Agenda item

To consider a report from the Head of Democratic Services introducing a range of information associated with visiting policies and patient advocacy arrangements within local health care and care home settings across Leeds.

The Head of Democratic Services submitted a report that introduced a range of information associated with visiting policies and patient advocacy arrangements within local health care and care home settings across Leeds.

Members were asked to consider the details presented in this report and the associated appendices and determine any specific further scrutiny activity.

The following were in attendance:

·  Cllr David Jenkins – Deputy Executive Member for Adult and Children's Social Care and Health Partnerships

·  Caroline Baria (Deputy Director Integrated CommissioningAdults and Health Directorate)

·  Jo Regan (Director of Nursing for Operations - Leeds Teaching Hospitals NHS Trust)

·  Rob Newton (Associate Director Policy and Partnerships - Leeds Teaching Hospitals NHS Trust)

·  Sara Munro (Chief ExecutiveLeeds and York Partnership Foundation NHS Trust)

·  Steph Lawrence (Executive Director of Nursing and Allied Health Professionals - Leeds Community Healthcare NHS Trust)

·  Heather McClelland (Chief Nurse - St Gemma’s Hospice)

·  Michelle Atkinson (Chief Officer - Leeds Care Association)

·  Harriet Wright (Community Project Worker - Healthwatch Leeds)

·  Andrew Paterson (Relative Representative)

In introducing the range of information presented, the Deputy Executive Member for Adult and Children's Social Care and Health Partnerships outlined the following points:

·  The details presented outline the approaches taken across the health and care sector in Leeds during the course of the pandemic in relation to visiting arrangements for people who have been in-patients in a health care setting, or residents in a care home setting.

·  The arrangements for visiting have been kept under constant review and have been revised and updated as the guidance has changed through the past couple of years.

·  Visiting arrangements have been a particularly sensitive matter as health and care providers have sought to balance the huge benefits that visiting brings people and their families in terms of emotional wellbeing, with the risks of spreading the COVID-19 virus.

·  Specific considerations and arrangements were put in place, particularly for people nearing the end of life or people with dementia, where contact with family members and loved ones, was critical to their wellbeing.

·  The various health and care teams working across Leeds’ health and care system have worked together to reduce the risk of transmission of COVID-19, to protect people most at risk due to their health and care needs.

·  At the start of pandemic, systems were set up as part of the health and care response, and significant focus had been given to visiting arrangements and patient advocacy during the various stages of the pandemic – particularly after the strict lockdown measures began to ease. 

The Deputy Director for Integrated Commissioning confirmed how visiting arrangements within local health care facilities, largely focused on care homes, had evolved during the pandemic. It was noted that local policies and arrangements were under constant review due to various changes to national guidance. The balance between the benefits to patients’ well-being arising from having visitors and the need to reduce the transmission of COVID-19 was vital to understand how and why the guidance changed and, in some instances differed, based on patient needs. 

Members were advised how technology had been provided to help provide access and contact between patients / residents and their family and external support networks.  Technology had also supported other developments, such as video conferencing with GPs. 

The health and care system became more integrated for guidance to be discussed and distributed, it was

It was highlighted that during the height of the pandemic, regular bulletins were shared with all Leeds care homes in order to distribute both national and locally tailored guidance.  In developing integrated guidance, the value of third sector engagement through the gold, silver and bronze command group meetings had been crucial in helping care providers and care homes control infection rates.

Members were presented with individual experiences from organisations, staff and service user representatives outlining how guidance for visiting rights and advocacy had been implemented and the effects this had on patients and their carers.

Board members raised and discussed a number of relevant matters, including:

·  Covid-19 related deaths within care home settings was one of the most sensitive and difficult part of the pandemic to hear about.  It was acknowledged that visiting restrictions implemented were a point of practicality, to help protect vulnerable people.

·  How Leeds Health and Care System planned to contribute to the national Covid-19 inquiry, particularly in relation to care homes and the government’s response and support.  It was noted that the Council had kept a strong record of local action and would be ready for any contribution to the national inquiry if called upon.

·  Difficulties and further barriers for some care home residents that resulted from language barriers and levels of cultural awareness.  It was suggested that a hierarchy of visiting would have been more useful and appropriate, as some service users should have had more flexibility if support from visitors was essential to their wellbeing.

·  Concern that some visiting restrictions were still in place within some care homes.  It was suggested that the recognised wellbeing benefits that result from family visiting now largely outweigh the risk of transmitting infection, given the success of the vaccination programme in protecting elderly care home residents.

·  The different approaches and levels of resilience between large- and small-scale care home providers.

·  Concern around standards and quality of care within care homes. Reassurance was given that the Care Quality Commission (CQC) had restarted their inspections, prioritising previously identified lower performing care homes and matters relating to safeguarding.

The Board also discussed the efforts of care home staff throughout the pandemic and expressed huge thanks and gratitude for the care and devotion shown during such difficult times.

RECOMMENDED

That the details presented in the submitted report and the associated appendices, together with comments raised during the discussion, be noted.