Leading care sector figures are calling for a rethink on restricted movement between care settings as outlined in the Government’s Winter Plan.
Announced last Monday, legislation is set to be introduced by the end of the year that will require care home providers to restrict all but essential movement of staff between settings in order to reduce COVID-19 transmission.
Care sector leaders though have expressed fears that the plan will have a disproportionate impact, with restricted movement effectively restricting care providers’ flexibility in the face of ongoing, existential challenges, something that will prove hugely detrimental in both the short and longer term.
Concerns also abound that the learning disabled will be hardest hit due to the prevalence of smaller care settings (which often have fewer staff who move between settings) amongst that particular area of care.
Maria Mills, who is on the board of directors of the Surrey Care Association and CEO of Active Prospects, an organisation that looks to help people with learning disabilities, and physical and mental health needs to live full and aspiring lives, outlined her fears: “Care managers have been doing everything they possibly can to restrict staff movement across services, and are already fully open to inspection from their regulator – the CQC – on how they are managing staff resources safely during COVID.”
“This change to movement will have a profoundly negative impact on the ability to offer safe care. It’s an occurrence across the industry for some staff to work across settings – especially in smaller 3, 4 or 5 person homes, such as managers and clinical staff.”
Maria elaborated: “Many care providers also rely on agency staff, who they’ll often have established working relationships with, calling them in to plug staffing gaps or simply fill in where needed. Requiring them to work at one setting only, removes the flexibility which may very well have attracted them to an agency role in the first place, while they already have to comply with COVID testing arrangements and wear full PPE.”
Fiona Aldridge, a fellow SCA board member is in full support of Maria’s viewpoint, saying: “We have worked tirelessly since March 2020 to restrict movements of staff whilst deploying trained, professional frontline workers during the pandemic.”
She continued: “No-one wants to put clients, staff, workers, or themselves at additional unnecessary risk. Weekly testing, full PPE, Infection control and COVID-19 training is now standard practice – despite no additional financial support having been offered to agencies to provide this, and with no Infection Control Grant to cover additional PPE supply or additional training for agency staff.”
She added: “There is risk, of course. Risk from permanent staff, managers, cleaners, kitchen staff, community staff who need to travel between homes. Domiciliary care and NHS are not restricted. What is the difference? And why are agency staff, yet again, being targeted as the ‘problem’ rather than a key part of the solution? Do other care providers or even the NHS know where their staff were last night? And how do you know they are any less of a risk than agency staff?”
Both Maria and Fiona also expressed concern on block booking being touted as a solution, with Maria saying: “Block-booking and exclusivity contracts, whilst working well in some scenarios, simply aren’t appropriate in all circumstances, as we are not always able to offer a minimum number of hours and the situation can change suddenly one day to the next.”
Fiona Aldridge concurred: “Block-booking contracts have been planned for and implemented where possible. But this is not a one-size fits all solution. It is not financially viable to overstaff or block book regular agency staff when the need is not there. Care environments are not seeing enough funding to cover this, and their bed occupancy is suffering.”
Further worry centres on recruitment. With the industry in desperate need of staff, Fiona fears the measures will prove detrimental in the long term, saying: “Many staff are unable or unwilling to commit to permanent contracts due to family commitments or other pressures. To force staff to transfer permanently leaves a sense of unease, and we will all end up losing out in the long run as staff leave social care all-together if treated in this way. It’s effectively a short-sighted recruitment plan. We are already seeing many staff taking whatever opportunity they can due to feeling they have no choice. Many are simply being frightened into taking permanent contracts. Sadly though, they will not remain – either in these roles or in social care long term – and so, post-pandemic recruitment in social care is set to become even worse not better.”
Fiona concluded: “I urge the Government to rethink this move. The regulatory changes are based on outdated data, compiled when the testing of staff was incredibly difficult to do. More regular testing (which needs to be ramped up to the 20-minute daily testing) is a huge step forward. But this additional level of regulation will add unnecessary pressure to an already struggling frontline service. It’s a huge amount of work to implement change in a regulatory platform when a vaccine is on the horizon. This is a short-term problem which is already being well-managed on the frontline. By the time the regulations are agreed, passed and implemented, we may very well be looking at fully vaccinated teams of staff who can work flexibly again – making the whole process redundant.”
Maria Mills added: “Of course, given the viral nature of COVID-19, we understand the need to minimise interaction between care settings, but for providers looking to deliver an efficient, quality and consistent service, this will just add to the difficulties in an already incredibly difficult period for the sector.”
The Surrey Care Association recently launched a manifesto titled ‘Reinventing Social Care’, which outlines its vision for the future of care and includes within its wider observations steps to ensure a valued care workforce going forward. You can read the report here.