Cornwall councillor responsible for social care says care workers should be paid more

The Cornwall councillor responsible for social care says that care workers should be paid more to help ensure there are enough people available to provide care.

Cllr Andy Virr said that whilst Cornwall Council was one of the first councils to pay care workers the Living Wage, he believed they should have a pay rise to help tackle the cost-of-living crisis.

With Cornwall still having issues with people being unable to be discharged from hospital as there are insufficient care resources around which have led to ambulances queuing up at Royal Cornwall Hospital, the need for more care staff has frequently been raised.

One area Dr Virr, Cabinet member for adult social care, said was a particular issue was in the recruitment and retention of care staff, a problem across the country but particularly seen in Cornwall due to low rates of pay and the increase in costs of housing and living.

"We have an issue in getting enough resources at the moment. That does impact our ability to meet the needs out there and that is a bit of a worry. We are working very hard to recruit people.

"But we have people who previously worked in care going to work in hospitality in the summer and supermarkets in the winter – but we are trying to get those people to come back and for more people to enter the care sector as a career.

"We were one of the first councils to pay the Living Wage for carers and we are hoping that more people will come forward to work in care."

Dr Virr said that it was difficult to get agency staff from outside of Cornwall to work here due to the high costs of housing and said that there was work being done across the health and social care sectors to see whether modular housing could be provided for staff.

However, he admitted that there were still ways to improve: "There is always a need for more money, particularly in the rates of pay that we offer our care workers.

"We are seeing rising inflation and I would like to see the pay offer for care staff to go up. It will have to come from the Government but the budget conversations in the council are currently underway as well and this department will have to deliver savings. We want those savings to be doing things differently and, I hope, better."

However, Cllr Virr said that attracting more care staff to work in Cornwall was not the only way to address current issues and said that there also needed to be a shift in how care is provided. He said that the council was aiming to get people able to rehabilitate and recuperate in their own homes, rather than going into residential care.

He said: "We have an over-reliance on bedded care. Often what is not seen is that someone has an illness or injury and we need to give them a chance of rehabilitation.

"We need to be more careful about how we assess people’s needs so that we get them the right care in the right place. Sometimes they can end up being more dependent than they actually need to be.

"We want to invest in this model approach of rehabilitation. We are trying to get the model right so that everybody has the opportunity for rehabilitation so they can, ideally, get back into their own homes.

"Too often people are placed in care home beds inappropriately and end up stuck where they shouldn’t be and it exhausts resources as well. It uses up resources that might not be needed.

"For those people who are able to have that rehabilitation stage at home we will send them home with a rehabilitation care package – we are not sending people home without care.

"You could argue that our system is too risk averse, there is never no risk, people can get confused or there can be a risk of falls, but there is a misunderstanding in the public about what we are trying to do. A bed in a care home is not always the safest place, and we should not be admitting people into care homes unless they absolutely need one. If you get the risk imbalance wrong, you end up with people stuck in beds for a long time."

Dr Virr said that one area where Cornwall does need more residential care is for people with dementia with a requirement for more specialist care, saying that it was the hardest group to meet the needs for in Cornwall right now.

As a consultant in the emergency department at Royal Cornwall Hospital Treliske Dr Virr is only too aware of the issues of ambulances queuing up outside the hospital and the problem of people stuck in beds waiting to be discharged. It has been said that this has been caused by a lack of social care packages to allow those people to leave hospital.

Dr Virr said: "It is unfair to blame that all on adult social care, that plays a big part in ensuring flow through the hospital, but it is not the only reason.

"We need more prevention work and alternatives to hospital when someone has a fall or a health crisis and we are working with GPs, hospitals and care homes on this – it is prevention work and responding differently to crisis.

"On the hospital side it is having the right risk threshold and making sure that people are in the right place to get the right care,

"Social care has a big part to play but it’s not the sole reason for the current issues. That jam has been totally unacceptable and it is a real concern. I work in the emergency department as well and before Covid we would have 20 people or so in the corridor, it wasn’t the best environment for them but they were out of ambulances and being treated. Now the same numbers can be in the back of an ambulance for the same time. They are being well looked after but those ambulances are not back out on the road where they should be. That is due to Covid and a surge in demand. This week it has been a much-improved situation."

But, we asked, do those photos of ambulances queuing up outside Treliske affect the morale of the staff inside? "It is a massive effort from health and social care colleagues, it is a battle to keep control. The staff are amazing and they work so hard, go home, dust themselves down and come back.”

One thing that has changed recently in Cornwall is the NHS and social care department at Cornwall Council working much closer together, united by the Integrated Care System which has been implemented across Cornwall and the Isles of Scilly.

Dr Virr said: "The ICS was designed to put the different people, whether hospital, adult social care or housing, in the same room to work collaboratively. Historically they might have blamed each other for any issues but now it has got to be a joint effort and I think we are starting to see that.

"Money has been drawn down from the Government and shared between the local council and NHS and you have to agree how to spend that money and we have been looking at how we put that money into rehabilitation. That is the benefit of that working together to work out how people can get discharged.

"The ICS is a fledgling organisation but we are starting to see the fruits of that, you can see where the accountability lies and there is no opportunity for just shrugging shoulders.”

Asked whether he is optimistic about the future of health and social care in Cornwall Dr Virr is quick to respond positively: "It is set up now and up and running at the right time and the right organisations to address the challenges we face, particularly around the current discharge issue.

"As we go into winter the winter control room is now hosted by the council with NHS colleagues working alongside them in there – that wouldn’t have happened before, it is a physical demonstration of that working together.

"I am optimistic, one of the great things is we have a great new senior leadership team, we have recruited from outside Cornwall and have a very high calibre director. That is fantastic and bringing in expertise from outside the county.

"We also have a fantastic public health team who are making sure we can live well and age well and in our own homes – they are promoting things like exercise, wellbeing and community."

One of the key things that Cllr Virr has spoken about in council meetings is the need for the community to play their role in providing care for family, friends and neighbours, and said there was also a role for parish and town councils.

"We do really want to encourage looking after your neighbours and having town and parish councils to look at things beyond potholes and double yellow lines. The fantastic big society effort that we saw in Covid, when we struggled to know how we would respond, the community and parish and town councils stepped up. People appeared out of nowhere, picking up prescriptions and doing shopping.

"We have amazing neighbours and that has to be a big part of the solution and it will reduce the burden on services."

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