Care Home Life – Working with the threat of COVID-19
We have been talking to many care home operators over the last few weeks about their experiences in continuing to provide a caring supportive environment to the people that live in their services.
To say that the Care Homes are providing an amazing service is an understatement. The dedication of staff is phenomenal, awe inspiring and beyond selflessness. We have been truly humbled by the way in which services have adapted to constantly changing advice from Government, Local Authorities, CCG’s, GP’s, all of whom have struggled to provide a consistent message, leading to confusion, frustration, even outrage at times, as the care home industry has come under attack from all directions. Yep despite this, they continue to deliver care to some of the most vulnerable people in our society for little in the way of recognition. It is but a few short weeks ago, that they were considered some of the lowest skilled workers. Suddenly they have become an essential service; in our opinion they have always been an essential service.
Obtaining adequate PPE (Personal Protective Equipment) has been a challenge for all providers often due to a lack of availability, although we have seen some unscrupulous suppliers increase costs of basic items, which has particularly affected smaller providers as they are neither able to purchase in bulk, or store larger quantities. PPE is getting through, and being appropriately used, but some of the initiatives referred to, are not always reflected on the ground, and it is a constant battle to obtain stock.
Obtaining basic provisions for staff working in care homes has been a challenge, as they are not part of the NHS, and therefore not considered an essential service by many supermarkets. We have heard of staff being turned away from stores, when trying to shop for residents to be able to have meals. Surely this is not an acceptable situation, and it has certainly caused considerable upset and distress when they are simply trying to do their job and care for residents. This has been particularly prevalent in smaller providers, who are not able to make use of commercial catering suppliers as their purchasing power is insufficient.
Today, we have heard about hospitals wishing to discharge residents to care homes, but they are failing to test all patients prior to transfer, and then continuing to care for them until test results are known. Care Homes are having to advise hospitals of this requirement, and are reporting having frustrating conversations with discharge co-ordinators, who are not aware of the announcement by Matt Hancock last night in the PM’s briefing. Discharging a Covid 19 positive person to a care home is inappropriate, but providers have felt pressure to accept people without being able to reassure themselves of the risk, leading to a period of enforced isolation for the new resident, whilst a quarantine timeframe is observed. Providers are understandably unhappy about having to do this, in order to protect other residents, but the lack of testing means they have no reasonable alternative.
From this week, the testing of care home staff suspected of having Covid 19 is now available and being co-ordinated by the CQC. Often however, the testing centre is some distance away from the care homes, and these very staff are often those without their own transport, and struggle to get there. Many staff are self-isolating from work with potential symptoms to protect the residents in their care, but have been unable to source a test, meaning that service providers have struggled to maintain appropriate staffing levels. We have heard of a number of care home staff that have moved into live with the residents to minimise the risk of inadvertently passing on Covid 19 from outside. This means leaving their families behind to protect them and the residents that they care for. Staff are having to share bedrooms in makeshift accommodation, but their overriding concern has been towards the residents, and making sure they are cared for.
Overwhelmingly, providers have sought to ensure that residents remain active, stimulated and lead a fulfilling life. We have seen many examples of innovation and invention, use of technology, and creativity to help residents remain connected to families and friends. Providers have found ways to ensure that those residents at end of life have been able to receive visitors (dressed in appropriate PPE) by adapting routes through the home, moving bedrooms to ground floor areas (with consent) to facilitate easier visiting, whilst maintaining strict hygiene measures.
Without a doubt, the stress of working in a sector that for far too long has been overlooked is without parallel, and it is interesting that it is only in the last few days that the government has finally started to acknowledge the tremendous contribution to care that the sector makes. In the main, the staff deliver exceptional levels of care to vulnerable people. Yes, there are occasions when things go wrong and lessons must be learnt from them to prevent it ever happening again. Care home staff should be applauded for the work that they do, supported with training to help them deliver excellent care, and be paid an appropriate wage. We are starting to see the recognition and some of the training, it remains to be seen if the purchasers of care are prepared to pay the true cost of care and help the sector to develop further.