Agenda item

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

The Chair invited Becky Wilkinson, Deputy Director of Adult Services to present the report.

The Deputy Director gave an overview of the background to the updated report on the implementation of the mandatory vaccination policy. The policy covers all CQC registered care homes and include anyone employed or in a voluntary position entering a care home. The policy will become law on 11 November 2021 and be monitored by the CQC, as the regulatory body. All registered managers within a care setting will then have a legal duty to prevent any scheduled admission to anyone who is not vaccinated.

The Deputy Director outline the work done to prepare for the policy and advised that 46 people in Adult Social Care were not vaccinated and in post requiring a double vaccination from 11 November 2021 based on recent data. The Deputy Director gave an update on vaccination rates for the following centres Bradley Resource Centre, Duke Street Bungalows, and the Ernest Bold where a small number of the employees have not yet been vaccinated but was confident that the shifts can be covered in the future. The Deputy Director reassured the panel that risk assessments at the establishments have been done to confirm that the required level of service needed can be provided and gave details of specific action planned.

The Deputy Director advised the panel that 401 employees have been identified as a requiring vaccination but have refused the offer will be contacted again to encourage them to do so.

The Deputy Director advised that the Council is awaiting detailed guidance from either the NHS or LGA on the managing the process and how it relates to the vaccination requirements for ancillary staff and contractors who will also need to go into care homes, for example, for maintenance workers. The issue is being discussed with colleagues and a list of people who may be affected is being prepared. The Deputy Director advised the panel that contractors and Heads of Service have been made aware that all employees and ancillary workers that work with Adult Social Care must be fully vaccinated by 11 November 2021 and that no unvaccinated employees will be deployed in care homes after this date.

The Deputy Director advised the panel that in terms of commissioned care homes there are estimated to be over 130 staff not yet vaccinated, which equates to 95 per cent of all staff who have been vaccinated. The Deputy Director added that those people unvaccinated would not be able to meet the deadline of being double vaccinated by 11 November 2021 and work is being done on risk assessments about how the situation will be managed and how they can be redeployed to other service areas.

The Deputy Director advised the panel of the work being done with commissioned care homes which are at greatest risk, 18 out of 71 care homes providers have expressed concerns about future staffing levels due to employee recruitment and retention issues because of the mandatory vaccination policy.

The Deputy Director detailed the support being offered to care home providers to manage the financial and other risks in this situation and reassured the panel that there is regular contact with them to monitor developments and offer support to manage and reduce the risk.

The Deputy Director gave details of commissioned care employees vaccination rates and currently of 2293 eligible staff, 2092 have had first dose and 1951 have been double doses. In terms of residents there are 1534 eligible for vaccination, 1506 have had their first vaccination and 1454 have had both doses.

The Deputy Director advised the panel of the work done to consult with unvaccinated employees jointly with colleagues in HR to consider different options, each case will be reviewed on an individual basis and the Council is not seeking to dismiss people. This option would be a last resort after the offer of redeployment is considered and other support is developed. The Deputy Director added that efforts are being made to understand the reasons why some care workers do not want to be vaccinated and accepting that people have been given a right to choose.

The Deputy Director advised the panel that in terms new starters job adverts have been reviewed to check that they comply with legal and HR advice about the need to be double vaccinated. As part of pre-employment enquiries, a check will be made about a new starters vaccination status before they start work. The Deputy Director commented on how the recording and storage of vaccination status data would be maintained and that the system has been developed to also record data on booster vaccination and the flu vaccination if required in the future.

The Deputy Director advised the panel of the work being done in liaison with Yoo Recruit to make sure the same communication messages that have gone to care workers has also gone to agency workers to make clear the vaccination requirements. In addition, care home providers have been advised by Public Health that current testing arrangements, even when vaccination rates are at 100% vaccination, will still be required.

The Deputy Director commented that the introduction of the mandatory vaccination is happening at a time when the social care sector is in a fragile financial position nationally and the service is experiencing an increase in home care demand, which is not currently subject to the mandatory vaccination policy.

The Deputy Director advised the panel that the national consultation on extending mandatory vaccination policy to other groups ends on 22 November 2021, and there could further implications for the social care sector as a result. There is evidence of significant numbers of beds been available in residential care sector as people are choosing homecare, if they can, as alternative to residential care, which presents several challenges to the sector.

The Deputy Director outlined the work being done to adopt a standardised approach towards implementing the national Government guidance with neighbouring authorities across the West Midlands region.

Across the region 3764 employees are unvaccinated and there has been a surge in the rate of vaccinations in recent weeks. The target of 100 per cent vaccination rate for Wolverhampton will not be achieved by 11 November 2021 deadline.

The Deputy Director commented on other challenges facing the social care sector, for example, the employee turnover rate of 27 percent, which means that there are 687 vacancies in Wolverhampton. The policy of mandatory vaccinations for social care staff working in care homes is, despite the recruitment and recruitment challenges, considered to be the correct approach and efforts will continue to support employees to get vaccinated.

The panel were invited to comment on the report.

The panel thanked the Deputy Director for the presentation. The panel discussed the challenges facing the social care sector despite the extra planned national funding and suggested the issue should be investigated the issue as a matter of urgency to better understand the issues. The review should specifically cover the issue of the recruitment and retention of social care workers.

The panel were advised by the Chair that a future briefing meeting of the panel planned for 6 December 2021 could also consider the issue. The panel agreed that this should be a formal meeting of the panel rather than a briefing to consider the matter further. The Deputy Director supported the proposal.

The panel discussed the idea of a scrutiny review of the topic and suggested that this option should also be considered.

The panel queried the process for recording when an employee has had a booster vaccination. The Deputy Director advised the panel that the mandatory vaccine policy has not been extended to include booster vaccinations, but work is ongoing with CCG to prepare for this to be done if this agreed.

The panel queried where information about which care, or residential homes have achieved 100 per cent vaccination status for their employees would be available and how it would be promoted to the public. The Deputy Director advised the panel that the CQC as the regulator would be publishing details about the vaccination status of individual care homes. The CQC will have power to act where this target has not been reached, but the approach will firstly be to understand the risk assessments of the care home and their ability to provide safe levels of care. The Deputy Director agreed to check when the information will be published and available to the public.

The panel expressed concern about the future use by the Council of care homes where 100 per cent of care staff have not been vaccinated or there are staff shortages, given its responsibilities to protect the welfare of residents. The panel also queried the contingency plans for managing this situation. The Deputy Director advised the panel that the Council have a duty of care to residents as detailed in Care Act and a legal duty and cannot act outside the law. The Deputy Director added that the Council’s intention would be safely place people in care homes with vaccinated employees and providers have been asked to review their business continuity plans and confirm that they can provide 100 per cent vaccinated teams from the 11 November 2021 to comply with the law.

The panel discussed the issues in persuading people who have refused the offer of vaccination and the risk of dismissal can be avoided by accepting redeployment as alternative.

The panel expressed concern about people choosing home care as an alternative to residential care and being supported by people who may not be double vaccinated and suggested there was a need for standardisation. The panel supported the view that people providing care to someone who is frail or vulnerable people should be double vaccinated to reduce the level of risk to them and the wider community.

The Deputy Director supported this view and commented that across the West Midlands it has been calculated that 30 per cent of homecare workers have not yet been vaccinated. The panel were advised that the current consultation on changes to the requirement for mandatory vaccinations could be extended to include this group and other frontline social care and health workers.

The panel queried the Council’s contingency plans for those care homes who do not meet the requirement to have 100 per cent of workers double vaccinated by 11 November 2021.

The Deputy Director advised the panel of preparation being work with colleagues in HR in advance of the deadline and added that the focus was on offering support to people who have decided not to get vaccinated, while recognising that there are people in specific circumstance, for example, workers who are pregnant and concerned about the implications for them.

The Deputy Director reminded the panel of the next steps detailed in the presentation and the timeline for key dates. A report will be presented to Strategic Executive Board next week with details of final numbers of workers who are unvaccinated and a proposed plan with options for the future to comply with the law. The Deputy Director reiterated the previous commitment to work with every employee affected and to explore all possible options, while acknowledging that the opportunities to re employ employees elsewhere will be limited and there is acceptance that some may leave at the end of the process.

The panel expressed concern about the policy of care homes asking relatives to take a resident to a hospital appointment during a lockdown in response to a case of Covid 19. The Deputy Director agreed to investigate further the practice and policy of transferring residents from a care home in lockdown and discuss the case with colleagues in infection control and advise the panel.

The panel thanked the presenter for the report.

Resolved:

1.     The Deputy Director to share a copy of the national guidance on implementation of the mandatory vaccination policy for ancillary staff and contractors with the panel.

2.     The Deputy Director provide details when CQC will be publishing data on the vaccination status of residential and care homes.

3.     The Deputy Director to advise on the policy of care residents from a home in lockdown due to Covid 19 attending hospital appointments with a relative.

4.     The Deputy Director to provide an update on the number of unvaccinated people in post after the deadline of 11 November 2021.

5.      The panel agreed that the proposed briefing meeting proposed for w/c 6.12.21 should be changed to the formal scheduled meeting to consider the challenges facing providers of care and residential care accommodation.