A change of tack
In Somerset, we’ve spent many years working to reduce the reliance on residential care, focusing instead on innovative domiciliary solutions. So, imagine my surprise when, in March 2020, we were tasked with getting two new ‘pop-up’ care homes up and running to support the COVID-19 response.
With around 400 bed vacancies in the county, my initial response was ‘Why are we doing this?’ However, it became clear we needed to support our existing providers by having somewhere for those who had tested positive to isolate safely. Making this provision would help protect our existing care home residents and maintain infection control.
Wind forward a couple of months, and we had two fully renovated former care homes, fully staffed and CQC registered. Thankfully, we only ever needed to open one, but we should not underestimate the achievement of getting both functional in record time.
During this period, many local health and care systems survived almost entirely on good will, collaboration and a ‘can-do’ attitude. Somerset was no different.
Overcoming challenges with collaboration
Whilst we succeeded, we also highlighted some of the challenges of a previously fragmented system. There was no lack of willingness - our acute and community trust colleagues were quick to offer staff support. However, trying to resolve issues with insurance terms and conditions proved a difficult obstacle to overcome.
Somerset County Council had no active CQC registration, which meant it would have been unable to register the home or appoint the registered manager. Thankfully, a registered provider in Somerset Care stepped up to take on the registration.
I am confident we will see great changes and, although there have been may challenges, there have also been moments of hope.
For example, we know that in normal circumstances, recruitment is a struggle for our social care providers. Yet the ‘pop-up’ facility was overwhelmed with applications.
Council staff, CHC Nurses, and acute staff were redeployed and joined by paid volunteers from our local communities. Some members of this latter group have chosen to stay in care and are now employed elsewhere by care agencies.
People across the system have begun to understand not only the role but also the value of social care. They understand that social care provision is as important as that of local NHS services. Partnerships in Somerset were good prior to this but now they are even wider and more developed. #TeamSomerset became - and continues to be - a mantra.
During this time, I’ve been reminded of a few key ingredients for successful collaboration that I described at NHS Expo a couple of years ago, these being; identifying key joint drivers, a bespoke approach to training, joint decision making and, of course, constructive challenge.
I am very proud of what we have achieved in Somerset. This work has reaffirmed my view that when we treat people as individuals and put their needs first, effective systems of support can follow. Integration is a much-used phrase, but the form or structure is not so important: it’s the outcomes that matter.
It is looking likely that in Somerset, we will be using a hybrid health model for our designated place (community hospital or similar) as we have a better handle this time around on capacity and ability to deliver services, with the correct medical cover and follow on market provider support.
Although we were ultimately successful in our objectives, what seemed clear to me throughout this process was that a lack of understanding about the challenges of running care homes still persists in the wider health and care sector.
Find out more
For more details on how health and care services can maximise safe discharge from hospitals to care settings for people testing positive for COVID-19, see the Adult Social Care Winter Plan on GOV.UK.