The government response to supporting adult social care through the coronavirus (COVID-19) pandemic needs to be more inclusive to enable the social care sector to support disabled people and their services, according to the Voluntary Organisations Disability Group (VODG).
VODG, in collaboration with Professor Chris Hatton from Lancaster University, undertook a rapid audit exploring services for working age adults aged under 65 years, both regulated by the Care Quality Commission (CQC) and non-regulated services (such as independent living networks) to examine how the pandemic is impacting on disability services.
The findings revealed that while the dominant focus remains on the NHS and older people’s care homes, there are a wide range of essential care and support services for the nation’s disabled people that are facing challenges and that risk being excluded from the government’s COVID-19 pandemic response.
The data revealed:
Disabled people and the staff who support them are not being tested. Testing needs be significantly increased urgently across all settings.
The rate of testing is low for both disabled people and the staff supporting them
These findings demonstrate the urgent need for more testing to be carried out to protect both people supported and staff, and to understand more about the virus. Without this, the sector is at significant risk of rising death rates compounded by serious workforce issues, including a lack of PPE.
- Only 0.6% of people supported (61 out of 9,708) were tested for COVID-19 but of those tested, 77% (47) tested positive.
- A further 166 people were newly suspected of having COVID-19 but not tested.
- Only 0.5% of frontline staff (36 out of 6,906) were tested for COVID-19 but of those tested, 53% (19) tested positive, 2 workers have died with a confirmed COVID-19 diagnosis, and one with a suspected diagnosis.
- Furthermore, 198 out of 4,658 staff were newly suspected of having COVID-19 but not tested (4.3% of staff).
An improved approach to testing is required to protect people supported and the workforce
The data revealed high rates of staff sickness absence – on average, 13% of frontline staff were off sick across the dates data was reported. This is putting significant strain on services and is made worse by existing workforce pressures around recruitment and retention of social care staff that existed prior to the pandemic.
That testing is not happening at speed leaves workers, their families and people supported at risk. VODG is calling for an improved testing system that goes to where people are as opposed to one that places obstacles in the way of people being tested. Testing must be followed up with contact tracing and providers need appropriate funding to enable them to pay staff who need to self-isolate as well as to hire workers where self-isolation leaves vacancies.
Personal protective equipment (PPE) is crucial to ensuring the safety of disabled people and the workforce supporting them in an appropriate and proportionate way
The supply chain for supporting the sector remains slow and undeveloped despite government assurances. The Department of Health and Social Care’s response has been primarily focused on supporting regulated care home services and this situation is leaving other services without. Supported living services, for example, are struggling to access supplies leaving them and people supported at risk.
Deaths from COVID-19 among disabled working age adults are still more common than general population death rates for the same age group
The number of deaths reported is fewer than in some other media reports – 24 out of 11,830 people supported died with a confirmed COVID-19 diagnosis (0.2%), and 18 out of 11,830 people supported died with a suspected COVID-19 diagnosis (0.2%).
These sad deaths are low, but they are still more common than general population death rates for the same age group.
These deaths are lower than some other reports on care homes for older people, which could be explained by disabled people being more likely to be support in smaller services and their own homes. In un-regulated settings (not overseen by CQC) death rates are lower.
Professor Chris Hatton at Lancaster University said: “This data provides a snapshot of how the social care sector, outside of care homes for older people, is being impacted by the pandemic.
“For government and policy makers, this audit should serve as an early warning of what could be around the corner if steps aren’t taken to resolve the issues it highlights. We need greater recognition of all social care services, we need comprehensive and regular testing across the sector, and we need greater support both for disabled people and for those supporting them across the country.”
Dr Rhidian Hughes, chief executive of VODG, commented across a number of areas:
Recognise all aspects of care and support provision:
“The NHS has been front and centre in government’s response to the pandemic, but we must also recognise support for disabled people, and not simply equate social care to older people’s care homes. If we are to comprehensively respond to this pandemic then the pressing issues around funding, personal protective equipment and testing need to be understood for everyone who needs care and support to live their lives.”
Testing needs to be scaled up significantly:
“The figures for disabled people being tested, as well as the staff supporting them, are alarmingly low. The worrying finding is that for both groups, when they are tested, they are more likely than not to test positive for COVID-19. Consequently, as testing is expanded, we could see an increase in the numbers of disabled people and support staff being diagnosed with this virus.”
Pressing workforce challenges:
“Add the usual vacancy rate in adult social care, which runs at around 8%, to an average COVID-19 related staff sickness rate of 13% and we can only conclude that we may quickly reach a point that is no longer sustainable.
“An improved testing process for the workforce could confirm whether or not people need to isolate. But with a cumbersome approach that is requiring some workers to drive many miles to testing centres, the opportunities to test could be limited at the present time.”
Funding needs to reach the first line of essential care provision:
“The additional funding given by central government to local authorities to support social care has reached some providers. But we are hearing from across the Voluntary Organisations Disability Group membership that in more cases than not, the additional financial costs providers are facing are not being met. Government provided funding to support the frontline and it is not right for some local authorities to be sitting on it.”
COVID-19 connected deaths and the release of data:
“The deaths reported in the VODG and Lancaster University audit of disabled people are more common than general population death rates for the same age group. Every death must count and government and its agencies, including NHS England and NHS Improvement, could release data on the deaths of people with a learning disability arising from COVID-19 if it chose to. We are calling on NHS England and NHS Improvement to release data on the deaths of people with a learning disability in order to truly count the lives lost and so that services can better respond to current and future need.