Working together to protect care homes in Leicester

By Martin Samuels | 21 October 2020

Leicester recently marked 100 days since it entered its second lockdown. Other areas have now joined us in having additional restrictions, but we have the dubious distinction of having been there longer than anywhere else.

What is perhaps less well known is that, even as the rest of the country has recently experienced a very rapid increase in infection rates, ours have virtually plateaued over the past couple of weeks. Moreover, we have seen particular success in keeping the virus out of our care homes and schools. As we marked 100 days in lockdown, we also marked 11 weeks since the last COVID-related death of an elderly care home resident. Of course, we also know from experience that this virus can spread quickly, so it is vital we maintain our guard, knowing the situation could change in a matter of days.

How have we achieved this success? There is no magic wand or golden bullet. Our success can be attributed to three things: data, working as a system, and trust.

A great deal has been said about data and COVID – who has it, how accurate it is, when it is shared.

Right at the start of the local lockdown, when proactive testing of care home staff and residents first began, we quickly realised we couldn’t get testing data from the national systems. We therefore established a local process to collect it from care homes direct. Since then, members of my staff have been ringing care homes on a daily basis to gather the results they receive from NHS Test & Trace.

Though laborious, these daily updates allow us to see what is happening with infection rates (infinitely more useful than raw numbers of positive cases), understand how individual homes are doing in terms of testing all their staff, and map the movement of the virus across the city.

The city mayor’s emphasis on robust data has been central to making this possible. The immense work done by the team proved its worth when, at the start of September, we spotted within a couple of days that the infection rate was rising rapidly. That early warning, about a week faster than had we been relying on the national data, was vital. It allowed us to take urgent steps to support care homes, rapidly bringing the infection rate down.

Those steps were based on a strong emphasis on system working. From the start of the pandemic, I have been chairing a cross-sector social care and education group, bringing together key players from all the local councils, along with colleagues from the NHS, care providers, and schools, across the Leicester, Leicestershire and Rutland system, as well as some national partners. The brisk 45-minute weekly calls provide a forum where subject-specific sub-cells raise issues and concerns, flag connections between different strands of work, and secure senior-level engagement.

The open discussions in the group have generated a strong sense of joint ownership and mutual regard, so that actions are taken in full recognition of their impact across the system. This has been assisted by repeated evidence that points raised on the call feed into our overall system arrangements and into wider routes, where we have frequently seen shifts in national policy in response to points we have highlighted. That has bred trust: between organisational partners, between local politicians and officers, and in the process. And that sense of trust and confidence cannot be underestimated in terms of its impact on our ability to maintain a tight grip on a situation that had and still retains every potential to become unmanageable.

This is the application of sound management, coupled with effective leadership and a firm foundation in data. But perhaps the key lesson, as we look ahead to what seem likely to be difficult times over the coming six months or so, is that there is no substitute for bringing a local team together, under local political direction, and entrusting them to assess the situation for the population they already know so well and then having the confidence in them to come up with and deliver the best solutions.

I have never been so proud of my colleagues as I have been over the past six months. I have no doubt that they will continue to impress and astound me over the next six months. And the people of Leicester and the surrounding areas will be the true winners.

Martin Samuels is strategic director for social care and education at Leicester City Council

@MartinSamuelSCE

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