A leaked letter seen by the BBC has revealed an extensive list of concerns about how the social care sector is coping with the coronavirus crisis.
The letter raises fears about funding, testing, personal protective equipment (PPE) and the shielding scheme for vulnerable people.
Written on Saturday, to a senior official at the Department of Health and Social Care by the Association of Directors of Adult Social Services (Adass), it says mixed messages from the government have created "confusion and additional workload".
On protective equipment for care workers, the letter says the national handling has been "shambolic".
Early drops of equipment have been "paltry" and more recent deliveries have been "haphazard", with some even being confiscated by border control for the NHS.
The letter says there have been contradictory messages from the Department of Communities and Local Government and the Department of Health on the shielding scheme for people particularly at risk from the illness.
And while the rollout of testing for care workers has been generally welcomed, the letter states "testing for care workers appears to be being rolled out without being given thought to who is going to be tested and what we are going to do with the result".
Adass is a charity that supports members from all 151 local authorities in England with responsibility for adult social care.
The organisation is also critical of the way central government has recruited volunteers, saying the national scheme has "diverted 750,000 volunteers away from supporting local communities and left them with nothing to do for the first three weeks", and claiming it was "shameful that this was not done in collaboration with local government".
While the letter, also reported in the Local Government Chronicle, welcomes some of the guidance given by Whitehall, it raises significant concerns about the interaction between central government and local government.
It suggests the sector had to make "invidious decisions before the pandemic" and now is not being given the same consideration as the NHS.
"We are very concerned that there is a significant imbalance between listening, hearing, and understanding NHS England as opposed to social care," it says.
The social care system helps and looks after older and disabled people in residential centres and in their own homes. There are more than 400,000 residents in care homes in 15,000 locations in England.
Action plan scepticism
Adass has broadly welcomed the health secretary's plan to help social care, which was announced on Wednesday.
Matt Hancock announced that all care home residents and staff with Covid-19 symptoms will be tested for coronavirus, as well as any new care home residents being discharged from hospital into care.
But senior figures in the care sector say there is scepticism about whether the commitments can be delivered.
Responding to Mr Hancock's announcements, Adass said: "We now have a national strategy; the challenge is now to implement it. Any strategy will ultimately be judged by actions it produces, not words it contains."
Speaking to Radio 4's Today programme, Mr Hancock said: "It's absolutely true that we need to do more - that's why we put the next stages of our action plan out... so we can test all people going from hospital into care homes."
He said that 15% of care homes in the UK have two or more cases of Covid-19.
When challenged on that figure - one care home boss, for example, says two thirds of his homes are infected - Mr Hancock said it was a "robust figure".
He told BBC Breakfast that "what really matters is availability of testing now in social care" where he said more than 10,000 tests of residents had been undertaken.
Mr Hancock also said his latest figures showed 1,500 care workers were tested on Tuesday, while 4,100 workers have the test "immediately available to them".
'Ramping up testing'
A spokesperson for the Department of Health said the government's plan in England included "ramping up testing, overhauling the way PPE is being delivered to care homes and helping to minimise the spread of the virus to keep people safe".
"We will continue to work closely with the social care sector to ensure they have everything they need to respond to this outbreak and receive the recognition they deserve," they added.
The government has also said it is "committed to ensuring that all areas have access to PPE" and is "working round the clock" with industry, the NHS, social care providers and the army to ensure supply.
It said 38 million items of PPE had been delivered to local resilience forums - multi-agency groups of emergency services and agencies - since last week.
Labour's shadow social care minister Liz Kendall said the concerns raised in the letter were "extremely worrying".
"Their view that the supply chain for PPE has been shambolic and that testing for care workers hasn't been properly thought through must be an urgent wake up call for ministers," she added.
"Coronavirus has exposed the already fragile state of these vital services. Ministers must heed the warnings from Adass and take all necessary to halt the emerging crisis in social care."
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