Following the introduction of lockdown, there were immediate changes to work practices and immediate challenges to service delivery within the care sector.
Upon the implementation of lockdown, a process of restricting all but essential visitors to care homes was introduced. With visits no longer possible the use of virtual technology has been promoted and encouraged to enable families to maintain contact with residents.
Working with partner agencies, the service has had to respond to the requirements stipulated by the Scottish Government. Along with the implementation of other measures this has resulted in changes to the physical environment of care homes.
There is daily contact with care homes by either a Quality Improvement Officer or Health Practitioner, and daily updates are reported to the oversight team, using a RAG (Red, Amber, Green) status framework. All care homes are currently rated green for all clinical and care aspects.
Staffing levels were adversely affected at the earliest stages of the pandemic. However, with the closure of Day services, the Day Care Service workforce was redeployed, including residential services. Employees met the challenge admirably.
A public appeal for people to come forward and support social care services was made. As a result of this we have recruited additional staff and we see this as an opportunity to attract people into the care profession.
Due to the age profile of the Home Care workforce, the service was immediately adversely impacted by the pandemic. Thanks must go to the families who stepped in and assumed all or part of care packages.
With more of the workforce having returned to work, and through the recruitment of additional relief staff, the service is managing to resume these points of care. However as the economy begins to restart many of the family members who have taken on care responsibilities as well as the temporary relief staff will now be returning to other work. With these changes the provision of points of care will once again become challenging.
Currently we are working on a reduced respite capacity as we support hospital and community pressures, however we recognize the need to support informal carers and will be working with commissioning colleagues to review and reinstate respite provision.
Testing for both staff and service users for COVID 19 has occurred throughout the social care sector during the pandemic. All tests thus far have returned as negative. The service has now entered its second week of sample testing of care home staff. The uptake has been very positive with a significant majority of residential staff now tested.
The high volume of negative test returns has provided further evidence of the likely R rating in the community and allows us to begin planning for some easing of the restrictions within care homes between residents, whilst continuing to ensue social distancing.
From next week the testing regime will likely change to utilizing the UK Testing Portal, where staff will self-test and the tests will be couriered to a mainland testing centre. Should there be a positive test, then Public Health will be notified in addition to the individual being tested, and a planning meeting will be convened.
Personal Protective Equipment
There has been a focus on infection prevention and control measures throughout all care homes. Staff use PPE, aprons, gloves and masks routinely in our care homes as part of the infection prevention and control measures. There is a robust system in place to access PPE supplies with hubs strategically placed across our island communities.
The 3 local PPE Hubs were set up in Stornoway (Lewis and Harris) Uist and Barra. Stock is delivered from the NSS National Distribution Centre to the three local Hubs and kept on site. Each Hub is open for business between 9am-5pm, Mon - Fri. Care homes, care at home and private providers are able to access stock if they are unable to source PPE through their usual supply.
Private paid and unpaid carers were also added to the group that could receive stock. Over 400 potential users could access stock and this was monitored each week though NSS and our local Health and Social Care Partnership. The hub successfully continues to provide PPE to those providing social care support in the community.
Learning Disability Service
For those living in the Core and Cluster Service, where they live in the community in their own supported tenancy, lockdown has proven to be a challenging experience. The employees supporting these service users have been very flexible in their work patterns to ensure supports have continued where possible.
Residents of Ardseileach, have enjoyed getting outside into the garden area when weather permits. Residents have adjusted well to staff wearing personal protective equipment. Resources such as social stories were used to help residents understand COVID – 19 and the measures put in place to prevent and control infection.
Although day services were reduced as per Scottish Government advice, the service did offer care at home if families were not able to provide care or access basic needs due to caring responsibilities while day centres were closed. Wellbeing phone calls for families were introduced to ensure that service users and families felt in touch with their service and to try to reduce the likelihood of crisis.
Day services partially restarted following the route map of phase one on the 16th of June. Day services buildings have been adapted to ensure safe distancing and easy to read information about infection prevention and control, PPE and Covid-19 is readily available and displayed.
A morning service incorporating social distancing and one to one activities has been introduced and will be reviewed on a three week cycle. Service users receive Social stories and activities are focussed on infection control, PPE and information on Corona Virus alongside usual activities.