Paul King, who sits on the board of the Surrey Care Association and is director of SmartCare, a home care provider in Epsom, reflects on the lessons he has learned during the coronavirus pandemic and discusses the urgent need to re-energise care staff as we enter a second wave.
The COVID-19 lockdown had a profound impact on the social care sector across the board, not just domiciliary care. So, while these reflections are my own and those of our domiciliary members, the experience will have been shared by many other organisations equally hard hit. Especially the vulnerable who rely on the care provided by these care organisations.
Between March and May, instead of receiving clear plans, relevant advice, and guidance from the authorities, we were inundated with fast changing and often contradictory information from different official sources, which was mostly tailored as guidance for the residential care home sector – not the domiciliary sector. This wasn’t easy to decipher, so the guiding hand and support from the SCA and its directors, along with selfless sharing from its members, to help interpret and keep all domiciliary providers informed helped enormously. When the going got tough, the SCA got going.
The goodwill of all care staff cannot last indefinitely. We need to re-energise the people who work in care and recognise the essential work they do.
New and different responses and methods emerged from the crisis; ones that bode well for the future of social care in Surrey. However, this will only be the case long-term if lessons from the COVID-19 pandemic are learnt.
I can identify the main lessons, although there are many individual lessons around PPE usage, supply chains, testing, track and trace, quarantine, coordinated efforts, trust from commissioning authorities, co-production, clear communications between all, and real cooperation of all; to name but a few.
In general, home care providers performed exceptionally well in the face of this crisis. Very few staff and clients suffered from COVID-19 infections. In fact, home care services proved to be generally safer then care home environments, with the infection rate of staff and clients incredibly low. The death rate across Surrey domiciliary care providers was better than the national average, and being cared for at home has proven to be one of the safest places to be – something the public should be reassured by.
Listening to people is key. Without this, a transformation of the social care world cannot happen.
The initial panic around what PPE to use, where to get supplies of face masks, which have never been a normal part of our PPE requirement, was indeed tough. Not least of all because of the sudden 1000% increase in costs for all of this and the increased usage. This was, and continues to be, a major financial burden that we have to absorb, despite the infection control fund offered by the Government.
All our domiciliary care staff have been fantastic. Front line care workers and office-based people have really stepped up and gone the extra mile in order to maintain the safe services provided to our clients. At last, social care providers were being recognised in the press for the fantastic work they did. We were the saviours of the vulnerable and of those in need who relied on us to do our job.
While the country shut down and stayed at home to avoid the dangers of COVID-19, we continued to go out and look after the wellbeing of our clients. We all made personal sacrifices to make sure we kept ourselves, our clients, our colleagues, and our own families safe. Our care staff have demonstrated a tremendous amount of goodwill in order to keep things going. The question now though, is will they be able to continue at this level as we face the second, perhaps bigger, wave of COVID infections?
Back in the spring and summer, we were recognised and applauded each week on Thursday evenings. Our care staff were clapped and recognised in the street, given priority in shopping queues and praised for the work we were doing. This made a real difference to us all, and we felt good about ourselves. Now though, the mainstream media seems to have changed the narrative. That appreciation and recognition no longer seems to be there.
When we thought we were already on the ropes, new budgets that are financially even tighter have been thrust upon us. Yet we must keep going.
Care homes are being compared with prisons, and seen as stopping families from visiting, even keeping residents locked up and infringing their human rights. By association, the wider care sector is also being portrayed in a negative light. There is a lesson to be learnt here. As we approach the winter and face the second wave, the need for care at home will be greater than ever, but the vulnerable people who need it will be scared to take it. The press isn’t serving the public well in this matter, and this could well chip away at the compassion and benevolence of those caring people who the public rely on.
Without doubt we are now into the second wave of COVID-19, which, with no vaccine expected before spring 2021, will keep going through the winter months along with seasonal flu. The goodwill of all care staff cannot last indefinitely. We need to re-energise the people who work in care – re-energise them and recognise the essential work they do with the appropriate rewards they deserve. The Government and local authorities must take the lead in this and show leadership. Our elderly population is growing year-on-year, so the need for care at home will grow. There is no substitute for good care staff, so let’s make them feel properly appreciated and raise the status of what they do to that of NHS nurses. It’s no more than they deserve.
Local authorities have offered cash flow support to those providers who were supporting state-funded clients, but they must work in cooperation with other care providers to co-produce a new sustainable plan that works for all.
Domiciliary care providers have had to be flexible, changing the way they work and managing their costs. There is nowhere to hide. The pressures on them have increased dramatically and we have had to adapt or fail. New ways of working have been adopted through necessity in these circumstances. When we thought we were already on the ropes, new budgets that are financially even tighter have been thrust upon us. Yet we must keep going.
Change must take place, led by the Government and local authorities. Social care must be properly funded going forward. Local authorities have offered cash flow support to those providers who were supporting state-funded clients, but they must work in cooperation with other care providers and the SCA to co-produce a new sustainable plan that works for all.
COVID-19 has forced supermarkets, food delivery services and even technology companies to change the way they meet the needs of the most vulnerable. In my opinion, commission-based services would never have been the best way to achieve this. Had Apple Pay been invented by social care services, it would have been so hobbled by safeguarding concerns, vested interest and cost policing it would have almost been unusable. Instead, it is the most amazing and useful payment system I have ever used.
What the COVID-19 crisis has shown is that many services we would not associate with social care, have now suddenly become a key part of the system. Zoom, FaceTime and more have become key tools to mitigate anxiety and assuage poor mental health.
The time has come to rethink what social care means and who delivers it. Listening to people is key. Without this, a transformation of the social care world cannot happen, and an opportunity is missed. If we only acknowledge and action some of this, I am certain social care would be the better for it.