Agenda item

12:00

a.    Admission to Care Homes during the Covid Pandemic

This paper (JHO8a) presents information about the discharge of people from acute hospital to care homes in Oxfordshire during the early days of the COVID-19 pandemic, and a response to that information by the County Council’s Director of Public Health and Director of Adult Social Care.

The Committee is RECOMMENDED to NOTE the information provided in the paper (Annex A) and response (Annex B).

b.    Covid-19 infection prevention and control in care homes

Councillor Dr Paul Barrow was asked by the previous chair of HOSC to produce a report (JHO8b) on infection control in care homes as a result of his long experience in infection control in a zoonotic context.

Recommendations:

1.    OCC, through its adult’s service, should hold regular discussions with OACP, OCHA on how locally we can maximise the advice from online sources beginning with the Bushproof and Department of Health documents.

2.    Oxfordshire County Council (OCC) carries out a regular review of current infection control procedures in care homes and the support provided.

3.    OCC should ensure that its winter plan contains the recommended training and infection control support as identified by recommendation 1 and 2.

LUNCH

12:45

It was agreed to take Item 8 Member Reports before Item 7 Community Services Strategy.

Covid-19 infection prevention and control in care homes

The Committee considered a report from District Councillor Paul Barrow which made three recommendations for future actions by the County Council.

Stephen Chandler, Corporate Director for Adults and Housing Services, thanked Councillor Barrow for his work on the report and accepted the recommendations.

Councillor Barrow asked that the Committee receive feedback from the care homes at the next meeting.  Stephen Chandler responded that a Care Home Cell had been formed at the onset of the pandemic and this included representatives from the care homes sector.  He would be happy to provide an update at the next meeting.

RESOLVED that:

a)            Oxfordshire County Council (OCC), through its adult services, should hold regular discussions with OACP, OCHA on how locally we can maximise the advice from online sources beginning with the Bushproof and Department of Health documents.

b)           OCC carries out a regular review of current infection control procedures in care homes and the support provided.

c)            OCC should ensure that its winter plan contains the recommended training and infection control support as identified by recommendation 1 and 2.

Admission to Care Homes During the Covid Pandemic - the First Thirty Days and Beyond

The Committee considered the report about the discharge of people from acute hospital to care homes in Oxfordshire during the early days of the COVID-19 pandemic, and a response to that information by the County Council’s Director of Public Health and Director of Adult and Housing Services.

Dr Alan Cohen noted that the report had been largely finished in January.  There were four recommendations which had been partly implemented in the meantime.

Barbara Shaw asked if it was possible to get information again on Delayed Transfers of Care (DTOC) even if there is not yet a standard national way of measuring.  One positive from the pandemic was that the numbers were greatly reduced.  However, when the John Radcliffe Hospital went to Opel 4 level of pressure, DTOCs were given as a reason.

Barbara Shaw also asked what was being done to standardise the level of infection control across the various care home organisations.

Stephen Chandler thanked both Committee Members for their work on the report.  A response was included in the agenda pack as Annex B.  There was now a call every day between OCC, Oxfordshire Clinical Commissioning Group, Oxford University Hospitals (OUH) and Oxford Health to discuss the patients ready for discharge.  Around one third of those could be from outside the county due to the specialist nature of many services at OUH.  He was happy to meet with the two Members to discuss what data they would like to receive.  It was agreed that the Chair would join that meeting and that it can include looking at reablement and any impact of the change of contract.

The Chair asked what changes in social care could help with the patient flow.  Stephen Chandler responded that there were 1200 people awaiting a social care assessment.  There was a need nationally to secure long term funding for services and part of that was providing appropriate recognition of the social care workforce including in terms of pay.  The Chair added that the Committee was fully supportive of that.

Dr Cohen thanked Stephen Chandler and Ansaf Azhar, Corporate Director for Public Health, for their input on the report.  He welcomed the fact that recommendation 3 had already been implemented and the officers’ support for a review of the system’s response to the pandemic.  He asked what form the review would take.

Officers responded that, while the government had announced that there would be a review, there was little information on what form that would take.  It was difficult to know what would be the right time for one.

The Chair made a recommendation that a report on learning from the pandemic be brought to this Committee in the first instance.  The Committee will identify the information needed from the various partners at an informal virtual meeting.  This was agreed.

RESOLVED:

1)            That Senior Officers provide further information on the reporting of people who have experienced a delayed discharge from acute hospitals, and how some of the successes in reducing that number can be maintained into the future.

2)            That Senior Officers provide further information as to the consequences of implementing national guidance associated with the discharge of patients to care homes in the early stages of the pandemic.

3)            That Senior Officers provide further information on the emerging pattern of community and home-based care, and how this can be linked to current developments in the County.

4)            That Senior Officers are able to re-affirm a commitment to a review of the response of the system partners to the pandemic, in so far as this would provide a plan of what would be included and a reasonable time scale, given the unpredictability of the current situation.

Actions:

·         Stephen Chandler agreed to provide an update on engagement with Care Homes at the next meeting

·         Stephen Chandler agreed to meet with Barbara Shaw, Alan Cohen and the Chair to discuss discharges to care in response to detail asked for and to discuss what other data the Committee might want to see in future.

·         Ansaf Azhar to report to the next meeting on a local learning exercise with health partners and Committee members with the Committee’s virtual meeting to decide what information is needed.