Robin Swann
North Antrim · Ulster Unionist Party · Northern Ireland
“I thank the Minister for his detailed statement. I know how passionate he is about the subject and how many times he has brought it to the Executive.”
“It has been reported that today will potentially be the warmest day of the year. As we move into the summer and our summer holidays, I want to raise public awareness of wildfires across Northern Ireland, which have been detrimental to farmland and our environment over the past number of years.”
“Wildfires are still having a detrimental impact on our environment and, occasionally, on livestock, but that reduction shows the impact of the Northern Ireland Fire and Rescue Service's proactive approach to educating the general public and engaging with rural communities and schools on its fire safety message, which is to stay alert, not…”
“There has been a lot of talk of sport in this place over the past few days, with everybody concentrating on UEFA. One sport that is going on across Northern Ireland at the minute is cross-community and goes across all age groups without fear, favour or distinction: pigeon racing.”
“I want to put on record that, since this place passed the amendment that recognised pigeon racing as a sport under the 2016 Act, over the past five years, pigeon racing clubs across Northern Ireland have been able to obtain £113,000 of rates rebates through the sports and recreation rate relief, allowing many of those clubs to continue ra…”
“There was much coverage on social media over the weekend of an incident in Staines in England, in which a police car rammed a young calf to bring it under control. It has restarted the conversation about animal cruelty. <BR /> <BR />I am dealing with a specific case in my constituency.”
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“That is a challenge for us all in the House, as it is an issue that transcends party politics.”
“<BR /> <BR />In conclusion, I express my sincere gratitude to all care home staff, working at every level, for their dedication and the professionalism that they have demonstrated during the pandemic. I also reiterate my thanks to the Health Committee for the report. There is much learning to be done and many improvements to be made to allow us to fully support this vital sector. I remain fully committed to supporting the sector, and I believe that there is a general acceptance that care homes and the wider social care sector have not been afforded the priority that they merit. That has been the case in jurisdictions across these islands for years, if not decades. The pandemic has shone a harsh light on the importance and vulnerability of the social care sector. We have to start making things better through reform and investment.”
“RQIA continues to provide support and advice to care homes, and I appreciate the Committee's recognition of the difficult decisions in this area. It is important that RQIA focuses its activity where it is most needed. Following an assessment of all the risks, I am confident that RQIA will continue to take a pragmatic and flexible approach to how and when inspections are made. <BR /> <BR />The Committee has made recommendations in relation to pandemic preparedness, and I will consider carefully all the issues that have been raised. My Department has established an adult social care governance surge planning group, which is co-chaired by the Chief Nursing Officer and the Chief Social Worker.”
“ACP decisions will be activated whenever the person cannot be directly involved in decision-making about their treatment and care because of a lack of mental capacity or where they are unable to communicate what their wishes are. Advance care planning is an important part of palliative care. It has been and continues to be a key priority for the Palliative Care in Partnership programme. As the Committee is aware, I have commissioned the development of an advance care planning policy for adults in Northern Ireland. <BR /> <BR />With regard to regulation, it has been an extremely challenging period for everyone across the Health and Social Care system. All decisions concerning the role of RQIA in the Health and Social Care response to the COVID-19 pandemic have been made with the safety of services at their heart.”
“I confirm that a programme of work led by the Chief Nursing Officer is under way to address the recommendation, and the enhanced clinical care framework will embed the standards being developed for a regionalised model of acute care at home service. GP participation is inherent throughout the development of the model and in the delivery of its aims. I acknowledge that there are potential resource costs with regard to staff funding, and that will be considered in due course. <BR /> <BR />I have noted the report's contents in relation to advance care planning (ACP), and I appreciate that it is an issue that has been raised over the pandemic period. I recognise that ACP is voluntary and empowers a person to talk about what matters to them in their living and for when the time comes that they are dying.”
“<BR /> <BR />Work has commenced on the Chief Nursing Officer's Delivering Care programme to review staffing levels across care homes. I fully agree that efforts must continue to be made to minimise staff movement between homes and note that the Public Health Agency (PHA) has provided clear guidance for bank and agency staff on that issue. However, we must not forget to acknowledge and commend what was working and continued in the midst of an ongoing pandemic, for example, acute care at home teams. However, it became clear that we needed to harness that good practice and work towards reducing variance across the region. I expect to see the benefits for residents as a result of the review of the regional acute care at home models and how they provide support to care home residents.”
“The reform work being undertaken by the Department has now created a new opportunity for social care workers to gain a social work degree, and that has been successfully implemented in conjunction with the Open University. That goes some way towards dealing with some of the issues raised in Mr Stewart Dickson's contribution. <BR /> <BR />A workforce strategy for social care is also being developed, and I will look at issues including training, continuing professional development (CPD) and career pathways for the workforce. In addition, a media awareness campaign to promote the value of social care and to support recruitment has been commissioned and will be delivered by the Northern Ireland Social Care Council (NISCC).”
“I said to the Member in response to questions earlier that I would rather have provided that financial support to enable visiting and make sure that staff had the provision of PPE rather than waiting for some of those companies looking to their reserves or dividends to pay for that. That is ongoing work. Many of those care home providers — I will not name any — need to look to their conscience and their board of directors as to where they see the value. Is it simply in the return to their shareholders or in the protection of their staff and residents in that sector? <BR /> <BR />As well as the ongoing measures regarding pay and conditions for our social care staff, I have asked officials to develop proposals relating to the development of improved career opportunities for the social care workforce.”
“I also look forward to the support of the Members who made similar calls during the debate. Ensuring that colleagues in care homes receive the recognition payments that I recently announced is another part of ensuring that we recognise the contribution that the sector makes. I will, of course, carefully consider the Committee's recommendation that financial support for care homes is linked to improvements in terms and conditions for their workers.”
“The Assembly will be well aware of my commitment to improving pay and terms and conditions for the social care workforce. I have asked my officials to develop a business case with options for improving low pay for social care workers who are employed by independent sector providers. That, along with improvement in training and career pathways, is in line with the key objectives for that reform, as was proposed in the expert panel's report, 'Power to People: proposals to reboot adult care and support in NI', which was published by my Department in 2017. It is clear that that will require a significant, recurrent financial commitment, and I will seek the support of colleagues across the Executive and the approval of funding from the Department of Finance.”
“As the Committee recognises in its recommendation, we need to balance administrative overheads with requirements for appropriate audit and verification. I remain concerned that, in some important areas, such as enhanced sick pay, care home providers choose not to utilise the funding that is available. Our trade union colleagues have raised their deep dissatisfaction on that point, and I share their dismay. Care home providers may wish to explain why some of them provide enhanced sick pay while others do not: I cannot explain it. <BR /> <BR />I was pleased to see the Committee acknowledge the skill and value of the work in care homes and the personal qualities shared by many for whom it is a vocation rather than a job and the need to look at recognition, reward and retention in what is a challenging environment: I could not agree more.”
“<BR /> <BR />Funding support for care homes was another area where we took early action. We guaranteed a level of income for care homes at an early point to minimise the impact of vacant beds and to provide certainty. As far as I am aware, Northern Ireland is the only part of the UK to have guaranteed income in that way. Additional funding has been made available to address the additional costs faced by homes. In April, I announced an additional £6·5 million. That was followed by further packages, including an additional £27·3 million in October. Officials and health and social care staff have continued to work closely with care home sector representatives on the process for claiming funding.”
“<BR /> <BR />I fully support the Committee's view that training remains critical and all staff should be able to access regular and prompt updates as new knowledge and innovations emerge. My Department has made available videos and training through both the Clinical Education Centre (CEC) and the Northern Ireland Social Care Council (NISCC), for instance, which focuses on infection prevention and control (IPC) and PPE. In addition, there are programmes from the CEC aimed at those staff who do not regularly look after respiratory patients and/or have limited or community-based experience, alongside a number of clinical skills-type programmes to support staff who deal with respiratory patients. CEC programmes relating specifically to COVID-19 are open, free of charge, to all sectors.”
“<BR /> <BR />We took an early decision in March 2020 that trusts should make PPE available to care homes without charge. Other nations have now followed that approach. We continue to provide millions of items of PPE to care homes without charge. Cumulatively, up to the weekend of 22 January, 85 million items have been provided to care homes in the independent care sector, with an estimated value of approximately £26 million. Funding has also been made available to support care homes where they have continued to purchase their own PPE. Trusts will continue to work with nursing and residential homes on the provision of appropriate PPE without charge where they are unable to source their own supplies.”
“Discharge policy is an area that we continue to keep under active consideration. We want to protect care homes from any risk of infection and ensure that residents are not held in hospital, with the risk that that creates for them, any longer than they need to be. The Assembly will be aware that it remains the case that individuals who are discharged from a hospital to a care home should be tested for COVID-19, ideally 48 hours before discharge, and be subject to 14 days' isolation on arrival. I hope that the research undertaken by Dr Niall Herity and published by my Department has helped to ensure that there is informed debate in that area. The survey that was undertaken by the Committee as part of its work is a further addition to that.”
“Consequently, if a care home advises that there is a requirement for a care partner to be tested for COVID-19, that will be undertaken through the regular care home testing programme. We are progressing work on a number of new testing interventions (NTI), including a care home NTI, which has recently commenced using lateral flow devices to support the visiting policy in care home settings. I am also pleased to say that all Northern Ireland's 483 care homes have been visited by our vaccination teams, and, by the close of play on Saturday evening, 410 had received their second visit. Care homes are the number-one priority in the Northern Ireland vaccination programme.”
“The requirement to vary the frequency of testing undertaken is kept under active review and is informed by emerging scientific evidence and other factors, such as local community transmission rates. My Department remains fully committed to supporting and taking all necessary measures to ensure that care home residents and staff are protected. In that context, officials will continue to carefully consider how new and emerging testing technologies can be implemented and extended more widely across a range of care settings in the future. <BR /> <BR />In January 2021, the Department further extended its COVID-19 testing policy to make provision for testing to be accessible to designated care partners.”
“We have been clear that that is an area that the RQIA will consider when assessing homes. It is also an area where we have made significant additional funding available, with £9 million allocated on top of previous packages. <BR /> <BR />Whilst recognising that the risk of transmission will be increased with any rise in footfall in care homes, we have sought to put in place a risk-based, sustainable approach to supporting residents and loved ones to have meaningful connections, in particular where isolation is detrimental to a resident's physical and mental health. That will be an area on which we continue to focus, giving careful consideration to the Committee's recommendations. <BR /> <BR />Regular testing in care homes has, undoubtedly, reduced the impact of COVID-19 during the second wave of the pandemic.”
“Like the Committee, I believe that, as a health and social care system, we must continue to facilitate and find creative ways of supporting people to have contact with family and friends. That includes the use of virtual visiting and other innovative ways to maintain contact. Those should supplement traditional visits, and we recommend that they happen weekly and more often in end-of-life and palliative care circumstances. <BR /> <BR />We continue to work with the care home sector and families on the implementation of the care partners initiative. Most other parts of the United Kingdom have recognised the need for schemes of that kind and have followed our lead. Officials are continuing to look closely at the implementation of visiting and care partners in care homes.”
“Probably more than in any other area, trying to find the balance between protecting life through reducing the transmission of the virus and ensuring good quality of life has been most difficult. I note that the Committee states in its report that that was "perhaps the most emotive issue" that it dealt with and that there are "no easy answers". I very much sympathise and empathise personally with that position. I also note how hard many care home staff have worked in order to protect residents whilst maintaining their quality of life. <BR /> <BR />We want to continue doing everything that we can to keep those who are most vulnerable safe, but we also know that keeping older and more vulnerable people away from contact with their loved ones is hugely detrimental to their physical and mental health and, indeed, to their human rights.”
“However, today I can provide the Committee with an assurance that I will consider each of the areas that are discussed in the report, with a view to taking forward, as appropriate, relevant measures that are suggested. <BR /> <BR />The report provides suggested recommendations for improvement in a number of areas. I do not propose at this point to go into detail on each of the recommendations, but I would like to provide you with some of the key actions, either planned or ongoing, to assure you of my commitment to support the care home sector, its staff and its residents. <BR /> <BR />First, I acknowledge the detrimental impact that COVID-19 has on residents and their loved ones. Care home residents rightly view care homes as their home, where they maintain connections to families and communities.”
“I fully recognise the resilience of staff working across the care sector right from the start of the pandemic through to now during these continuing challenging times. <BR /> <BR />Key learning from the first surge of the pandemic was the requirement to work together in partnership across the independent and statutory sectors in order to seek solutions to the pandemic response. COVID-19 did not respect any boundaries between those sectors. <BR /> <BR />As I am sure the Committee will appreciate, the level of detail in the report and the number of recommendations are substantial, and my Department will require time to fully consider each finding and how we can best address them. A report of this nature deserves such a considered response.”
“We have done that through the provision of guidance, dedicated support teams, huge quantities of free PPE, additional funding and income support, testing for residents and staff and the deployment of health and social care staff into care homes. There are undoubtedly lessons to be learned and improvements to be made, and I thank the Committee for producing the report and for providing my Department and the wider health and social care sector with opportunities to learn and improve. <BR /> <BR />I reiterate my appreciation of those in the care home workforce throughout Northern Ireland for the dedication and professionalism that they have demonstrated during the pandemic. Care home staff play an essential role in looking after some of the most vulnerable people.”
“I will begin by passing on my sympathies to all those who have lost a loved one during the pandemic. I also welcome the publication of the Health Committee's 'Inquiry Report on the Impact of COVID-19 in Care'. <BR /> <BR />Care homes illustrate more than anything else the tightrope that we have to walk in order to balance quality of life with protecting life. We want to do everything that we can to keep safe those who are the most vulnerable. From the beginning of the pandemic, I have been clear that supporting the work of the care home sector has been an absolute priority for the health and social care system.”
“I want to be clear to the Member: this is one of the payments that has proven the most difficult for us to progress due to how we might establish the definition. I have a meeting tomorrow afternoon with a number of carers' organisations on how we define that role, where we take the register from and how we progress the payment. It is something that I will have to get back to Members on. I will also go to the Member's party colleague the Minister for Communities to see whether there may be something that we should do jointly so that we recognise those who provide unpaid care and make sure that we get that recognition to them.”
“One thing that the Minister of Education has never done is push his way into my Department or any of my announcements, so I will do likewise. However, I will say that an intense piece of work has been done on the issue, even over the weekend. I commend officials from both Departments who have been working on this to bring a resolution regarding what staff within special schools could receive a vaccination.”
“Those staff members are the responsibility of the Education Minister, so I will leave it to him to make that announcement.”
“As I indicated in an earlier answer, my Department, the Department of Education, the Education Minister and I spoke about this at 10.00 pm last night. There is ongoing engagement on the support that we can provide in the vaccination programme, keeping within the confines of the Joint Committee on Vaccination and Immunisation recommendation and vaccinating some special school staff. I will leave it at that. That ongoing work should lead to a joint announcement some time today, if not tomorrow, on how that work has progressed.”
“Again, I have not previously considered that. It has not been in my train of thought or come across my desk. We are looking into how care homes and what they provide are being regulated. If it comes up in the discussions or is brought forward in the review of regulations or the decision-making process, I will certainly take cognisance of it. I am not currently working on that.”
“I am unwilling to comment on any specific individual who sought employment after leaving the employment of the RQIA. It is not an area that I want to get into in the Chamber.”
“The Member raised this in his contribution to the debate earlier. He challenged me on how much free PPE we gave to care home providers that make extensive profits, even during the pandemic. I would rather supply them than see the workers and residents go short of the PPE that they need. The Member has heard me say that there is a piece of work on the regulation and conduct of some of those care home providers. It looks at how they support residents and staff; how they support the families of the residents to access their loved ones; and how to ensure consistency of approach to and support for all residents, no matter what home it is or who owns it.”
“I thank the Member for his question. He raised that point in his contribution to the debate earlier today. Due to the associated costs, we have not actively looked at that. Even with our political differences, the Member knows how much I support the people working in those homes. I have often said that care homes are the Cinderella service of our healthcare service and that they need more recognition. My senior social worker is leading a significant piece of work on some of the recommendations in the Committee's report. I asked for that ongoing work to be brought forward to make sure that people working in care homes are valued, appreciated and recognised.”
“I am certainly supportive of the two-island approach to hotel quarantine, specifically working on a five-nations basis to progress that. There will be a quad meeting this afternoon between us, the Secretary of State and Ministers from the Republic of Ireland, at which, I am sure, that issue will be raised. The Member will be aware that there were concerns about the sharing of data and information on passenger locator forms. That work is still ongoing. We hope that there will be a resolution as to how that data can be shared. The Member knows that, if we do not get that information from people landing at Dublin Airport, there is a weakness in the steps that we take in Northern Ireland, so we need a two-island approach, as he rightly acknowledged in his question.”
“As I said earlier — the Member picked up on this — I have not heard the conversation and nor do I know what the announcement is about door-to-door testing for that variant. We have good communication among all the Departments across these islands about what is happening and specifically about the different variants as they present themselves. As I said to the Member who asked earlier, I will check up on that as soon as Question Time and the debate that follows it are finished.”
“As the Member will know, due to the working arrangements of this place and our Executive, I cannot directly contact Finance, Treasury or the Department for Work and Pensions. It has to go through the relevant departmental officials and the relevant Ministers. I am aware that the Communities Minister and the Finance Minister are supportive of making those approaches to make sure that as much of that money as possible reaches the pockets of those for whom it is intended.”
“I will start with the Member's second point. The student recognition payment will cost in the region of £7·5 million. The £500 payment for directly employed Health and Social Care staff will cost roughly £44 million. We have set aside £10 million for primary care and approximately £15 million for the independent care sector. However, as I said in earlier answers, the latter, especially, is subject to change, given the breadth of work and partners involved and the engagements that we are having with stakeholders. <BR /> <BR />As regards communication, I have been in contact with the Finance Minister and the Communities Minister, and both have responded positively to say that they will engage with their Westminster counterparts to see what can be done.”
“I thank the Member for his question. It is a valid one, considering the extent of our health and social care family across Northern Ireland. At this stage, I am looking at approximately 3,850 students, almost 75,000 directly employed Health and Social Care staff, 33,500 independent sector care workers and about 20,000 others, including those in primary care and community pharmacy.”
“Conversations have been ongoing between my Department and the Department of Education with regard to staff working in special schools who fit or may fit the criteria that align with the caring roles of domiciliary care and hospital workers. If their role closely aligns to that recommended by the JCVI, we will move in that direction.”
“I thank the Member for raising that topic. One of the clear directions from the JCVI is the direction of travel and the priority risks especially to those higher groups. That is why we have been strict and stringent as to the phases that we have taken — phase 1 and phase 2 — in our vaccination programme. The Member has seen that; it has been widely publicised and has been brought to light and communicated through the Health Committee. <BR /> <BR />With regard to accessing different priority groups as they come, the JCVI is currently working on that. We are led to believe that it is looking at the risk base of certain professions for once we get through those age groups and the clinically extremely vulnerable. <BR /> <BR />The Member mentioned special school staff.”
“I encourage anyone who is not registered with a GP to make themselves known to their local GP or to get in touch with the Health and Social Care Board. There is no danger or harm in being registered with your local GP, outwith the provision of the vaccine. People who are in hospital will not fall through the cracks, because GPs, working with the hospital clinicians, will make sure that they are put onto the vaccination list and are covered.”
“I thank the Member for his question. There is work going on with regard to stakeholders in the independent sector, as to how we carry forward that recognition payment so that it can be properly utilised and get to the people who are the most deserving.”
“This is not the experience that I would have hoped for for expectant mothers, and I recognise that it is an anxious time for all families. Many difficult requests have been made, and will continue to be made, of the public in all aspects of health service provision, in order to reduce the spread of infection and to protect expectant mothers, their families and the staff providing the care.”
“The decision to admit visitors to a facility on a day-to-day basis will still lie with the nurse in charge and be based on a risk assessment and the ability to ensure social distancing and the safety of patients and visitors.”
“I thank the Member for her question. I also welcome her to the Health Committee and look forward to working with her. <BR /> <BR />The updated visiting guidance that came into effect from 15 January outlines that the specific restrictions for each care setting are aligned to the pandemic surge levels and the R value. The R value represents the risk of the virus spreading from one infected person to another on average. The guidance is based on the best scientific advice available at any given time. Northern Ireland is currently in surge level 5, the guidance for which states that:”
“I want to put on record my thanks to those homes that are doing extra work to make sure visiting can proceed safely and with less risk — it will never be risk-free — than in some of the homes. The Chief Nursing Officer and the Chief Social Work Officer met the Patient Client Council and a number of families' representatives in the last couple of weeks about that ongoing work and engagement. They discussed some of the particular difficulties in certain homes and regions and the way in which the offer of support and encouragement from my Department to facilitate visiting for families and residents is taken up.”
“I thank the Member for that critical point. We have been doing a piece of work that has been led by the Patient Client Council (PCC). It is about supporting families who have experienced difficulties in accessing homes that use the Department's guidance and have been implementing the care partner arrangements. We have asked the Patient Client Council to lead that work as an independent body interacting between the Department and the families who have been affected. There are some very harrowing stories, and I am sure that most Members have heard about that through their constituency offices. <BR /> <BR />However, there are many examples of good practice from good homes as well.”
“Nevertheless, there is an appreciation of the right to a family life for those living in care home settings and, in particular, an acknowledgement of the critical importance of sustaining relationships between residents and their families and friends at this time of the year. It is clear that a significant number of families feel that they have not been able to visit their relatives or set up care partner arrangements in line with regional guidance. <BR /> <BR />Some of the stories that families have told are deeply concerning. We know that the stories do not reflect the sector as a whole. I appreciate how hard many homes are working to facilitate both the care partner concept and safe visiting arrangements between residents and their friends or families.”
“<BR /> <BR />Health and social care trusts have been asked to work with care homes to provide the support they may require to move forward with risk assessments that facilitate safe, managed and meaningful visiting arrangements and the implementation of the care partner concept. In addition, the Public Health Agency is working with relevant stakeholders to continue to support the processes for implementing meaningful visiting and the care partner concept. <BR /> <BR />I fully understand why some care homes remain cautious about implementing both visiting arrangements and the care partner concept because of their experience of managing the transmission and impact of COVID-19.”
“I thank the Member for her question. It remains the position of my Department that care home visits can be safely facilitated through compliance with the regional principles for visiting in care settings that are clearly set out in the existing guidance. We encourage all involved to work together to ensure that care home residents can avail themselves of visits from their friends and families while maintaining a safe environment. The decision to permit visitors into a care home and how that is organised remains the responsibility of the care home manager. The discussions should be based on a dynamic risk assessment that takes into account the particular circumstances of the individual care home to ensure the safety of all residents and visitors.”
“I thank the Member. To be quite honest, before coming into the Chamber, I had not heard of door-to-door testing for the variant. Her party colleague Robin Newton raised it as soon as he and I sat down, because he had his ear to the ground. We will follow up on the utilisation of our testing centres when considering how we best position them. If door-to-door testing is being used in a region, I would be concerned that that is because there has been a breakout or a hotspot of the variant in that area. Fortunately, we have yet to see that in Northern Ireland.”