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The Department of Health and Social Care (DHSC) has published a new adult social care plan for 2020-2021, which outlines the UK Government’s ambitions for the sector and the challenges facing adult social care this winter, with a particular focus on COVID-19.

Called ‘Adult social care: coronavirus (COVID-19) winter plan 2020 to 2021’, the guidance sets out the key actions for national bodies, local systems and adult social care providers in England to cope with the upcoming winter pressures.

The plan applies to all settings and contexts in which people receive adult social care, including people’s own homes, residential care homes and nursing homes.

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It also discusses the importance of collaboration across health and care services, preventing the spread of coronavirus as well as the significance of technology-enabled care (TEC) to keep people connected during the pandemic and beyond.

“Working together will ensure that high-quality, safe and timely care is provided to everyone who needs it, whilst protecting people who need care, their carers and the social care workforce from COVID-19,” the guidance states.

As winter approaches, the government’s three overarching priorities for adult social care are: ensuring everyone who needs care can get high-quality and timely care throughout winter; protecting those who need care and the social care workforce from COVID-19; and ensuring that people who need care remain connected to essential services and their loved ones.

The winter plan is complementary to the letter to the NHS on phase three of the COVID-19 response, with services starting back up as levels of COVID-19 have fallen in the community.

National support

In the winter plan, the government pledges that it will continue to provide national leadership and coordination as the sector moves into the next phase of the COVID-19 response. It says it will achieve this by providing essential resources, evidence and high-quality data to empower local leadership.

DHSC says that over the winter months, it will continue to engage with local authorities, care providers and people with care needs to understand their needs and provide appropriate support.

It adds that it will continue to provide financial support to the sector, by providing over £500 million of additional funding to extend the Infection Control Fund to March 2021.

Furthermore, the government promises to lead and coordinate the national response to COVID-19 and provide support to local areas, where necessary, as well as continue to produce relevant guidance for the social care sector.

The department also promises to ensure sufficient appropriate COVID-19 testing capacity and provide free personal protective equipment (PPE) for coronavirus needs in line with current guidance to care homes and domiciliary care providers through the PPE portal. The government also says it will continue to deliver and review the social care testing strategy, in line with the latest evidence and available testing capacity.

Importantly, the government says it is providing free flu vaccinations to all health and care staff, personal assistants and unpaid carers throughout autumn and winter.

Actions for local authorities and NHS organisations

Relevant for both self-funded care providers and local authority commissioned services, this part of the guidance notes that throughout winter, it will be essential that local authorities and NHS organisations continue to collaborate to support those with care needs, their families and carers.

DHSC says that local authorities and NHS organisations should continue to put coproduction at the heart of decision-making, adopting a more person-centred approach by involving people who receive health and care services, their families and carers.

Additionally, the guidance outlines that local systems should continue to take appropriate actions to treat and investigate cases of COVID-19. This includes hospitals continuing to test people on discharge to a care home and Public Health England local health protection teams continuing to arrange for testing of whole care homes with outbreaks of the virus.

“Local authorities and NHS organisations should continue to work with providers to provide appropriate primary and community care at home and in care homes, to prevent avoidable admissions, support safe and timely discharge from hospitals, and to resume Continuing Healthcare (CHC) assessments at speed,” DHSC recommends.

NHS Continuing Healthcare (NHS CHC) is a package of care for adults that is arranged and funded solely by the NHS. It can help people who have a lot of difficulty with things like moving around, eating and drinking, breathing, taking medicines, and moving and thinking.

However, due to the coronavirus crisis, NHS CHC was temporarily suspended between 19 March and 31 August 2020, with the health service instead focusing on treating patients with COVID-19, preventing the spread of the virus and meeting the unprecedented demand.

From 1 September 2020, NHS CHC resumed to coincide with the NHS entering phase three of its coronavirus response.

Collaboration across health and care services

Safe discharge from NHS settings and preventing avoidable admissions

The guidance details that care should be delivered as close to the home as possible and measures should be introduced to prevent avoidable hospital admissions to help the health and social care sector to cope with increased demands over winter.

As part of the £3 billion new funding announced by DHSC for the NHS for this winter, £588 million of extra funding was also confirmed to continue the hospital discharge service over winter. This half-a-billion-pound fund covers the cost of post-discharge recovery and support services, such as rehabilitation and reablement, for up to a maximum of six weeks, in all settings to ensure people leaving hospital have access to vital rehabilitation.

Actions for local authorities and NHS organisations

According to the winter plan, local authorities and Clinical Commissioning Groups (CCGs) should work together to jointly commission care packages for those discharged (including commissioning of care home beds). The local authority should be the lead commissioner unless otherwise agreed between the CCG and the local authority, DHSC emphasises.

Furthermore, the government advises that local authorities and CCGs establish an Executive Lead for the leadership and delivery of the new ‘discharge to assess’ model.

The department also recommends that these organisations secure sufficient staff to rapidly complete deferred assessments and tackle the backlog of patients.

CCGs are local authorities are also advised to work with partners to coordinate activity to provide services and support to people requiring support around discharge from hospital and subsequent recovery. This could include installing a vital stairlift in somebody’s home following discharge or providing essential physiotherapy services.

TEC

Recognising the impact of technology enabled care (TEC) throughout the coronavirus pandemic to keep people safe and connected, without the need for face-to-face contact, the guidance underlines that the care sector should continue to provide digitally enabled care services to support individuals.

In the adult social care plan, all providers are asked to consider how technical or digital solutions may help them to protect the people they support from COVID-19 and connect them to their loved ones.

Additionally, the UK Government promises to offer discounted broadband deals for care home providers, allowing care homes to improve their internet connections and access video consultations for residents and better enable connections to loved ones.

DHSC also pledges to distribute tablet devices to care homes that are in greatest need, so that care home staff can access remote health consultations for the people in their care.

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