The recent emergency legislation titled Coronavirus Act 2020 created “easements” which were measures, put in place by the Government to help the care system manage its pressures.
The Guidance to the easements states that Local Authorities should do everything they can to continue meeting their existing duties prior to the Coronavirus Act provisions coming into force, however in the event that they are unable to do so, it is essential that they are able to streamline present assessment arrangements and prioritise care so that the most urgent and acute needs are met. These measures are time-limited, are to be used as narrowly as possible, and the use of them must be reported to the Department of Health and Social Care (DHSC) at central government.
In the period approaching the peak of the COVID -19 outbreak Middlesbrough Council’s Adult Social Care department experienced significant pressure as a consequence of individual staff members self-isolating; this required the re-deployment of some staff within the department to maintain urgent critical services. The “reasonable worst case” planning assumptions suggested the pressure would become more intense and so, to ensure the sustainability of critical functions such as hospital discharges, some staff were re-deployed internally to support these activities. The focussing of these staff members on hospital discharge meant some other work would have to be temporarily postponed and we took the pre-emptive decision to temporarily delay some scheduled reviews and utilise the staff resource elsewhere within the department. These reviews were the annual reviews for those individuals where there is an established, settled care support package, and the review was to ensure that it still meets the person’s needs. At this stage, the expectation was that the reviews would be delayed for a period of approximately a few weeks until we were beyond what was thought to be the first wave of the pandemic.
As we were considering need to prioritise services under these easements, and in line with the Coronavirus Act 2020 we notified the DHSC that with effect from 14.04.20 we moved from “Stage 2: Applying flexibilities under the pre-amendment Care Act” to “Stage 3: Streamlining services under Care Act easements”. However, as events unfolded it became almost immediately apparent that our staffing position was becoming less pressured and we were able to continue with all work as planned. We have subsequently reviewed our position in line with guidance and notified the DHSC that, with effect from 22.04.20, we have moved out of “Stage 3: Streamlining services under Care Act easements” and back to “Stage 2: Applying flexibilities under the pre-amendment Care Act”.
Middlesbrough Council’s Adult Social Care department is committed to upholding the rights of disabled and vulnerable individuals. We declared that we were moving to Stage 3 of the easements when it became apparent we were likely to be unable to fulfil all of our Care Act duties in terms of the timescales for scheduled reviews. This was not the case as the outbreak did not cause further staffing pressure as anticipated; the flexibility allowed at Stage 3 of the easements was not employed; no individuals were disadvantaged as a result and we reverted to Stage 2 eight days after our initial declaration. The operational decision to anticipate the delaying of some scheduled reviews was forced upon us by circumstances surrounding COVID-19; in the absence of the Coronavirus Act 2020 this would still have been the case.
Our approach to the easements was made in good faith, at pace, at a time of uncertainty and increasing operational pressure. Our view was that the move to Stage 3 reflected the delaying of some scheduled reviews rather than a larger scale derogation from Care Act duties. It is not anticipated that we will use the Care Act easements in future as our the workforce is no longer significantly depleted, nor has the demand on social care increased to an extent that it is no longer reasonably practicable for it to comply with its Care Act duties.
Director of Adult Social Services