Closure warning from Sheffield care homes in Covid costs row with council

After an emotional video diary chronicling her team’s experiences at the peak of the UK’s coronavirus pandemic was shown on Sky News in April, Nicola Richards says it was incredibly moving when people living close to the nursing homes she runs in Sheffield started showing up at their doors to leave support parcels outside.

But Richards, owner of Palms Row Health Care whose three homes in the city have suffered 20 deaths of patients with confirmed coronavirus, is altogether less happy with the support she has received from Sheffield Council. She says this applies to both the peak of the crisis in late March and early April and now in the aftermath in relation to the authority’s handling of its £34m slice of a £3.2bn emergency fund from Government for local authorities towards the extra costs of the pandemic.

She says a lack of financial guarantees at the height of the crisis affected how she was able to staff her homes, while a petition supported by the Sheffield Care Association which she chairs that is calling for a permanent increase in care fees paid in the city has now received over 1,000 signatures.

“Without intervention homes will close and our elderly deserve better,” she says. “The sector that has been hit the hardest during Covid-19 is the one now most at risk.”

With Palms Row’s three homes offering a mixture of nursing, end-of-life and intermediate care for people who have left hospital but are not yet well enough to return home, Richards says around 95 per cent of her residents have their places publicly funded by either by the NHS Sheffield Clinical Commissioning Group or Sheffield Council.

She says speaking out against the council has not been easy.

“I’m being critical of a big organisation that is ultimately our biggest customer. It is a tough thing to do but for me I can’t just ignore it because what has happened is wrong.”

Her company’s first coronavirus case was confirmed on March 28 and as the virus started to spread among staff and residents, Richards says she wrote to the council at the start of April seeking urgent financial help but did not receive a reply for over a week and has only received extra funding in the last fortnight.

She says being paid more promptly or having guaranteed funding was on its way would have altered the way the homes dealt with the peak of the crisis. “I would have used that money to over-staff units in anticipation of sickness. I couldn’t do that because I was worried about next month’s payroll bill.

“If I can’t pay wages there is no workforce and nobody looking after residents. We have got through really by trying to keep normality the best we could and relying on the goodwill of the workforce.”

George Lindars-Hammond, cabinet member for Health and Social Care at the council, said support had been provided to Palms Row at the time, including temporarily deploying workers to help with staffing needs and testing, as well as providing PPE.

But Richards says the staff sent by the council after repeated requests for help did not include any frontline carers and was instead a couple of case managers to assist with discharging patients and some kitchen workers.

Sheffield Council was allocated an additional £34.3m in funding to cover Covid costs in late April, with Local Government Secretary Robert Jenrick saying social care providers should receive temporary additional funding of up to 10 per cent where necessary.

But Sheffield Council has raised bed fees by just five per cent and says it is facing a £77m hit from coronavirus-related costs – meaning the extra Government funding does not go far enough.

Richards says her three homes - Westbourne House, Northfield and Newfield Nursing Homes – accrued around £100,000 in additional costs at the height of the pandemic but to date she has only received around £4,000 in extra income from the council’s emergency funding allocation to date.

“It feels like you are being thrown scraps and we have been hung out to dry,” she says.

Coun Lindars-Hammond said Palms Row “has received significant support from us”, with the first payment being £4,999 and a further payment due this week. A further £13,635 payment covering occupancy costs for now empty beds is also to be made this week to the firm.

Another £93,000 has already been provided to Palms Row from a separate £600m ‘infection control’ fund set up by the Government and again administered by local councils, with a second tranche of £93,000 potentially available.

But Richards says she is reluctant to touch the infection control fund money as it comes with stringent spending conditions attached relating to use for potential future costs rather than assisting with previous expenditure.

“We can’t access it until we have concrete information on what we can use it for, especially as it is subject to clawback.”

Richards says one of the central issues in Sheffield is that its council bed rate fees were already lower than many comparable areas, even with the uplift which has now taken its rates up to £539 per week. She says another concern is that there has been no confirmation yet that a temporary agreement for the council to cover the costs of now-unoccupied beds will be extended beyond this month.

“Sheffield has historically been low on fees for many years. It is lower than the fees paid in Bradford for example. If you are in a low fee-paying area, it puts you under incredible financial pressure. The five per cent uplift now is not what the Government has asked for. It is not enough and it is too little, too late.”

Another bone of contention for Richards has been the level of detailed financial information which has been requested by the council to receive further funding.

“We are being asked to complete detailed financial information central Government didn’t ask for and it almost feels like there are barriers in accessing this money.”

The council said that 62 homes so far in the city have provided the necessary financial details it has requested.

Coun Lindars-Hammond said: “We continue to work closely with the sector to ensure they are getting all the help that is available. However, we cannot just provide funding without being advised of what is needed and where. Payments have to be fair, based on facts.

“This is why the council asked all care homes to provide us with their financial position based on resident numbers so we could implement fairly across all care homes a financial increase which the majority have helped us with and who have received this financial increase.

“We continue to urge those care homes who have not informed us of their financial circumstances to do so. Our main message, for those homes that engage with us is ‘we’ll do the paperwork our end as quickly as possible and stand by you to help you through this’.”

But Richards says the council have “moved the goalposts” from their initial advice to submit a record of additional costs.

“At the time we were fighting Covid, we were pulling together information in a spreadsheet with all our additional costs because that is what we were told to do. We then submitted them to the council and then these forms came out.

“We were not happy with submitting sensitive information over a Google form but they were also asking for things like mortgage payments details and it was like they were means-testing us on things that had nothing to do with Covid.

“I have got all the invoices for our additional costs if they want to scrutinise anything. Other local authorities have not asked for any of what Sheffield is.”

Coun Lindars-Hammond said: “Sheffield City Council has put a tremendous amount of work into supporting our care homes during this crisis.

“We have ensured as much financial aid as is possible has gone to the worst affected care homes and others across the system. So far, COVID-19 has cost the council £77 million across all services yet we’ve received only £34m from the Government.

“Our officers, along with our partners, have physically helped care homes by providing over 800 hours of support through additional temporary staffing. Before the lockdown had come into effect we had provided practical help, including PPE, to care homes.

“Sheffield City Council is determined to help. We do not want our most vulnerable to suffer and they are our key priority during this crisis. We believe we are doing all we can in very difficult circumstances to help and support the care home sector.”

But Richards is not alone in raising concerns. Operators of Silver Healthcare and Country Court Care, which both have two homes in Sheffield, have also made criticisms.

Roy Young of Silver Healthcare said: “Sheffield City Council’s recent financial offers are quite frankly insulting. We demand a debate by the full council about this scandal and the problems the current administration has allowed to grow on its watch.”

Alykhan Kachra, managing director of Country Court Care, said the five per cent uplift “does not come close to meeting the needs of homes even prior to this pandemic when factoring in additional PPE and staff costs.”

Last month, Care England, which represents independent care providers, said a 10 per cent uplift in weekly bed rates to be made across the board to care providers to deal with Covid-19 costs and warned that money from the emergency fund was not reaching providers quickly enough.

Richards says she has limited sympathy to the council saying it has not received enough funding from Government. “Other authorities have been able to provide more money in a more timely and effective manner. I just don’t think Sheffield Council understand the gravity of the financial consequences this has had for providers. It feels like we are fighting for everything.”

Highs and lows for care company of past few months

The Covid-19 crisis has brought a series of ups and downs for Palms Row Health Care.

In March, the company was criticised by some family members of 22 residents who were moved from Newfield Nursing Home to Westbourne House Nursing Home to free up capacity for patients coming out of hospital as the NHS looked to make extra beds available in hospital. The incident was raised with the Care Quality Commission, who said today they are “monitoring the service and engaging with them about the concerns”.

But last month, a photograph taken at Newfield of a resident and carer dancing inspired the Duchess of Cambridge to launch a new exhibition celebrating ‘resilience, bravery and kindness’ during the pandemic.

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