Covid, compulsory vaccination for care home staff, Brexit and unaffordable homes have been blamed for the adult social care crisis gripping Cornwall.
One of the largest care home companies in the Duchy believes that while adult social care in Cornwall has been under immense pressure throughout the pandemic the crisis that is being felt at present is the result of years of compounding issues affecting the sector nationally.
Leah Marsh, the managing director of Swallowcourt, which manages six care homes in Cornwall, believes staffing pressures are the main cause of concern for her industry, an issue which will not be resolved soon without a holistic approach that would tackle low wages and high housing prices.
Read more: Cornwall Council declares social care critical incident but didn't tell its own councillors
She said: Fundamentally, staffing pressures as a result of mandatory Covid vaccinations, the impact of Brexit on reducing European workers and a lack of affordable housing to attract new staff to the area present a very real and very serious problem.
Mrs Marsh said that all adult social care providers like Swallowcourt and others have their hands tied by Governments regulations and ever-changing rules in term of what they can do in responding to the Covid pandemic.
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The current guidance for infection prevention is designed to cope with 'outbreaks'," said Mrs Marsh. "Those as clearly defined within a setting where infection has been passed from one person to another and 'clusters' where there are more than two cases, but where these are not related to each other.
However, neither of these scenarios account for widespread community transmission impacting on a service. The guidance to close any home for 14 days following more than two cases has resulted in the majority of care services being closed to admissions and this is set to stay in place as the closure period extends with each new case identified.
This has the knock-on effect of being unable to support hospital discharges.
The call for holistic approach to health and social care is not new and even Kate Shields, the former chief executive officer of the Royal Cornwall Hospitals Trust, who is now the accountable officer for NHS Kernow Clinical Commissioning Group (KCCG) and the chief executive designate for NHS Cornwall and the Isles of Scilly Integrated Care Board, announced last week that it was better to focus on having a better integrated health and social care system so people who do not need to be in hospital can be cared for at home for as long as possible or in community hospitals, rather than take up ward and theatre beds at Treliske, Truro.
The NHS boss said there was no need for a second hospital to be built in Cornwall because of the current crisis impacting both the health service and social care providers.
Cornwall Council has now announced that it is joining the NHS in declaring a critical incident in adult social care as a means to help alleviate pressure on the countys hospitals, reduce ambulance waiting times and allow more patients who no longer require hospital care to be discharged back into the community. You can read about how councillors complained that they were not told about it until they saw a press release here.
The council said it will work with its 70 commissioned homecare providers and 222 care homes to provide support for around 180 people who have finished their hospital treatment, as well as helping support others in the community who are waiting for care packages.
The local authority announced it will also be drawing on its own workforce, potentially redeploying staff into different roles to support social care, as well as asking the voluntary sector to mobilise all its available resources to support efforts to free up 100 beds within two weeks.
Councillor Andy Virr, A&E consultant and Cornwall Council Cabinet member for care and wellbeing, said: These extraordinary circumstances require a different level of response in our care system, which is currently unable to meet demand - particularly for hospital discharges. This approach will see us work as one system, sharing risk in order to meet these increased demands, and Id like to say a big thank you to those families and service users who are helping support us in this.
Mrs Marsh said Swallowcourt, which is a Foundation Living Wage employer, will be part of that team effort and would continue to work collaboratively with the wider system to ensure the minimisation of risk that community transmission has on our homes and its impact for us to safely and effectively support timely hospital discharges.
She added: Decisions need to be made by central Government in respect of providers receiving a fair cost of care via local authorities and health trusts, ensuring the social care system promotes fairness for the individual, the taxpayer, the local authority, the NHS and the provider.
"While of course this needs to be a long term commitment, the pressures being faced are immediate and decisive action needs to be taken now and not in three years time when the Health and Social Care Tax Levy filters down.
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