Here we go again: Care homes under pressure on Covid-19

Some care homes are being put under pressure to accept Covid-19 positive patients being discharged from hospitals, according to a worrying ITV report. Many in the social care sector are worried that this policy risks a repeat of the disaster earlier this year when mass discharge of hospital patients into care homes helped spread coronavirus in care homes. At the peak of the pandemic 400 care home residents were dying every day. 

Admittedly, more precautions are being taken this time round. All patients being discharged must first be tested for coronavirus this time around and if they come back positive, or are still awaiting their results, care homes must isolate them. Care homes also seem to be no longer facing the acute PPE shortages that undermined their attempts at infection control earlier this year.  

More worryingly the growing chaos affecting UK coronavirus testing is undermining the government commitment to test carers weekly for the virus. Failures to implement this early on in the crisis contributed to the tragedy in care homes. When finally implemented results for tests were supposed to arrive within 72 hours and for a while they did. Now, however, carers have found themselves waiting a week, or even ten days in some cases, for their results. 

Understandably, some in the care sector are now reluctant to admit Covid-19 positive patients who could infect staff or other residents. Robert Kilgour, Executive Chairman of Renaissance Care Homes, said: “We have not been asked to do so as yet and we would be unlikely to say yes to this.” 

A DHSC spokesperson has stated: “No care home will be forced to admit an existing or new resident to the care home if they do not feel they can provide the appropriate care.” However, financial pressures earlier this year pushed a number of care homes to accept coronavirus positive residents despite being reluctant to do so. 

Indeed, even before the pandemic many care homes’ finances were strained and the costs of the pandemic have only piled more pressure onto them. 

The government has stepped in to provide help here announcing an extra £546m for social care’s Infection Control Fund yesterday, bringing the total to roughly £1.1 billion, and extending it until March 2021. It has also announced it will be providing the sector with free PPE until March. A new chief nurse will also be appointed to provide more guidance for nurses working in the care sector. 

The money will be used to help fund infection control measures and sick pay for care home staff. Sick pay has proved particularly important as many carers were only eligible for Statutory Sick Pay, £95.85 a week, substantially lower than their already low wages. Ensuring their sick pay matched their wages was not just a matter of supporting carers, but ensuring they don’t feel pressured by financial worries to continue working even if they suspect they might be ill.  

Additionally, the government is taking action to ensure that carers don’t work in multiple homes to help further limit the potential spread of the virus. Working different shifts in different homes is common practise in the care sector’s flexible and poorly paid labour market. The new government funds are intended to help cover the extra costs of hiring the additional staff necessary to end this practise. 

Unison, the union that represents care workers, has said government measures were not enough. In a statement today, UNISON assistant general secretary Christina McAnea has already raised concerns many workers were being denied full sick pay. Indeed a recent Unison survey found that just 40% of care workers, and 25% of workers in care homes, said they had received full pay when taking a leave of absence for covid-related reasons. 

Speaking today McAnea raised further concerns. “Making safety kit free for all employers should mean there’s no repeat of the fiasco earlier this year. But the sourcing and distribution of personal protective equipment must be managed centrally for it to work.

She added: “A winter plan is necessary but it’s short-term and won’t solve the underlying issues. The government must bring in a national care service to banish profit-making and put workers and the people they look after at its heart.”

Even those in the care sector who have welcomed these measures also suggested longer term solutions are needed. Kilgour said: “This very welcome short-term support for the winter period will help us fight off a second wave while we wait for the much-needed social care reform which is key.” 

While Kilgour said ensuring carers only worked at one home was “the correct thing to do”, and he said that his firm Renaissance care homes already had this policy in place, care homes may struggle with the new requirement. 

Even before the pandemic a Skills for Care report published in October 2019 found that the care sector had 122,000 outstanding vacancies i.e. a vacancy rate of 7.8%. Workforce burnout, with staff quitting or finding themselves unable to perform their duties from sheer exhaustion or stress has also become a major issue during the pandemic. Quickly finding thousands more workers in a sector that was already struggling to fill key positions may well be a difficult task. 

Under the circumstances some feel even more support is necessary. Mike Padgham, Chair of the Independent Care Group, said: “We welcome the funding package but more is needed to enable local authorities to commission more care this winter. Staffing problems will not be solved short term and we must give carers a proper salary. We are ready to help with Covid patients in the war against the virus but need more help and guidance.”