Today was COVID Vaccination Day at The Croft Residential Home, marking a major milestone in a tumultuous year at the home.  Like everyone else in the social care sector, we hope the arrival of the vaccines signals the beginning of the end of the worst of the challenges created by the COVID-19 virus.  But we are worried the under funding plight of care homes will sink back into obscurity after the COVID pressure has eased.  

As well as the horrendous death toll among care home residents, another significant problem has been the impact of isolation of elderly residents from their loved ones.  Most residents at The Croft have not been in the same room as their nearest and dearest for almost 12 months.  And, in many cases, this has really taken its toll in terms of their mental and physical well being.  All the hugs and love from our team of dedicated carers can’t make up for time with family.  Like many other care homes, we’ve done our best to provide access via window visits and Zoom calls.  And we had high hopes when the rapid Lateral Flow Device (LFD) tests were first announced for visitors, which enabled us to test people just before entry.  But concerns about the accuracy of these LFD tests called into question whether it was sensible for us to make decisions on admitting people on the basis of their 50/50 reliability.   

Having experienced an outbreak in April 2020, including the loss of one resident to COVID-19, we are perhaps more cautious than other care homes.  So we have not been prepared to admit relatives on the basis of these tests and we have only reluctantly complied with the Government’s requirement to use these LFDs with our staff each week.  LFDs are known for both false negative and false positive results.  The last thing we want to do is send staff home to isolate for up to 10 days on the basis of a false positive.  Or have a carer potentially let their guard down with their PPE after a false negative result.  So we are proceeding with extreme caution in our application of these tests, as highlighted in this recent article by BBC Spotlight. 

 The Croft On BBC Spotlight in January 2021

Our participation in several BBC South West care home stories on television, as well as featuring in local and national radio, has been part of an effort to help highlight the plight of all care homes during this pandemic, as well as advocating for more systemic change in the social care sector.  Slow release of the extra funding necessary to help cover all the additional infection control costs, plus massive over-promising and under delivering by Central Government on PPE supplies and testing in the first six months of the pandemic, have now been resolved.  But problems of chronic underfunding of social care and the issue of low pay for dedicated and heroic carers continue to be ignored.  Indeed the Government has used its preoccupation with the pandemic response as an excuse for not dealing with these issues, despite Boris Johnson and others highlighting the need to “fix social care” as a top priority on the doorstep of number 10 back in the summer of 2019. 

We are left to hope now that the arrival of the vaccine heralds the banishment of our most pressing issues at The Croft.  We are looking forward to admitting relatives again, once the second vaccines have been issued and a significant level of immunity achieved.  It’s likely PPE will be an ongoing feature in the home for many months, if not years, but at least residents will be able to hug their loved ones.  The vaccination should also help create some peace of mind for our valiant carers, many of whom put their own health and life at risk to look after vulnerable people during our outbreak last year.  The COVID-19 death toll for social care workers stood at over 100 by the summer last year, and more recent figures are hard to find.  But the outstanding commitment of all social care staff should not be forgotten now that the threat level is easing. 

Which brings us again to the chronic underfunding of social care.  According to the Kings Fund, an influential charitable organisation working to improve health and care in England, unless there is a radical change in approach to improving the funding of social care, there will be further rapid decline in the provision of social care while demand increases.  Care homes will continue closing and those left will continue to struggle to attract staff, who can now earn much more working in supermarkets and distribution centres. 

Will the arrival of the vaccine and a reduction of the COVID related pressures on social care mean the media spotlight turns elsewhere, providing further scope for the Government to procrastinate on delivering reform?  If so, the implications for our vulnerable elderly and their families will be profound.  Families will be left with loved ones they are ill equipped to care for, while those without a support network will languish in their homes, if they have one.  These issues may not be as acute as the COVID-19 death toll in care homes, but the impact on the quality of life and life expectancy of our ageing and vulnerable could be as significant.

Unfortunately, we think this scenario is still quite likely.  In which case, like many others in the sector, we will continue to do all we can to continue highlighting the plight of the sector and those who depend on it, while we also prepare to reopen our doors to our residents’ loved ones! 

Simon is co-owner and Registered Provider of The Croft Residential Home in Newton Abbot, Devon, as well as owning other small businesses.  He is a Fellow of the Royal Society of Arts.

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