Agenda item

[Becky Wilkinson, Deputy Director Adult Services, to present report]

Emma Bennett, Director of Children’s and Adult Services, introduced the report to the panel on behalf of Becky Wilkinson, Deputy Director Adult Services, who had submitted apologies for the meeting.

The Director outlined the progress from earlier consultation on Government proposals to make it mandatory for care home staff, volunteers, ancillary and visiting professionals to receive the COVID vaccination. The consultation was done between April and May 2021 and included staff, residents, providers and families.

The Director advised the panel that following the consultation the Government announced that the proposal would be implemented. The proposal was approved in Parliament last week and will be considered by the House of Lords. If the proposal is approved, it will be implemented in October 2021.

The Director advised that any worker entering a care home will need to have received double vaccination and the Government are also considering extending the mandatory vaccines rule to include the flu vaccination.

The Director updated the panel on the current vaccine situation in Wolverhampton care homes.

 The Director advised that the number of care home staff who have refused to be vaccinated has reduced from 500 to 310 since the report was published.

The number of care home residents who have been vaccinated has increased to about 94 percent. It is estimated that 85 percent of care home staff have now been double vaccinated. The Director advised the panel that it is unlikely that the percentage of residents vaccinated will increase any further, this may be due to a small cohort of residents either refusing or who have a medical exemption.

The service is working with those care homes where they have less than 100% staff vaccination rate.

The Director briefed the panel on the most common reasons given for ‘outright refusals’ when asked, for example concerns about the impact of the vaccine on fertility. There is work being done to better understand the concerns of people in the group who are not medically exempt, and focus efforts on persuading them about the safety of the vaccine.

The Director briefed the panel on the potential impact on the Council and the care market of the proposed changes. The Director highlighted the risk that the change will reduce the supply of care workers at the time when the sector is recovering from the impact of the pandemic and shortage of workers in retail and hospitality services. This development has led to care workers moving away from the sector as lockdown measures ease attracted by higher wages. The Director also highlighted the increased costs for the sector as fewer people are working in the sector, which has led to an increase in the hourly rate and agency costs.

These changes will increase costs for the Council and the fees paid by residents if there are fewer permanent staff in the market and the greater use of agency staff.

The Director briefed the panel about the work being done across the Council and with the care home sector on vaccination plans for other professional groups that will be visiting care homes, such as therapists who will also need to double vaccinated to work in these settings.

The Director commented on the possible lengthy HR and legal processes that will have to be followed for managing care home staff who refuse to be vaccinated. The Director briefed the panel on the range of work being done to prepare for the changes.

A project team has been created and has representation from colleagues in public health, adult services, HR and legal services. The Director advised the panel that some dedicated support has been given to care home providers where there is a low vaccine uptake. This work has been supported by the offer of site visits to care homes from quality and safety nurse who will be available to speak care staff about their concerns. 

The Director advised the panel that the care home providers have been asked to review their continuity and contingency arrangements in preparation for the change and to include having a risk assessment plan for unvaccinated care staff.

The panel discussed the timeline for the new arrangements and when care staff would need to have had their first vaccination asap in order to have their second jab in time to meet the October deadline. The Director advised the panel that the Council is working closely with the trade union representatives to discuss the implications of the change and to encourage affected staff to get vaccinated.

The Chair thanked the presenter for the report and invited panel members for comments and questions.

The panel queried the process for identifying those care staff who have and who not yet been vaccinated and hat proof, if any, would they need to provide to confirm this.

The Director advised the panel that the checking the vaccine status of a care worker would be based on partly on conversations and information collected via the Governments national capacity tracker. The information includes details about vaccination rates, which can be used to have further conversations with the care home providers if there are concerns about care staff vaccination rates.

The panel queried if vaccinated care staff working alongside unvaccinated care staff was creating any issue. The Director responded that she was not aware of any issues and the expectation is that this would hopefully be picked up through HR processes the closer to the date when new changes are made.

The panel discussed the issue of respecting the choices of care staff who do want to be vaccinated and the need to protect care home residents from risk.

The panel queried the testing arrangements for care home staff. The Director reassured the panel that testing for Covid 19 is done regularly – care home staff undertake daily lateral flow tests and a weekly PCR test. At present an estimated 15 per cent of care staff are unvaccinated who are either refusing the vaccine or who have a medical exemption.

The panel proposed that the current figure of 310 people who are refusing a vaccine as a benchmark against which progress can be assessed and the also how well current efforts to persuade staff are working. The panel requested a rolling monthly update on the numbers.

The Director advised that the panel that there was a plan to provide an update to the panel at the end of August 2021 on progress.

The panel queried the vaccine update figures, and specifically the 69 per cent of home care staff who have vaccinated and if this also included care staff from other commissioned care providers. The Director confirmed that this figure includes both groups of care workers.

The panel expressed concern about the lack of information about the planned changes for people receiving home care and queried if the communication plan also covered people in this situation and not just home care providers.

The Director responded that mandatory Covid 19 vaccinations for the wider care sector will be part of future Government plans. The plan will include a consultation on mandatory flu vaccine for care sector workers. The service will continue to encourage all care staff working with vulnerable people to get vaccinated.

The panel queried current data on how many elderly people in need of care and the number of care homes that would be needed in the future to meet expected demand. The panel also queried how this figure compares to the number of people who are cared for at home.

The Director responded that over the last over the last 18 months there has the been a reduction in the number of people moving into residential care settings.  The care home sector has experienced   a high proportion of deaths among the elderly population as a result of Covid – 19. The specific figures were not currently available. The Director agreed to investigate the impact matter further and report the findings to a future meeting.

The panel expressed concerns about local reports of increasing numbers of people being taken out of residential care homes to receive care at home and the likely impact on the need for more health and social care sector workers to support them.

The panel discussed the risks to residents contracting Covid 19 when care workers are moving between different homes to support people in the community. The panel commented on the importance of care workers being vaccinated to protect vulnerable people in such circumstances and wanted reassurance the lessons from the past had been learnt.

The panel acknowledged the important and valuable work of care home staff particularly during the pandemic. The panel expressed concern that with areas of employment such as hospitality experiencing severe job shortages that current care home staff may choose to move to in response to the requirement to be vaccinated, which may lead to future workforce challenges.

The Director accepted the risk of current staff leaving and explained that the approach taken by the service has been to work closely with the care home sector to support people who have concerns.

To support this work, a tender for an occupational health professional is being prepared which will offer an extra source of support to care home providers. The Director added that there are also discussions between the local university and health colleagues around giving people the skills needed and developing a succession plan.

The panel discussed the issue of low pay and working conditions of care home staff and the link to possible reasons for their reluctance to be vaccinated.

The Director acknowledged the concerns of the panel and offered reassurance that in view of this the service is seeking to persuade care home staff to choose to accept the offer to be vaccinated.

The panel thanked the Director for the presentation.

Resolved:

1.    The panel agreed to note the actions and progress made in the presentation to prepare for a planned introduction by Government for the mandatory vaccination of care home staff in October 2021.

2.    The panel agreed to receive an update from the Director of Children’s and Adult Services in September 2021 on the number of unvaccinated care home staff.

3.    The panel to be briefed on any progress updates on the preparation for the mandatory vaccination of care home staff to the panel meeting on 19.10.21.