Submission to Health, Social Care and Sports Committee, Senedd Cymru, Covid-19 Impact

United Kingdom Homecare Association (UKHCA)

Is a member-led professional association, with over 2,100 homecare provider members across the UK, including in Wales. Our members encompass the diversity of providers in the market: from small to large; predominantly state-funded to predominantly private-pay funded; generalist to specialist; and from start-ups to mature businesses. Our purpose is to enable a strong, sustainable, innovative and person-led homecare sector to flourish, representing and supporting members so that people can live well and independently at home.

Testing

There is significant risk to domiciliary care staff when visiting people in their own homes. The Welsh Government's Winter Protection Plan builds on the experience of the pandemic and sets out to provide safe and effective health and social care services and support the workforce over the coming months. Domiciliary care workers have carried a heavy burden during the last six months, and continuing to support them by providing the right protective equipment, providing tests if they need them and recognising the impact on their wellbeing and taking action to support them, must be at the centre of what is done in future planning. Test, tracing and expanded flu vaccination campaign is paramount to safeguard the vital services offered by domiciliary care providers and workforce.

PPE

The challenges providers faced in securing sufficient and appropriate PPE for the social care sector is widely recognised, as supplies from usual sources became alarmingly inadequate. UKHCA recognises that the situation has improved with both the supply chain and matching by Welsh Government through local authorities. However, there remains concerns over the increase in the cost of PPE and potential ongoing supply issues and logistics.

Finances and Sustainability

The staffing impact from dealing with Covid-19 has had a major influence on an operator’s costs that are workforce related. For example, under normal circumstance around 75% of a domiciliary support services costs are workforce related. The Covid-19 pandemic has had a major impact on staffing levels, workforce costs escalating to 80% / 90%. The increase in the level of National Living Wage of 6.2% in April was mandatory before a number of local authorities announced any uplift in fees for 2020/2021. Some fees failed to recognise that not all increases are transparent but relate to costs that occur as a direct result of specific measurable values. For example, increase in minimum wage impacts on travel time, NI, pensions, holiday pay etc. Costs that increase by business continuity risks include workforce unavailability by self-isolating and stress related symptoms, sick pay and wage replacement costs. Insurance renewals costs are increasing with all insurers looking to exclude Loss of Income cover for losses arising from COVID19. The impact of policy on cost, management and administrative time reporting on Covid-19 related obligations has also increased the pressures on provider sustainability.

Conclusions

UKHCA welcomed the Welsh Government £40m fund for social care, announced in April, but remain very concerned that there is evidence from our members that some local authorities are still defining how best to give access to the hardship fund. In some instances, we understand, that layers of bureaucracy and time driven arrangements are still in the development stage, despite guidance calling for providing funding in a timely manner.

This pandemic situation has demonstrated the crucial and key role of the social care sector in supporting the people of Wales. More importantly, clearly displays how fragile the system has become from a prolonged underinvestment programme.