residential/nursing care home providers equivalent to 5% of the cost of current placements.

Reason: NCL care home commissioners had suggested that a regional approach to meeting short-term additional costs associated with COVID-19 would be helpful. This was because the market-place was regional, and consistency was therefore helpful to prevent an upward pressure on cost; and also because multiple organisations were purchasing services from shared providers. Enfield currently had 82 homes with 1831 beds. In total Enfield had placed 862 individual placements in care homes both in and out of Borough. Enfield’s providers were a significant source of both employment and care placements within the borough. As a council we must support this vital sector who support Adult Social Care and the local economy.