Agenda item

To receive a presentation from Liz Noakes, Director for Public Health, Telford and Wrekin Council and Helen Onions, Consultant in Public Health, Telford and Wrekin Council on COVID-19.

To receive a report from Amadeep Grewal, Service Delivery Manager: Community Social Work and Adult Social Care, Telford & Wrekin Council on easements relating to the Care Act 2014 duties.  

The Board received a presentation on COVID-19 in Telford and Wrekin by the Director for Public Health. The presentation covered the latest infection, testing and hospital admission rates, the opening of new testing facilities, communication and engagement and the Health Protection Hub. The Board heard that for the week ending the 29th November 2020, there were 308 cases of COVID-19 detected, giving the population an infection rate of 171 per 100,000. This was a 30% reduction compared to the previous week and that the rate of infection had halved since the peak of the second wave on November 11th 2020.

The Board were informed that testing rates were currently higher than the West Midlands average, which was made possible through the new walk-through testing centres that had opened in October and November, targeted communication to areas with low testing and the introduction of PCR and rapid testing to Domiciliary Care works and teachers. The next section focused on communications and engagement such as “Get Tested” for main and precautionary symptoms and the “For the Love of Christmas” campaign along with the promotion of Tier 2 restrictions. Finally, the Board heard an update on the Health Protection Hub, and their work in supporting a range of settings which included schools, workplaces and care providers to manage outbreaks.

Members asked if hospitals in the borough were accepting patients with COVID-19 and whether this also applied to overflow patients from outside the area. The Director of Public Health confirmed that Hospitals in Telford and Wrekin were accepting COVID-19 patients. David Evans, Account Officer for Shropshire, Telford and Wrekin Clinical Commissioning Groups explained that at the start of the second wave, there were out-of-area patients in the intensive treatment centres at Shrewsbury and Telford Hospital NHS Trust (SaTH) sites as there was capacity, which formed part of a mutual aid agreement with neighbouring systems. However, this had concluded some weeks ago and at present, were no out-of-area COVID-19 patients in SaTH.

Members were concerned that the most vulnerable individuals in care homes would not be able to access the Pfizer-BioNtech vaccine given the low temperatures needed to store it. The Accountable Officer for Shropshire, Telford and Wrekin Clinical Commissioning Groups said it appeared there were a number of other vaccines that would be licensed for use along with the Pfizer-BioNtech vaccine, which would be logistically easier to distribute to vulnerable individuals.

Members asked the Director for Public Health if there were concerns surrounding the temporary lifting of restrictions over Christmas and whether these were fluid and likely to change. The Director for Public Health responded by saying she thought the guidance wouldn’t change and that everyone should be careful and sensible in their approach to the Christmas period (such as those exhibiting any COVID-19 symptoms not partaking in household mixing) and that everyone should still follow national guidance on “Hands, Space and Face” and keeping rooms as ventilated as possible.

Members asked what percentage of testing was being utilised for pre-cautionary testing and if there was enough testing capacity in the borough as a whole. The Director for Public Health did not have the exact percentage and confirmed there was enough capacity within the testing centres to safely do this. The Director for Public Health also informed the Board that in the first few days of the launch, just over one third of positive cases had come from pre-cautionary testing.

Members referenced hospital discharge policy on how patients need to self-isolate for 14 days regardless of if they have tested positive for COVID-19 and asked whether this would be reviewed. The Accountable Officer for Shropshire, Telford and Wrekin Clinical Commissioning Groups responded by saying hospital discharge policy was nationally determined, and not as a result of local decision making. The guidance was introduced to protect the population against COVID-19, as there was no guarantee a patient discharged from hospital did not have COVID-19.

Members asked if any consideration had been given to individuals living in homeless supported living schemes and other homeless provisions across the borough in terms of testing. The Director for Public Health responded by saying nationally the first round of provision for individuals in supported living and extra care accommodation had been rolled out but recognised the question referred to a wider group. The Director for Public Health offered to meet with members outside of the meeting to work on this provision.

Care Act Easements

Along with the COVID-19 update, the Board also received a presentation an update on the four Care Act easements, which were created under the Coronavirus Act 2020 and how they were applied in Telford and Wrekin by Amardeep Grewal, Principle Social Worker, Telford & Wrekin Council. The Board heard how council was assessed at stage two in regards to the use of the easements, meaning that there had not been a significant change to the care and support provided by the council, but there were some variation in the way it is was delivered.

The first easement meant that detailed assessments of individual care and support could be suspended, and instead local authorities only needed to respond in a timely manner to identify what the care and support needs were. The Board heard how council have not had to do this, instead have undertaken detailed assessments using the telephone or remote conferencing software. Likewise, essential visits were suspended during restrictions, but as these were lifted, essential visits returned with staff being provided with the appropriate personal protective equipment and undertook pre-visit questionnaires.

The second easement permitted for the suspension of financial assessments which were in compliance with the pre-amendment Care Act and for care and support provided to be charged retrospectively, subject to reasonable information provided in advance and followed by a financial assessment at a later date. The Board were informed that financial assessments continued as business as usual and the decision was made to suspend client contribution for three months for care and support delivered in this time.

The third easement allowed local authorities to not prepare or review care and support plans in line with the pre-amendment Care Act provisions. However, Telford & Wrekin Council continued to deliver the scheduled reviews and these were completed remotely where possible.

The final easement for local authorities related to the duty to meet eligible care and support needs, which was replaced with the power to meet needs, or prioritise the most pressing needs. However Telford & Wrekin Council did not need to implement this easement as they had not experienced significant impact on frontline staff or a surge in the demand in the care market.

Members asked for clarification on which services provided by Telford & Wrekin Council were cancelled. The Principal Social Worker responded by saying the services mostly impacted were the day centres due to the social distancing measures. Those impacted by these closures were identified and alternative support was established, such as the launch of MyOptions online weekly activity for individuals with learning difficulties, and smaller social bubbles for individuals with staff to access the community.

Members asked for clarification on what DFG applications were and how they were used. The Principal Social Worker said that these were Disability Funded Grants, which were a means-tested grant to provide monetary value towards changes required in an individual’s house, which related to their disability.  This grant was administered by the housing team in conjunction with assessments made by the occupational health team the council.