Covid-19: Social Care

Helen Whately Excerpts

Thursday 22nd April 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

I will do so. It is a pleasure to serve under your chairmanship, Mr Twigg. I wish the shadow Minister’s mother a happy birthday today.

I thank the hon. Member for Dulwich and West Norwood (Helen Hayes) and my right hon. Friend the Member for Ashford (Damian Green) for securing this debate on social care and covid and for the work they do as co-chairs of the APPG on adult social care, bringing the sector together and being a voice for it in Parliament and beyond.

As the hon. Lady and my right hon. Friend said—as, in fact, all speakers today have said, and as we all know —the pandemic has been cruel to those who receive social care, especially those living in care homes around the world, here in the UK, and indeed in England. Sadly, both residents and care staff have lost their lives, and each one will be missed by friends, family, and those who love them. I thank those working in social care—staff in care homes, home care workers, those supporting people in extra care and supported living, personal assistants, social workers, and millions of unpaid carers as well—for all they have done during the pandemic, and are continuing to do now, to care for those who rely on their care and could not live without it.

Members have spoken about the many challenges the sector has faced during the pandemic. I want to outline some of the things that the Government have done to support social care, with a level of intervention—a level of support—that is unprecedented for social care, and rightly so in the circumstances of the pandemic. First, the hon. Member for Dulwich and West Norwood spoke about the extra costs that social care has faced during the pandemic. We have put in £1.8 billion of specific, ring-fenced covid funding for social care during the pandemic, including £1.3 billion for infection control measures, and providers have told me what a huge difference this support has made to them and how essential it has been all the way through the pandemic.

Secondly, the Government have stepped in to provide PPE to the social care sector, and PPE has been available free for many months via a portal to meet the covid needs of social care providers on demand. Over 2 billion items of PPE have been supplied to the social care sector, and the Government have committed to continue PPE supply through to March 2022.

Thirdly, social care has been prioritised as our testing volumes have increased. Last summer, we introduced weekly polymerase chain reaction testing for care home staff, and since December, that has been supplemented by twice-weekly lateral flow device tests. That has made a difference, because we can not only quickly identify when a staff member may be covid positive but, through the introduction of the LFD tests, we are able to identify whether a member of staff is covid positive before they set foot in the care home. During this time, we have sent out over 28 million PCR tests and 47 million LFD tests to the social care sector across care homes, home care, supported living, and other parts of the sector. We have also made rapid tests available to visitors, supported by £288 million of funding for the staff costs involved in that testing, to help people see loved ones. I will say more about visiting in a moment.

Fourthly, many hon. Members have spoken about the impact of the pandemic on the social care workforce. Again, we cannot thank care workers enough for what they have done, and how they have gone the extra mile time and again. Through the virtual visits I have made to care homes and the conversations I have had, I have seen what staff have done, particularly to step in and support residents at a time when visiting has been restricted.

I also know the difficult experiences that some care workers have been through. We have specifically advised care providers to use some of the funding for paid sick leave for social care staff who have had to isolate due to covid. We have also put in place mental health support for the social care workforce, seeking as far as we can to mirror the mental health support offer to NHS staff, and we will continue to see how we can support staff through the mental health impacts of the pandemic.

As hon. Members have said, we know that there are workforce shortages within social care, and at times covid has made that harder, with staff rightly taking time to isolate. Recognising that, we provided £120 million of funding for the workforce capacity fund, which was passed to local authorities to boost staffing for the sector during the second wave.

To increase the voice of the social care sector and to give further leadership—particularly clinical leadership—to the social care workforce, we appointed the fantastic Deborah Sturdy as the chief nurse for social care. She is already doing brilliant work with the sector and the workforce, and contributing to plans for the workforce of the future.

To increase our understanding of the social care situation on the ground, we created a social care data dashboard as a single point of information for the system. We came into the pandemic with relatively small amounts of timely data about social care; as hon. Members know, it is a highly fragmented system, with over 25,000 different providers. We have built a way of having up-to-date information and self-reported data from providers, which has given us truly valuable information to which local authorities also have access. It gives a good sense of what has been happening on the ground.

We have also established a regional assurance team for social care, as this is now the Department of Health and Social Care. They are a group of people with great experience in the sector who have been able to reach out during the pandemic, working with local authorities, directors of public health, providers and others, to understand some of the challenges being faced and provide more localised support.

On visiting, on many occasions we have developed an iterated visiting guidance, responding to requests from the sector for a steer on how to manage the challenge of wanting people in care homes to be visited while acknowledging the risks to residents of more people coming through the door. We have drawn a huge amount of clinical guidance from the deputy chief medical officer of Public Health England on how we can enable safe visiting. Clearly, we have substantial caution because we know the great risks to care home residents when covid gets in and how difficult it is to stop an outbreak from spreading through a care home, even with the PPE, the testing and the other things I have outlined. One reason why we introduced visitor testing was to reduce that risk.

Since 12 April, care homes have been able to open up to two visitors, and the essential care giver scheme addresses particular need. I look forward to care homes being able to continue to open up, step by step, through the combination of lower infection rates and vaccination, to enable people to once again spend much more time with their loved ones.

Several hon. Members spoke about visits out. I recognise the importance of both having visitors at care homes and being able to leave—to go out and about. This applies to older people, but particularly to families who have relatives of working age in residential settings, who I have spoken to. Often, somebody of working age might come out every weekend to spend time with their mum and dad, and their family. Clearly, they have not been able to do that during the pandemic.

I ask other hon. Members with an interest in this subject to listen to the Joint Committee on Human Rights sitting held yesterday, when I was asked about this. With me was Dr Éamonn O’Moore from Public Health England, who explained in some detail, which we do not have time for today, the reason for the caution around visiting out and the clinical reasons for the requirement to isolate for 14 days on return. To respond to the hon. Member for Worsley and Eccles South, I should say that that is not the same as somebody coming from overseas to the UK and quarantining, because of the particular circumstances within care homes. There may be people who are very vulnerable. In the event that someone brings covid into the care home, that can lead to an outbreak, which can lead, sadly, to people dying. Therefore, rightly, the issue is taken seriously.

I assure colleagues that, as Dr O’Moore said to the Health and Social Care Committee yesterday, I have asked Public Health England to provide advice on how to make more visits possible—particularly those with lower risk, such as those outdoors—and on what could be done to reduce quarantine requirements afterwards. I am mindful of the May elections and of those who might want to vote in person.

My right hon. Friend the Member for Ashford rightly said that vaccines are the answer to allowing more visiting and for much of life to come back to normal, for those who receive social care. We prioritised the social care sector for vaccinations—and particularly care homes, who were top of the list. The vaccine was offered to all care homes by the end of January, on time. Soon, all residents who can be vaccinated will have been offered their second dose.

The impact of vaccination is already being seen, with the rates of covid coming right down in care homes. There are still some outbreaks and I would caution those listening to the debate that the vaccine is not 100% effective. Many residents have had their second dose but others are still only on their first, and it is important in that situation that the precautions continue. For instance, we are continuing to urge care homes to make sure that staff use PPE and infection control measures, even when everyone has been vaccinated. However, there are far fewer outbreaks and the consequences are much less serious. I want to use this opportunity to thank the NHS vaccination teams, and the social care workforce, who have been involved in the tremendous and lifesaving effort to vaccinate so many thousands of people in social care.

Many hon. Members spoke about the importance of reform, and how the pandemic has shone a light on the social care sector and the need for reform. I truly welcome the support for reform among hon. Members who have taken part in the debate in this room and virtually. Some steps have begun, and I urge the hon. Member for Dulwich and West Norwood to look again at some of the social care content in the health and social care White Paper, including the voice of social care in integrated care systems—and I agree with the point made by my right hon. Friend the Member for Ashford that it is not just about a local authority voice, but the wider sector.

The White Paper also proposes the introduction of a new oversight and assurance system for social care, which I see as an important part of building on the experiences of the pandemic, to give us more oversight and the ability to drive quality and outcomes more strongly for those who receive social care. It also includes steps to support better use of data and data sharing for social care.

Those things are, however, just the beginning and we need to go further. We have committed to go further and to publishing a long-term plan for social care this year.

[Barbara Keeley]

As the Minister is talking about the White Paper, I wanted to point out that we have talked quite a lot about unpaid carers in the debate, but they are not mentioned once in the White Paper. Carers’ organisations took that in a bad way and felt that all the efforts that unpaid carers put in during the pandemic were not recognised at all. The Minister and the Health Secretary need to address that.

[Helen Whately]

The hon. Member makes a really important point, and I really appreciate how she has spoken about unpaid carers during this debate. I absolutely recognise the crucial role of unpaid carers, the things that unpaid carers do and the demands on and challenges for unpaid carers during the pandemic. I absolutely see unpaid carers as part of the breadth of the social care system that we must consider for the reforms as we go forward.

I very much welcomed the expertise, in the room and virtually, on social care reform. My right hon. Friend the Member for Ashford reminded us that the reform debate has been going on for nearly 25 years. He has extremely valuable experience. My hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) has great experience from local government and flagged the work of Sir Paul Carter, whom I know because he is the former leader of Kent County Council and I am a Kent MP. I will indeed be looking at the work that my hon. Friend mentioned. My hon. Friend the Member for Somerton and Frome (David Warburton) called for a social care workforce strategy. Yes, absolutely, as part of the reform work, we need and plan to bring forward a strategy for the social care workforce.

I am conscious of the time and so that is probably as far as I can go today, but broadly, I truly welcome the support for social care reform expressed during this debate. I assure those in the room and all those listening to the debate that we are determined to seize this moment. We have supported social care at an unprecedented level during the pandemic; on the back of that, we are determined to bring forward the reform that we know social care needs.