To receive a report on the current situation relating to Covid-19 in Enfield Care Homes.
1) Cllr Alev Cazimoglu, Cabinet Member for Health and Social Care introduced this item and noted the progress made, especially relating to systematic testing and the provision of PPE. The rate of new cases of covid-19 has reduced with no covid-19 related deaths in care homes within the last 2 months.
2) It was noted that the Council must support family members, where appropriate, to maintain safe and regular contact with their loved ones. Care home staff should receive their pay when required to self-isolate during these challenging times. Cllr Cazimoglu thanked all front-line staff for continuing to care for our family and friends.
3) Enfield has 82 care homes, providing 1800 beds. As the pandemic developed, Enfield Council mobilised quickly in partnership with health service colleagues and service providers. Enfield acquired good levels of PPE and continued to push for mass testing for residents and staff in the care homes.
4) Care home staff were praised for the way they have adapted and carried out their work in very trying circumstances.
5) The physical impact of the pandemic is clear but the mental toll upon residents and family members can’t be underestimated. Care homes must be kept safe by keeping infection out, balanced with allowing appropriate access visits. This has been achieved in a number of ways, via skype calls or garden visits. With end of life care, the appropriate precautions are taken to allow family members to be with their loved ones.
6) Although the Council will not be complacent, in April there were infections in over 50 care homes, that figure is now less than 10.
7) The Council provide care homes with the latest Government guidance as we work to ensure that staff, residents and residents families are safe.
The Chair thanked Cllr Cazimoglu and Doug Wilson for their input and asked members for any questions and comments.
8) In response to a question relating to visits, it was noted that guidance is provided to care homes by the Director of Public Health, advising of benefits and the risks of enabling personal visits to car homes. However, a capacity issue can arise when staff in care homes are in self-isolation as a number of staff members may be required to facilitate a personal visit from a family member.
9) The current guidance requires all care home staff to be tested in the past 7 days and residents to be tested in the past 28 days. It was confirmed that this has been achieved in 79 care homes in the borough, with the remaining 3 to receive support in reaching this target.
10) Mass testing is being developed to provide results within 30 minutes. Enfield Council, via Public Health England have applied to be a test site for this trial.
11) It was noted that the issue of visits is very difficult for residents, families and staff. Current Government guidance is not to allow visits to care homes, however, the council are being humane in interpreting the guidance and working with service providers to ensure all concerned are kept safe, with appropriate risk assessments being undertaken.
12) Issues relating to statistics available from Public Health England were highlighted. Previously, information on numbers of tests in homes was provided to the Council but since this has stopped, Officers are required to contact each home individually to ask for the information. Representations have been made with Public Health England as to why this information is no longer provided but a response has yet to be received. This will be followed up and the scrutiny panel advised accordingly.
ACTION : Bindi Nagra/Stuart Lines
13) The number of vacant beds in care homes had increased from 62 in March to 270 in October. It was confirmed that this was mainly as a result of the number of deaths and the reduction in new placements.
14) The issue of low pay for care workers was commented upon. The additional monies received from Government was to be used to fight the infection levels and was not intended for front-line staff. To address this issue of low pay, there needs to be a reform of Social Care. It was recognised that the workers the community relies upon the most receive the lowest salary.
15) The importance of containing any infection and not working in more than one site was noted. It was confirmed that part of additional government funding was provided to care homes to pay staff, in full, if they needed to self-isolate or they were required to give up part of their employment at another site.
16) The Council are instructing care homes not to allow staff to work in other care settings as this is recognised as one of the main ways that infection is spread.
17)A comment was received in relation to the National Living Wage and the Chair reminded all members to remain non-partisan during scrutiny meetings.
18)It was highlighted that in preparation for the 2nd wave of the pandemic, 85 step-down, additional capacity beds will be available in North Central London. These beds will be used by patients leaving hospital care, who test positive for covid-19, rather than returning to a care home. The beds in Enfield are located at the St.Micheal’s site and Chase Farm Hospital. Currently, only a very small number of these beds are occupied across the North Central London area. If the NHS were to become over-whelmed, the use of these beds would need to be reconsidered. Enfield Council will resist, for as long as possible, hospital discharges in to care homes as it was apparent that this resulted in the great number of deaths witnessed during the first wave of the pandemic.
19)In response to a question, it was confirmed that NHS workers are taken from other parts of the service to staff these step-down beds.
20)A question was asked as to whether local hospitals were able to provide covid-free areas within their premises, to safeguard covid-negative patients. In response, it was noted that hospitals could be classed as ‘hot or ‘cold’ sites. Hot sites would take covid-positive patients, however, cold sites would not. Within Enfield, Chase Farm is a cold site, with much elective surgery taking place here, but North Middlesex hospital is a hot site, with covid positive patients being admitted via GP referral or A&E.
In closing this item, The Chair commented that Members would feel assured by the work being undertaken and thanked Cllr Cazimoglu and Officers for their contributions.