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IN-DEPTH: Coronavirus’ cost on care

Home-Care-Insight

Frontline workers, and more specifically frontline care workers, have been vital to saving lives and protecting the public from the virus throughout the last few months.

As time progressed, dealers who were predominantly closed from a retail point of view, began safe visits to users homes to ensure maintenance and service. Another vital cog in the care wheel.

However, as industries begin to open up, care settings have had to adapt. The most recent move in this has been Government guidelines allowing for visitors to return to care home settings.

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As reported by AMP’s sister publication Care Home Professional, The ‘Visiting care homes during coronavirus’ guidance is now available on the government’s website.

Residential Care

Matt Hancock, Health & Social Care Secretary, (pictured) said: “I know how painful it has been for those in care homes not being able to receive visits from their loved ones throughout this difficult period.

“We are now able to carefully and safely allow visits to care homes, which will be based on local knowledge and circumstances for each care home. It is really important that we don’t undo all of the hard work of care homes over the last few months while ensuring families and friends can be safely reunited so we have put in place guidance that protects everyone.”

The government said care home providers should encourage all visitors to wear a face covering and to wash their hands thoroughly before and after putting it on and taking it off. Visitors should wear appropriate further PPE depending on the need of their visit, including gloves and aprons.

Providers should also consider whether visits could take place in a communal garden or outdoor area, which can be accessed without anyone going through a shared building. The government advises that visits should be limited to a single visitor per resident where possible.

Care homes are urged to support NHS Test and Trace by keeping a temporary record, including address and phone number, of current and previous residents, staff and visitors as well as keeping track of visitor numbers and staff.

It is recommended they have an arrangement to enable bookings or appointments for visitors with ad hoc visits not permitted.

Professor Martin Green OBE, CEO of Care England, was critical of the timing and content of the guidance, however, arguing it should have been with providers last month. Martin said the guidance failed to address supporting living, volunteers and support staff ratios, and contained insufficient information about Local Outbreak Boards and how a dynamic risk assessment may affect the frequency of visits.

“This guidance fails to consider the issues around visitors and residents leaving the care setting,” he said. “As lockdown lifts we are likely to see many care providers and relatives wanting to take their loved one out for visits. Also, we need to look beyond outdoor visits and recognise that these new conditions may be with us for quite some time. The failure to acknowledge this nuance underscores the lack of governmental understanding of the complexities present within the whole adult social care sector.”

Dr Sanjeev Kanoria, Founder and Chairman at Advinia Health Care, said: “Throughout the pandemic our homes have sometimes felt more like hospital wards. After an incredibly challenging few months, we are so excited to carefully welcome families and visitors once again and bring back the sense of community and warmth that gives our patients and tireless staff such a boost.”

Tele and Tech

Elsewhere in the care market, the enforcement of social distancing and lockdown rules meant service providers had to find new and innovative ways to adapt to the ‘new normal.’ Two seen over the past few weeks have been a rise in telecare services and technology to help with ‘virtual care.’

In Hampshire, technology-enabled care (TEC) helped Hampshire County Council save £3.4 million in social care costs last year, the local authority has revealed.

Image credit: Sean Gallup/Getty Images

Mark Allen, head of Digitally Enabled Care at the council, said that more than a third (39%) of TEC users avoided an increase in their package of care or an admission to hospital in 2019/20. This led to a saving of £3.4m, when all TEC services costs were accounted for.

“These TEC service users were much more self-reliant and were not using invasive and more complex services that would normally be put in place,” Allen said during the Innovation and Independent Living webinar, which took place earlier this month in July.

Allen added that the savings figure is “quite a conservative estimate” as it disregards people who are self-funding their care.

“We were very clear that those people were not going to contribute to the savings that we made, so those individuals were disregarded in this process. Equally, we put in place some formulas that enabled us to disregard a proportion of the savings that we would have claimed because of the people who would be partially funded,” he explained.

Hampshire CC works in partnership with Argenti to offer care technology to everyone who lives in the county.

Its solutions include a wearable GPS device to give carers and loved ones peace of mind that the service user is not at home; a ‘lifeline unit’ and pendent from Tunstall Healthcare, featuring an SOS button that alerts a 24/7 monitoring centre; a wireless smoke detector; and a device that detects slips, trips and falls.

As telecare operations grow, so did the roll out of virtual care technology. This month, Essex County Council, Kent County Council and Suffolk County Council rolled out COVID-19 virtual care.

As part of the announcement, local government explained how the COVID-19 pandemic has led the Government to take measures to encourage social isolation and slow the spread of the disease. This roll out forms part of its rapid care technology deployment tool.

The three councils wanted to protect vulnerable service users from the risk of infection, support them to self-isolate, and make sure they continue to receive the care and support they need in the most effective way and as the number of available care workers reduces.

This includes shielded individuals and high-risk people. Virtual visual check-in via video is a key part of this. The councils also wanted to make it easy and safe for family members, neighbours and local community services to play their part in supporting people.

As well as protecting care workers from disease and infection risks, councils were keen to ensure that care workers can continue to work and earn income while they are self-isolating. Virtual video check-in can be done from their own homes if they are self-isolating and will significantly increase productivity and capacity by avoiding unnecessary travel time.

They also outlined how a stabilisation to the care sector as the workforce reduces through sickness and isolation was important. To solve the above criteria, Essex, Kent and Suffolk county councils made commitments early during the COVID-19 pandemic to utilise greater care technology to support communities and care providers.

Whilst there is a wide-ranging market of care technology options available, the councils identified a locked-down tablet device (Alcove Video Carephone) to best suit their needs. The video carephone allows care workers, family members and other approved services to be able to contact the recipient and vice versa through a video call.

The device is locked down and the system is a closed system, which is simple to use for vulnerable users – only approved responders who have access to the system can use the device. It also has a SIM card pre-installed so the recipient does not require WIFI.

Users can acknowledge completion of asks and carers or responders can be notified if users don’t respond to pop-up reminders. The councils worked with the supplier to ensure a contactless delivery and support option. The device is delivered, without entering the home, to recipients together with operating instructions.

Once the recipient has plugged in their device, they will be instructed to press the support button which will call the supplier’s Technical Support. The user is then talked through the process of setting up and any questions or concerns they have. Looking at the expected impact, the service will enable vulnerable residents to continue to receive care and support in the event that the number of available care workers reduces.

The provision simultaneously offers an alternate method of care delivery that maximises care workforce productivity and may assist in maintaining a higher level of healthy care workers by enabling increased social distancing and protecting the care workers from disease and infection risks.

It will also enable councils’ front-line services to better manage a dip in care capacity if the workforce reduces through sickness while service demands escalate.  

Fragile markets

According to directors of adult social care services in England, the coronavirus crisis has made “extremely fragile” care markets even more susceptible to market failure, at the detriment to people accessing care and support services.

A report by ADASS has revealed that prior to the pandemic, directors reported seeing a downward trend in the number of care providers that have closed, ceased trading or handed back contracts, compared to previous years.

However, since the onset of the crisis, directors are now more concerned about the financial sustainability of care providers.

In the past six months, 43% of local authorities reported that providers in their area had closed, ceased trading or handed back contracts. The number reporting closures has decreased from 75% of councils in 2019 and 66% in 2018, while the number seeing contract hand backs has remained constant.

Three quarters of directors responding to the survey last month said they are concerned about the financial sustainability of some of their home care providers, a figure that remains unchanged since before the pandemic started to take effect on the country in March.

However, 15% of directors now have concerns about the financial sustainability of most of their home and community care providers, up from 3% prior to the onset of COVID-19.

Furthermore, nearly every director (96%) highlighted the need for additional funding to help them, their staff and providers manage the local response to the pandemic.

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Alex Douglas

The author Alex Douglas

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