Almost 1,000 vulnerable people in Norfolk are not having their care needs fully met, as widespread rationing is introduced in the under-pressure system which supports them.
Norfolk County Council says that there are currently 870 people on its 'interim care list' - indicating their needs are not being fully met - and that the situation is getting worse.
It has been forced to ration the care it offers, because its resources are so stretched, and is using volunteers - including from County Hall staff and Voluntary Norfolk - to carry out welfare checks on some people in need of care.
That is because the numbers of home visits they receive from care workers have been reduced, as staff are needed to help others, or they are isolating due to sickness.
There are 220 people in Norfolk's hospitals who have tested positive for Covid.
And, with 112 outbreaks in the county's 350 plus care homes, county council social care bosses are also struggling to find providers with beds and staff to take in people, including those discharged after hospital treatment.
Kelling Hospital is serving as a 'step down centre' for people coming out of hospital, while the council's in-house service Norfolk First Support is providing extra help in people's homes.
But with 870 people on the interim care list, James Bullion, the county council's director of adult social care, said it was a difficult time and was worsening.
Pre-Covid that list would have been closer to 150. And the high number is despite the council commissioning thousands of extra hours of home care.
Mr Bullion said: "Although Covid cases are coming down, we are still experiencing a growth in people with interim status as a result of more people being discharged from hospital or due to sickness and isolation among care staff."
Some of the people on that list, which is reviewed each day, might be being supported by carers, families or Norfolk First Support while longer term care can be arranged.
And Mr Bullion said staff were having to make judgements, including rationing care.
He said: "We look at them on a case by case basis and we make sure we get care for those with the most urgent needs.
"But we have prioritised care for the purpose of rationing. We have looked at where we could reduce some care, so we can offer it to other people.
"That is a very time limited approach and cannot go beyond the current crisis.
"What we have been saying is where a person who is visited by care workers at home, say four times a day, could have that number cut to three.
"And then that might enable care for someone who is still in hospital or who is at home but has not got care."
Mr Bullion said 150 volunteers from Voluntary Norfolk, plus others from County Hall, were stepping in to carry out welfare checks in place of the reduced care worker visits.
He said that could mean they would slot in where, for example, a lunchtime care worker visit was stopped. The volunteer would check on the person and ensure they had some lunch.
Mr Bullion said the council had used government grants to incentivise the care market, increasing what the council pays from £19.68 an hour to £25 an hour.
But, with a further 2,500 people on a holding list awaiting full assessment, Mr Bullion said a long-term solution needed to be found.
The people on that holding list are waiting for full assessments, reviews or for decision on deprivation of liberty orders.
Mr Bullion said: "Because we are doing all the urgent and interim work, we are building up a backlog."
He said the council was contacting those people every two weeks, but conceded some could have to wait - and potentially for over a year - to be fully reviewed.
And this all comes against a backdrop when the Covid-19 pandemic has contributed to falling standards of care in the county's care homes.
Mr Bullion said: "Quality has got worse and Norfolk is the poorest in East Anglia for purchased social care. It is getting really concerning.
"It is going to take a major workforce initiative to improve that. That's really a financial question that leaders across Norfolk will need to tackle."
At that meeting, the council agreed to bring in a consultancy firm - at a cost of more than £6m - to help transform the way Norfolk looks after vulnerable people.
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