We are starting to, but the impacts will be enduring and challenging
Recent reports in the press suggest most people in the UK now consider the COVID-19 pandemic to be over. This is evidenced by increasing concerns amongst public health officials that the take up of the next Autumn booster is likely to be much lower than other vaccine rounds, since many over 50’s don’t feel the need. In care homes, where the impacts of COVID have hit hardest, life is gradually returning to normal thanks to the ongoing programme of vaccinations. While the virus is still present, it’s now the long term consequences of the pandemic that offer the biggest challenges for care homes.
At The Croft, after more than 2 1/2 years of heightened infection control measures, our residents and team are finally getting a little bit of respite from the onerous PPE, visiting and testing regimes which have dominated their lives. Each care home is now encouraged by the Government to devise infection control policies which balance resident and staff well being, especially their mental health, along with protecting them from COVID. So, our visitor access is now much less restricted, residents are making external trips with family and staff, entertainers have returned and at last our team have been given permission to lower their masks when not within immediate proximity of residents. We are even starting to plan a small fête for The Croft in the Spring of 2023!
We have the UK’s vaccination programme to thank for this opening up of The Croft. Indeed, during a recent outbreak of the virus at the home, residents who were infected with the virus fared far better than members of staff in terms of how ill they became. We attribute the difference entirely to the extra vaccine booster residents received in the Spring this year. So, the majority of our team are grateful the Autumn booster is being offered to social care staff as well this time.
All of this progress certainly makes us feel we should be looking forward to the end of the pandemic. But, there are several consequences of the pandemic which make it hard to look forward with optimism as they are putting care homes under considerable financial pressure. Occupancy levels in many homes have struggled as families now wait until they absolutely have no other choice before admitting their loved one into a home. Care homes were stigmatised by high death-rates in the early years of the pandemic (which were not of their making!). So, it’s not surprising families have been reticent to send their loved ones to homes. Care home income levels are being hit hard, while costs are spiralling up.
The cost of living crisis, precipitated mainly by the war in Ukraine, is compounded in care homes by other sector specific factors. Not the least of these is that the care needs of residents have risen significantly over the last two years. This is partly due to delays in admissions until people are unable to cope at home, but also due to the negative health impacts on residents who were isolated from loved ones, or spent too much time immobile while isolating. These higher care needs require higher staffing levels, which cannot be immediately passed on in fees. The fee review process for both local authority funded and self-funding residents tends to be annual. At The Croft we are having to break this precedent where we can, but it’s a slow and sensitive process.
But, the most significant impact has been the loss of many dedicated people from the care workforce as part of the “great resignation”. Better paid opportunities with fewer unsociable hours are luring carers out of care, while others are retiring early. Vacancies in the sector are now running at over 140,000. The Government has backtracked on the need for a visa scheme for care workers. However, the sponsorship process is time consuming and costly, meaning that few homes are using this source. Care homes with staffing pressures are increasingly turning to agency staff, often at double the cost, to fill short term gaps while also increasing pay for staff in an effort to retain them. Pay rates in the sector are rapidly increasing. This is great for care staff who really do deserve better pay, but it is making it much harder for care providers to make ends meet.
As Providers at The Croft, David and I are using all our past business experience to help us manage all these conflicting pressures and weather this ongoing storm. But, other homes in our area are now giving up. In our neighbourhood in Newton Abbot one home has recently closed, and rumour suggests that two more are about to close their doors. The pandemic may soon be behind us, but its impacts on social care, compounded by the cost of living crisis, have taken our sector beyond breaking point.
Simon Spiller 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.