Progress so far with careworkers’ sick pay

Almost a third of COVID19 deaths, over 16,000 people, have occurred in carehomes. Careworkers are twice as likely to die of COVID19 than the general public.

A little acknowledged but major factor in these carehome deaths is the low pay and insecure employment of careworkers. It is estimated that around 440,000 care workers have no rights to occupational sick pay.¹ If they develop symptoms of Coronavirus or a member of their household develops symptoms, then they are faced with an impossible choice: take time off on Statutory Sick Pay (just £95.85 a week) or continue to work potentially infecting vulnerable adults. A Unison survey of 2600 careworkers found 8 out of 10 would not get paid if they had to self-isolate. The survey found many careworkers and their co-workers are not always selfisolating because of poverty and fear of poverty.² A GMB survey found 78% of careworkers feared getting a test in case it meant they had to take time off on Statutory Sick Pay.³

In the words of Nadia Whittome MP: “Those least able to afford to self-isolate are working with those most likely to die if they catch Coronavirus.”⁴

But careworkers have been organising with the Safe and Equal campaign and in their unions and have been winning victories.

Unison North West has won a number of victories, securing full isolation pay for careworkers in Salford and a number of other local authority areas.⁵

In Scotland the government announced on 24^th May that it was introducing an “Enhanced” Statutory Sick Pay for careworkers. The details of this scheme are yet to be confirmed.⁶

In Northern Ireland, the Department of Health announced on 3^rd June that it would pay 80% wages for any careworker that needs to isolate following public health advice.⁷

In England in mid-May, the government announced a £600 million Infection Control Fund for carehomes. Among other measures this money s for “ensuring that staff who are isolating in line with government guidance receive their normal wages while doing so. At the time of issuing this grant determination this included staff with suspected symptoms of Covid 19 awaiting a test, or any staff member for a period following a positive test.”⁸

Local authorities were supposed to write to the government by 29^th May explaining how the money has been used and reporting any problems. These returns were supposed to be made public. Some local authorities have complied, others have not.⁹ Safe and Equal are collating information to find out if the £600 million taxpayers money is reaching the frontline and specifically ensuring that careworkers do not miss out if they need to selfisolate.

Below is a list that will be updated as we receive more information. The number next to the local authority name is the number of carehomes who are paying normal wages for workers who need to self-isolate as a fraction of the total number of carehomes within the local authority area e,g, in Barking and Dagenham 7 out of 20 carehomes are paying full isolation pay.

Barking and Dagenham 7/20 “Care homes have identified that they would require support in funding full wages for staff isolating after a positive test.”¹⁰

Bath and North East Somerset 31/58 “This is in place, where appropriate, but providers have taken forward a range of options to support staff. SSP being paid in some services – Another service is paying staff their SSP and company sick pay entitlement from the first day of isolation (regardless of a test). If they are entitled to full sick pay then yes paid in full but if they have used there entitlement previously then no or possibly half pay.”¹¹

Bexley 14/31 “14 out of 31 care homes confirm that they are able to pay staff full wages while isolating following a positive test.”

“care home providers said that being able to offer more than Statutory Sick Pay would be helpful. For example, extra funding to give full or at least 80% pay would be helpful. However, this may be difficult for small providers

extra financial support would be helpful. For example, to maintain cashflow and debt liquidity to maintain supplier relationships or to cover the added expenses of agency staff, whilst a staff member self isolates

“currently, where staff are concerned or unclear about whether they will be paid a full wage whilst off, they may be discouraged from getting tested, particularly those who are asymptomatic

some providers mentioned that Statutory Sick Pay is agreed from Day 1 currently
the feedback suggests that care providers may have different policies in place. For example, only paying full pay for the first period of isolation or making this dependent on previous sickness record. Getting some consistency in approach across the independent sector, sharing good employment practice, promoting adoption of minimum standards or taking action to raise these standards should be further considered at a national level”¹²

Birmingham “Financial assistance has been provided to care providers who have been unable to claim Statutory Sick Pay at present, to allow them to continue to pay staff wages.”¹³

Blackpool 19/69 “Most homes report they would require additional funding – either nationally or from the Council to be able to afford this. Mainly rely on SSP.”¹⁴

Brent 61/61 “We know that not all homes pay all staff when they are absent because of sickness. However, we would expect the infection control funding to be used in order to do this so that staff do”¹⁵

Brighton and Hove 29/93 “Information taken from Capacity Tracker, but not all Care Home’s have completed this field. In-house staff are being paid their contracted hours if they have to self isolate or cannot work from home. But this only makes up a very small proportion of care home (three in total). The vast majority of homes are privately owned or run by charities. The Registered Care Association Chair has stated that care homes are very unlikely to be paying staff who are self isolating their full wage. Staff who are self isolating are regarded as off sick and therefore receive SSP. People who are ‘shielding’ for 12 weeks are treated differently; they are unlikely to be paid but will be furloughed by the government (as they have instructed them to stay at home), so will receive 80% of their pay.”¹⁶

Bromley “Just under 30% of the care homes reported paying full wages to those staff isolating following a positive test. The most common issue raised by providers was the need for funding to implement this measure.”¹⁷

Buckinghamshire: 35/134 responses “Homes require further information on the expectation of care homes to do this and whether this is covered by Covid-19 crisis funding. Ensuring everybody understood how to access the financial assistance during Covid. If 100% of care homes claimed for 100% of this related cost and the additional staff to cover the shift this would cause huge pressure on the monies given to the local authority.” ¹⁸

Bury 56/56 care homes responded: “Every care home is able to access additional funding to any additonal costs related to the pandemic including this one”¹⁹

Cheshire West and Chester “The funding will also allow providers to pay staff ‘normal’ wages when they are self-isolating or following a positive test to prevent staff attempting to return to work too soon. We welcome this additional measure as a means of supporting delivery of the “Unison versus Covid-19” pledge, which the Council Leader has committed to support.”²⁰

Cumbria 78/150 “A separate centrally managed scheme (similar to the furlough scheme) for care staff isolating due to COVID-19. This would reduce the risk of transition of the infection and improve staff take up of testing as we are aware that some care staff are reluctant to be tested due to the financial impact of only receiving statutory sick pay. Many care homes have identified that statutory sick pay is payable to care staff who are isolating following a positive test. This may explain the reluctance of some staff to participate in covid-19 testing.”²¹

Darlington 10/32 “A number of providers only able to pay SSP/80% of pay.”²²

Derbyshire 90/260 “228 responses were received to this question. The county council is clear in its view that if care staff are paid their normal wages there is greater chance they will take the right decision to self isolate rather than needing to work to maintain family income, with some care providers needing to pay the worker their average wage for a working week to compensate for any short hours contracts. The additional Government funding which has been announced for care homes will enable care providers to put this is place as quickly as possible, and the county council has arrangements ready to passport the funds to providers as a matter of urgency.”²³

Doncaster 18/79 “64 homes have answered this question (15 have not) 18 answered yes 46 answered no.”²⁴

Durham: 33/145 “Provider Data from Capacity Tracker: Yes 33 / No 68 / Did not respond 44”

Our guidance to care homes on financial support from the Council and associated contract addendum, specify that providers should continue to pay staff as appropriate, in line with Government guidance and PPN 02/20 in particular. This does not include the specific arrangements covered by the question however. With c150 care homes in the County and the relevant staff being employed directly by a high number of independent sector providers as a result, we would need to engage with providers across the market specificlly in order to fully confirm the position on this issue.”²⁵

Ealing 28/48 “Care Homes suggested a change in national policy to either provide more direct financial support to pay full wage during the isolation period, and cover backfill costs, and have access to a Government funding for this purpose. A pressing concern for many homes, impacting financial viability as reduced occupancy affects income. “²⁶

East Sussex 78/314 “This situation will be monitored through direct dialogue with providers, and the use of the new ICF to support workforce costs.”²⁷

Hampshire 287/485 “The Hampshire Care Home Support Plan has identified and is working with providers to support them to utilise all available funding. This includes additional temporary funding provided by Hampshire County Council for publically funded residents, additional NHS funded provision, access to national government support and provision of the £600m infection prevention and control funding.”²⁸

Harrow: 25/56 “Provider feedback indicates this is a financial issue for their homes and they would require further financial support to pay staff their wages following a positive test.”²⁹

Hartlepool 7/26 “Providers will be encouraged to use the Infection Control Funding to deliver this action.”³⁰

Havering 24/63: “The theme was focussed on financial support for additional costs in relation to additional staff, sick pay and more general financial support.”³¹

Hounslow: 14/31: “The Adult Social Care Infection Control Fund should address this with financial support”

Herefordshire 33/87 “This requirement was flagged to providers at the start of the crisis period, however the council or partners cannot mandate this. We would like national direction on this issue, it feels unfair that providers who do not do this should receive equal funding.”³²

Gloucestershire 91/229 “Financial implications of extending clause to cover pay for staff who are self isolating. Providers have raised the issue that they need security around what funding is being provided and how long for. Query about move from paying SSP to full wages.

Islington: Response to lobbying by Unison “Despite the Government claiming it as extra funding for councils, the additional £600 million ring fenced infection control fund to support care homes, which you mentioned, is in effect an industry fund and not Council cash – an industry that faces mounting challenges. It is estimated that the fund will provide a 50 bedded care home with about £50,000 additional resources, but if the occupancy levels are down to around 30 residents, the home will be making a loss of around £10,000 per week. Islington Council has also seen income reduce sharply over the past few months as costs linked to the pandemic rise and we have no idea for how long the current situation will go on.”

Kent 154/543³³

Lambeth 17/40 “Additional funding support for local authority or passported directly to providers”³⁴

Leeds 51/151 “We would expect this figure to go up once the Infection Control Fund is distribute.”

Leicestershire: 49/182 “Funding to support Care Homes to pay for this after September. Only 39% of those who responded pay staff isolating. This is a key area to be addressed by additional funding”³⁵

Lincolnshire 93/287 “The Infection Control Fund will go some way in enabling Care Homes to pay staff full wages, although issues of equality will be raised as homes may not have been able to afford to pay staff full wages prior to being in receipt of this fund.”³⁶

Liverpool: “In April 2020, the Council made available grant funding to all commissioned care home operators in the City on a non-selective basis to cover additional costs incurred related to Covid-19. An initial grant equivalent to one full week’s commissioned services was offered to 30 June 20. Permitted uses of the grant [include] To ‘top-up’ SSP and/or normal contractual sick pay so that care workers receive full pay when self-isolating and/or during any period of sickness absence directly due to infection with Covid-19.”

“Funding has been made available to providers to pay staff when they are self-isolating or symptomatic. This ensures that the risk of staff working when symptomatic due to financial concerns is minimised.”³⁷

Luton 19/40 “from these responses it seems that providers are not all paying staff when isolating. It is important that there is no dis -incentive for staff to self -isolate so this needs to be looked at further and supported.”

Manchester: No responses from 91 providers: “Unable to respond whether this is an issue or further support is required because this question is not asked of care homes on our daily ring around”³⁸ The response for Manchester is strange as Mayor Andy Burnham had previously been on national television arguing that careworkers need full isolation pay³⁹.

Medway 22/72 “22 of the 45 homes that have responded indicated that they are paying their self isolating staff a full wage.”⁴⁰

Middlesborough 16/45 “Infection Control Fund will assist in part to improve these measures. Test, track and trace may increase the number of staff self isolating and therefore funding may not meet the top up costs.”⁴¹

Newcastle upon Tyne “Our Care Homes Programme Board will consider this area of provider response in more detail in order to fully understand the support a home might require to pay staff while isolating, particularly as some homes are already doing so. It is also worth noting that in some instances, it would be appropriate also to pay staff in continuing isolation following a negative test, when clinical suspicion or assessment of prevalence / prior probability of infection renders the negative predictive value of the test too low to be considered safe. Where meeting this expectation creates an additional funding requiremen, then that funding would need to be provided centrally.”⁴²

Response to lobbying from Unison “The council has received £3.4M from the government with another tranche to be provided end of July/start of August 75% of that money has to be passed through to care home providers based on the number of beds in that care home, the council has no discretion about how that money is spent. The remining 25% does have some conditions, but they’re not particularly strict. None of the conditions stipulate that workers have to receive the money or anything about full pay for self-isolation. The second tranche of cash also requires 75% to be passed over to care home providers on a per bed basis, but they are supposed to supply an infection control compliance plan.The remaining 25% requires an action plan to be provided

In terms of council funding, NCC applied a 5% uplift to the rates paid to care home providers with a promise that they would provide “full cost recovery” for costs associate with covid-19, most other councils only provided the 5% uplift.”

Newham 21/25 “Additional communication will be sent to the homes that reported NO to ensure they are aware that this should be met from the additonal funding provided.”⁴³

Norfolk 111/348 “DHSC to issue clearer guidance around the expectations of care homes paying full wages as a result of a positive test. Longer-term, it is essential to retain the numbers and skills of an engaged and supported workforce. DHSC to support additional Financial assistance in exceptional circumstances, for example, loss of revenue from empty beds and the risk this brings to care home business continuity.”⁴⁴

Northamptonshire 77/246: “While there remains a consistent proportion of homes that have not answered, the return shows that a sizeable group of homes (98) are not able to pay staff their full wages during a period of self-isolation. we know that this relates to the use of flexible or zero-hour contracts for some staff or because of provider specific employment policies that may only follow minimum statutory sick pay requirements. These are common features across the care market and therefore not unique to Northamptonshire.”⁴⁵

North Lincolnshire 25/60 “This will be an expectation of the infection control grant”⁴⁶

North Somerset: 44/99 “NSC has provided all contracted care homes with an additional payment to address pressures, incuding the need to enable staff to isolate. This amounts to £100 per week per funded bed. Currently in place at least until 30^th June. We will provide additional infection control payment in line with guidance. COVID-19 represents a pressure on local authority finances generally, of which adult care is a major but not sole issue. Funds provided are not sufficent to enable all costs of all providers to be fully reimbursed. Further engagement with providers to prioritise this support”⁴⁷

Nottingham City “Information has been received from 70 care homes to date, of these 29 have continued to pay staff full wages whilst isolating following a positive test. The other 41 either have not had a positive test or staff will be accessing statutory sick pay.”⁴⁸

Nottinghamshire 270/270 “We expect funding in the infection control grant to be insufficient in some cases and therefore we may require further funding for COVID-19 costs. A number of measures have been put in place locally to support providers financially. This includes an increase in fees to account for the NLW, a 5% upfront payment to support with cashflow and also monthly claims for additional costs incurred relating to Covid – 19. PPE has also be supplied free of charge when providers have not been able to source their own. Whilst the additional grant funding is welcomed it is not thought to be sufficient to sustain the sector and to be able to cover all of the additional costs incurred. Some homes will have had significant reductions in the numbers of people within their service due to the high number of deaths from Covid-19 which will impact significantly on their income. However, income is not something that the Council can reimburse for due to State Aid regulations and also the cost to do this for all services would be prohibitive.”⁴⁹

Oldham 44/44 “How this is sustainable in the longer term in the absence of a continuance of increased funding post covid specific support. Through the financial support offered by the local authority from central government non-recurrent covid grants received, providers are able to claim finanical assistance with the cost of backfill for absent staff, which enables them to pay their absent staff a full wage.”⁵⁰

Oxfordshire 61/123 “There has been no national statement mandating that this is in place, this would help the care sector in ensuring this.”⁵¹

Peterborough and Cambridgeshire “We recognise that some infection prevention and control measures can be difficult for providers to implement due to available space and associated costs, including isolating of residents, minimising workforce movement and maintaining staff salaries whilst staff are isolating or off sick. Practical support to aid these specific areas of concern are being implemented via the introduction of alternative isolation accommodation and financial support, including via the Infection Control Fund.”⁵²

Portsmouth 18/39 “Further clarity to homes about how to manage this in line with the grant conditions. Additional funding may be required to support this. A number of homes have rasied concern about how they can do this equably in line with their existign HR terms and condiiton”⁵³

Redbridge 38/71 “National policy/law/grant to pay staff in full if sick with covid not just S”⁵⁴

Rutland 7/11 “Funding to support Care Homes to pay for this after September.”⁵⁵

Sandwell 35/86 homes responded

Salford 20/45 “Salford’s existing integrated commissioning arrangements together with our pooled budget provided a framework through which the Council, Salford CCG and Salford Care Organisation have been able to quickly develop a local financial support offer. We wrote to our care providers on the 27 March with this initial local financial support offer that included: • Funding to support pay for people who are unable to work due to Covid related issues, to reduce their financial pressure and likelihood of them working with Covid symptoms • Funding to support backfill at 100% of cost • Funding for additional PPE costs • Funding for additional staffing linked to Covid pressures • Block-booking of existing commissioned beds to increase market stability We will be further enhancing this local financial support using our share of the recently announced £600m to enable the adult social care workforce to receive 100% of their normal pay if they are unable to work during the Covid crisis. Salford will publish on our web site, information on how we have financially supported our care homes over this Covid crisis. Through this period the Council has maintained close liaison with local Unions who have played an important role in providing intelligence and constructive challenge in support of our collective aspiration to support the adult social care workforce through this crisis.”

“Salford is planning to update our local financial support offer to enable funding to be allocated to care homes for this purpose. This funding will be backdated to the start of the Covid period.”⁵⁶

Sefton 30/131 “Financial support model availible to help Care Homes meet the cost of additional staffing. Further engagement with the market needed. Please note 76 said no and 25 did not respond”⁵⁷

Slough: 9/16 providers responded “A reduction in demand for care homes and an increase in vacancies mean that some providers have concerns around financial sustainability and are not paying staff full wages whilst isolating.”⁵⁸

Solihull 24/64 “[Would like additional support to] enable this to be possible on a more long term basis”⁵⁹

South Gloucestershire “The LA is normally unable to mandate terms and conditions of private organisations, although good practice can be encouraged. However, we interpret the IPC fund allocation as being intended to cover this and can seek compliance within the funding arrangement. 4 care homes (all of which belong to the same group) did not answer this question but from previous recorded conversations we know that they pay SSP from day one. 1 home did not enter any data. All have been contacted to encourage responses.”⁶⁰

South Tyneside 16/34 “We will be working with the homes as part of the allocation of the infection control fund to ensure full payment of wages where required, for those homes who havent as yet paid full wages, those staff have been in receipt of statutory sick pay. No additional support is necessary as we can facilitate this locally.”⁶¹

Southend “Over 40% of Southend homes have consistently paid staff their full wages when self isolating and additional funding will move to 100%.”⁶²

St Helens 36/37 “Payments are being made on a block basis and the Council have moved to payment in advance arrangements for Care Homes where they have been happy to do this, easing cash flow concerns. The following is funded from the grant announced by the government for local authorities to support the costs of COVID-19 for providers:

• Staff who self-isolate due to Covid-19;
• Paying staff who are shielding due to Covid-19;
• Increased overtime and agency use to cover staff absences related to Covid-19;
• Supplying additional PPE to Care Home staff in line with government guidance;
• Any other reasonable additional costs associated with the provision of services. This includes funding training or releasing staff to attend Covid-19 related training.”⁶³

Stockton-on-Tees 19/53 “Additional IPC funding will accommodate”⁶⁴

Thurrock 16/29 “The risk of care staff returning to work whilst they should be isolating does not just relate to those who are isolating as a result of a positive test. The ‘ask’ should be broadened to include those who are shielding, and those who are selfisolating whilst waiting for a test aswell as those who have to self-isolate as the result of a positive test. There are a number of scenarios to be considered that includes zero hours workers and those staff who do regular extra overtime.”⁶⁵

Trafford “Sufficient funding to enable us to pass on funds to providers, to ensure stability and sustainability post COVID. Long term funding for Social Care to be addressed by central government – not as part of payments to the NHS. We have advised homes to pay staff required to isolate, however this information has not been collected and the expectation has been that they would be paying staff at least 80% of their wages. The Council is looking to make it a condition for care homes of receiving any additional funding from us following the latest government announcement re. infection control funding in May 2020. To support the care home sector, the Council has inflated the market prices for 20/21 through its inflationary uplift together with carrying out a rebasing of as decsribed in the FPFC executive report to the Council in Feb 2020; moved to payments in advance from March 2020 and payment on planned care for home care, block contracts for D2A, residential and nursing care, making additional increases to fee rates as a COVID payment in April following goverment funding announcements, and the introduction of a sustainability payment if care home providers drop below 90% occupancy back dated to April 2020.”⁶⁶

Wandsworth 22/34 “Care homes as employers report that one of the biggest issues they face in staff pay and the additional costs associated with staff sickness or having to self isolate (given SSP is very limited). Reliance upon limited Council funding will unlikely resolve this as an on-going issue.”⁶⁷

Warwickshire: 58/172 “WCC needs to engage with providers and Association of Directors of Adult Social Services (ADASS) partners to better understand the detail, scope and financial implications of this issue; ensure aligned messages (national and local) to help providers better understand available support and provide advice to individual care homes regarding strategic approach and managing individual situations.”⁶⁸

Wokingham 29/52 “Further financial support going forward to cover sickness costs for the care homes. We would expect that this additional funding will support providers to be able to carry out this task, should it not be their current practise.”⁶⁹

Worcestershire 46/179 “Infection Control Fund will support with this area. Financial support has been offered to homes through percentage increases and additional funding on a case by case basis, and workforce payments via IPC. There is ongoing work through the One Worcestershire business support offer to ensure homes are aware of and can access all available funding streams. ⁷⁰

1 https://www.newstatesman.com/politics/2020/04/care-workers-sick-pay-homes-coronavirus-deaths

2media.www.kent.ac.uk/se/11148/CareworkersHealthandSafetyreport15042.pdf

3 https://www.glasgowtimes.co.uk/news/18455805.glasgow-care-home-worker-says-poor-sick-pay-left-colleagues-terrified-result/

4 https://twitter.com/NadiaWhittomeMP/status/1257360719365971968

5 https://d3n8a8pro7vhmx.cloudfront.net/unisonnw/pages/2523/attachments/original/1591615573/NW_INTOUCH_June_2020_v2.pdf?1591615573

6 https://www.gov.scot/news/supporting-scotlands-social-care-workers/

7 https://www.unison.org.uk/news/article/2020/06/unison-welcomes-ni-pledge-covid-sick-pay/

8 https://www.gov.uk/government/publications/adult-social-care-infection-control-fund/grant-conditions-annex-c-of-circular

9 https://www.gov.uk/government/publications/adult-social-care-infection-control-fund/local-authority-circular-adult-social-care-infection-control-fund-ring-fenced-grant-2020

10 https://www.lbbd.gov.uk/sites/default/files/attachments/Care_home_support_for_LAs_Barking-and-Dagenham.pdf

11 https://beta.bathnes.gov.uk/sites/default/files/2020-05/Care_home_support_for_LAs_template%20BaNES.V3.ods

12 https://www.bexley.gov.uk/bexley-covid-19-care-home-support-implementation-status