Working in collaboration to plan and deliver quality care
The delivery of adult social care in Scotland requires effective collaborative working between planners, commissioners, providers and improvement and protection bodies.
Enhanced winter measures:
In May it was announced that multi-disciplinary enhanced clinical and professional oversight arrangements for care homes should be put in place in every HSCP area. This included a daily meeting of the Chief Officer, Chief Social Work Officer, Director of Nursing, Director of Public Health and Clinical Director (or their representatives) to review the position of all adult care homes in their area. The Care Inspectorate are included as appropriate in these considerations. For the 2020/21 winter period, it is expected that these daily huddles will continue to operate. The scope of interest should now be extended to wider adult social care provision to protect services over the winter. It is also expected that ensuring appropriate health and safety procedures are in place is within the remit of the oversight function. As part of this work local partners should support providers to review and update their continuity plans for winter. Provider engagement with the local multidisciplinary oversight team should be sought where there are concerns by no later than the end of November.
The Turas Care Management – Safety Huddle tool has been developed to enable a consistent approach to data collection, report staffing decisions and early escalation and warning to enable timely support and intervention. Over the last 2 months providers have demonstrated a high level of commitment to the adoption of the huddle tool and input to the huddle tool will continue to be promoted and supported by all partners. The RCA conclusions have recommended that more proactive monitoring and review of local data will support increased early outbreak minimisation and management. For that reason, ensuring that the huddle tool is being proactively used by all local partners to record, analyse and act upon information must be a priority. Support and training will continue to ensure greater understanding of the functions that support early escalation of concerns over the winter months and beyond.
Effective scrutiny of, and support to, care homes to ensure the safety and wellbeing of residents will continue. The Care Inspectorate will be supported to continue to carry out scrutiny and improvement activity during the winter months. As the pandemic continues, this remains a vital mechanism for protecting and improving services for individuals. The role of the Care Inspectorate remains under continuous review to ensure they have the necessary powers to respond to a continually developing landscape. This was demonstrated in the response to the pandemic, when new emergency regulations were introduced to ensure that the Care Inspectorate could act swiftly to protect and promote high quality social care service delivery.
New winter measures:
National and local partners will work at a local level with the public to prevent, contain and manage outbreaks during the winter period. A number of further processes should be adopted this winter:
- In the event of a suspected outbreak this winter the HSCP will immediately provide support to care providers.
- Whilst awaiting confirmation of an outbreak providers should be supported by local partners to immediately review IPC processes and brief all staff on the heightened risk.
- Where any single member of staff or a care home resident shows symptoms of COVID, along with testing and self-isolation of the individual(s) concerned, the local Public Health Team should provide immediate advice on whether all staff and residents should be tested and take the necessary action (ie on the same day of symptoms showing)
- All staff and residents (where clinically appropriate) at care home sites should be tested immediately on confirmation of one positive test and the Health Board will prioritise the analysis and communication of test results ideally within the same day.
- Staff not at work on the day an outbreak is confirmed will be required to be tested and receive a negative result prior to returning to work. Local health protection teams should provide advice on additional follow up testing.
- Local oversight teams are to provide support for care homes in managing outbreaks and ensuring continuity of care by providing mutual aid – for example through staffing if the provider is unable to secure sufficient support through normal routes.
National and local partners, including care providers, need to work together to plan and prepare for EU exit. At both national and local level, we need to plan for concurrent risks, with the end of the Transition Period on 31 December coinciding with the ongoing Covid-19 pandemic (and potential for further surges) and the impact of winter (including flu and severe weather).