Adult social care - winter preparedness plan: 2021-22

Supporting the social care workforce and unpaid carers

We recognise the pressures currently being experienced across the social care system, in particular with regards to attracting, recruiting and retaining staff. In care at home, the combination of workforce shortages and increasing needs means that we need more people in the sector. We are supporting a national recruitment campaign, and working to establish minimum terms and conditions for existing staff. We are also accelerating placements for people in training, and looking across the public sector to see if vacancies can be filled by staff with appropriate training and supervision.

In our care homes we continue to support services with increased access to infection, prevention and control support and training. We are working with the sector on the recruitment, retention and training of staff in our care homes as well as enhancing community and district nursing support. It is fundamental that we support this part of the system as it is the cornerstone of support to our acute sector. We are also looking at the role of technology, prevention, and multi-disciplinary approaches to develop innovative ways to increase the support to people.

One system-shared workforce – competing pressures

Care homes

• More complex health issues
• Lower numbers of people
• Some localised capacity
• Staff shortages
• Media and regulatory spotlight
• Recruitment and retention – Qualified nursing staff, Social Workers, Social Care Workers
• Pay, terms and conditions
• Access to learning and development
• Competition from retail and hospitality

Supported Living - Care at home - Community Nursing - GP services - Social Work

• More complex health issues
• Higher numbers of people
• MDT capacity to do assessments
• More statutory social work
• Support to care homes

Hospital

• Higher numbers of people
• COVID-19 cases
• Awaiting treatment
• Delayed discharge
• Care destination issues

The wellbeing of the health and social care workforce is of critical importance to ensuring the delivery of high quality services across the sector. This year, we are providing an increased budget of £12 million – an increase of £7 million on last year – to provide ongoing support for the wellbeing of health and social care staff across Scotland. This includes targeted support to the primary and community care and social care workforce of £2 million. We will continue to support and evolve local wellbeing support for the workforce while also maintaining and improving nationally-led initiatives, including developing a work stream on the wellbeing of those working in social care/social work as part of the new National Wellbeing Programme to be implemented from autumn 2021. We will continue the 24/7 National Wellbeing Helpline, the National Wellbeing Hub, Coaching for Wellbeing and Workforce Specialist Service as well as developing further practical support measures and additional resources for Boards. The

National Wellbeing Hub, has already been used more than 115,000 times by health and social care staff since it was launched in May 2020. This includes a dedicated page for unpaid carers, developed with carer representatives and promoted via local carer support organisations.

The Workforce Specialist Service, launched in February 2021, also provides tailored, confidential mental health support to regulated staff across the NHS and social care workforces. It is the most expansive of its kind anywhere in the UK. Over 200 staff have already received bespoke mental health care and we will continue to invest in and grow the service in line with what staff tell us they need. We are also taking forward specific targeted work to support the recovery and wellbeing of care home managers in light of a commission from the Clinical and Professional Advisory Group for Adult Social Care (CPAG).

Attracting, recruiting and retaining staff across all areas of the social care sector remains a critical priority. Up to £48 million of funding will be made available to enable employers to update the hourly rate of Adult Social Care Staff offering direct care. The funding will enable an increase from at least £9.50 per hour to at least £10.02 per hour, which will take effect from 1st December 2021. This funding is critical to support retaining and recruiting staff in the sector and to alleviate the immediate pressures in Social Care and NHS/ Community based health services.

We have extended and will continue to raise awareness of the Disclosure Scotland Priority COVID Staff process to support the prompt recruitment and appointment of additional resource. We have extended our agreement with MyJobScotland, in partnership with COSLA, which enables third sector and independent social care providers to advertise jobs on the MyJobScotland website free of charge. This will be in place until the end of March 2022, and provides a single place for social care job adverts to better support people to access opportunities in the sector. We are currently working at pace with Scottish Social Services Council and other key partners to:

• develop a national induction programme for new entrants to Adult Social Care, to support entry to both care home and care at home roles;
• promote career opportunities and deliver policies on upskilling and developing the workforce to retain and attract new people to the sector and ensure the sustainability of services over winter and beyond;
• develop leadership and management resources on managing risks and communication which can be undertaken online and will be tailored to specific live issues.

We will run a national marketing campaign to attract more people to the sector. This will take a different approach to previous campaigns, with a focus on social media, a younger target audience and working with schools and colleges. This links to the medium term work being undertaken with the SSSC on career pathways and learning and development, referenced above.

To identify and address risks of staffing deficits, local level workforce plans and staff rosters should be reviewed frequently by Health and Social Care Partnerships as part of professional oversight and offer advice and/or mutual aid where required. In circumstances where mutual aid is required, it will be facilitated in a timely fashion to support safe care where necessary and

provide support and sick pay to staff where it is required. Mutual aid across geographical boundaries should also be effected where necessary. Further measures to address staffing deficits within the social care workforce are discussed on p9.

The principles of ensuring Fair Work for the adult social care workforce remain a top priority for Scottish Government. The recent recommendations from the report developed by the Fair Work in Social Care Group – which focused on improvements to the Real Living Wage Policy, developing minimum standards for terms and conditions and minimum standards for effective voice – is now being progressed in partnership with key stakeholders, and we will continue to engage with key sector stakeholders to ensure the experience of the workforce shapes policy and practice.

The Social Care Staff Support Fund has also been extended to the end of March 2022 to continue to ensure that social care workers who are ill with COVID-19, or self-isolating in line with public health guidance, receive their normal income for that period.

Unpaid carers have faced significant additional pressures over the course of the pandemic, not only as a result of COVID-19 and the associated restrictions but also the impacts on services and support for them and those they care for. Wider work to strengthen health and social care support should also help reduce pressure on carers. We are also putting an additional £400,000 into the Time to Live Fund to provide micro-grants to give unpaid carers a break. Local delivery will be supported by funding and working with partners including the Carer Centre Manager Network and Scottish Young Carer Services Alliance. This will help local services to share practice and resources, and ensure that local carers' services can access tools to support staff to build resilience over the winter months. We are providing £1.4m to deliver the ScotSpirit Holiday Voucher Scheme which will help low income families, unpaid carers and disadvantaged young people to enjoy a break over the winter. We will also continue to raise awareness of the Equal Partners in Care (EPiC) learning resource. This is an e-resource primarily for workforce to help staff identify and have better conversations and interactions with unpaid carers.

There are real pressures with the availability of registered nurses in care homes which existed pre-pandemic but which have worsened with the pandemic. The current situation in care homes with registered nurses needs to be considered alongside the supply, capacity and access to district nursing teams or care home liaison teams. We will set up a task group comprising members of CPAG and other stakeholders to scope short term actions now and over the winter period. This will include consideration around increasing community nursing and Allied Health Professional capacity, including Advanced Practitioners, to support care homes and people living with complexity in the community over the winter period. This should be linked to Health and Social Care Partnerships (HSCPs) and NHS Board resilience planning for winter.

Following a review of the existing PPE support arrangements, it has been confirmed that the PPE Hubs and PPE Support Centre, which provide free PPE to providers across the sector where supply routes fail, and to unpaid carers who are unable to access PPE through their normal routes, will continue to operate until end March 2022. For care providers, payments for PPE over and above usual amounts as a result of the pandemic have also been extended to end March 2022 as part of the Financial Support for Adult Social Care Providers. These arrangements will continue to be monitored by the Adult Social Care PPE Steering Group, which consists of a range of stakeholders from the adult social care sector, NSS and the Scottish Government.

Links to training, funding and guidance for social care workforce and unpaid carers

• Staff wellbeing during a Pandemic and Beyond
• Psychological mental health & wellbeing support
• Going home check list
• Questions to support staff during the day
• Guidance for support workers
• Unpaid Carers
• Protecting yourself and workplace environment
• PPE
• Coronavirus (COVID-19): clinical guidance for the management of clients accessing care at home, housing support and supported housing – gov.scot (www.gov.scot)
• Delegation
• Mental health improvement, and prevention of self-harm and suicide | Turas | Learn (nhs.scot)
• https://wellbeinghub.scot/
• https://learn.sssc.uk.com/careers/
• https://caretocare.scot/
• https://www.myjobscotland.gov.uk/social-care
• https://hub.careinspectorate.com/resources/national-saferrecruitment-guidance/