A national strategy is urgently needed to stop homecare organisations collapsing and thousands of carers losing their jobs after risking themselves to support people through covid-19, Scottish Care has warned.

Chief executive of Scottish Care Dr Donald Macaskill says without action we “could end up in a situation where we have a decimated provision of homecare in the country”.

As we go through the pandemic, he says there could be “thousands of unemployed carers, ironically, even though during this period they have quite literally been putting their lives on the line to deliver services”.

Last week the Scottish Government promised protective kit would be delivered directly to over 1,000 care homes in Scotland.

Dr Macaskill is calling for an “equally significant commitment” for homecare providers who he says are facing spiralling costs that could put many of them our of business at a time when they are desperately needed.

Scottish Care, which represents hundreds of independent and third sector social care providers in Scotland, has had members contact them about situations where some of Scotland’s 31 health and social care partnerships have been providing PPE to in-house staff but not making it available for organisations delivering care on behalf of the partnership.

The manager of one homecare service told healthandcare.scot that a lack of PPE meant each time him staff went on a home visit – which could be over ten different households over the course of one shift – they risked spreading the virus to some of the city’s most vulnerable people.

Dr Macaskill says the introduction of direct delivery of PPE to care homes was already starting to make a “huge difference” but an equal focus on homecare was needed to help break the chain of infection, protect staff and those they look after, and stop many providers collapsing.

“We are equally concerned about the issue of PPE for homecare because last week’s statistics indicated unfortunately that 25% of the total death rate were people in care homes, but it also indicated that 13% were individuals in the community, of whom we would estimate that many, if not most of them, would be in receipt of homecare.

“We would also calculate a significant number of those who died in hospital would have also fallen into that category, so we would like to see an equally significant commitment for direct distribution of PPE to homecare organisations.

“There are various reasons for that – one of them is the financial risk of homecare in particular.

“These are organisations who were and are extremely financially fragile and vulnerable, and since coronavirus they have seen an absolutely exponential rise in the costs of PPE – from which they have had to pay most of themselves and they have very little resource or capital to fall back on.

“One provider in Aberdeen told me last week that they could get hold of PPE but they don’t have a spare quarter of a million pounds to buy in the bulk suppliers were stipulating in order for a sale to be secured.”

Local authorities often buy in homecare services from independent providers and Scottish Care has seen commissioning guidance from COSLA – the representative body for Scotland’s local authorities – that asks health and social care partnerships and local authorities to appreciate many homecare organisations have lost business – either because individuals are furloughed and so they can look after their older relatives or relatives who need care, or because people are worried about having a carer coming into the house so have taken on that care themselves meaning providers lose business.

“Given they were economically fragile in the first place,” Dr Macaskill continues, “there is a real danger of those organisations going to the wall without support from local authorities and health and social care partnerships.

“We wrote to the chief executive of COSLA on Friday urgently asking for homecare providers to be given priority in mobilisation plans at local level.

“We have seen good practice across the country, but we’ve also seen some really poor practice. One local authority has continued to require payment for contracts tied to electronic call monitoring.

“Even during the pandemic this local authority is expecting staff to clock in and out to be paid by the minute and not appreciating the staff are concerned about signs of covid-19, about reassuring individuals and being supportive of people who they might be the only point of contact for.

“This local authority is still insisting this is a requirement which is against guidance COSLA. We urgently need a national strategy to save homecare.”

 

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