COVID-19 and its impact on the social care sector: Care homes in crisis

Apr 6, 2020

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COVID-19 and its impact on the social care sector: Care homes in crisis

COVID-19 and its impact on the social care sector: Care homes in crisis

Posted in : Dementia Care on by : Pooja Jain

COVD-19 (coronavirus) is the topic of news articles, tweets, memes, blogs, and in general seems to be omni-present wherever you look. People are starting to limit how much they read on this topic, and I get that. But if you are interested in understanding how this virus is affecting the care industry, specifically residential care homes, I would recommend carrying on reading this one. I have summarised the impact of COVID-19 on this sector, the interventions (both digital and non-digital) that are being adopted and the potential side effects.

There are over 40,000 people living in care homes across Scotland with an estimated average age of 84. 50% of these residents have a formal diagnosis of dementia although the real numbers are likely to be higher. 

The challenge is not just fighting the virus itself, it’s containing it, so it does not spread at scale. It’s particularly important to prevent it from spreading to care homes and elderly communities who are most susceptible to COVID-19.  

Residential care homes:

What challenges are care homes facing?

Workforce shortages: Large numbers of staff are becoming sick or are forced to self-isolate. The social care system already has 120,000 vacancies. If 20% of the current staff were to self-isolate, it would leave the sector with more than 220,000 staff short. This means the social care staff that can work, are working around the clock to keep people feeling safe and happy.  

Lockdown: Care homes where staff or residents test positive for the virus are in lockdown, not allowing any visitors. Entertainers, mobile hairdresser and health appointments have also been cancelled. This impacts the daily routines for the residents. But in particular those that have dementia need routine and a lack of routine could even worsen disease progression.

Ambiguity: The system is gearing up to support the NHS and help them navigate through this pandemic, but social care has not been given much attention. It is not clear how the £5bn fund, that was recently announced, will be distributed between the NHS and social care and under what circumstances. Neither is there a plan of action for the care homes to follow. They are not prepared to respond to workforce shortages, procurement of medicine and equipment and managing family visits when faced with such a pandemic. At the moment, individual care homes are making their own decisions on how to best protect their residents and staff based on government advice. 

What is being done? 

Increasing the workforce and their efficiency: A number of measures are being implemented to increase the workforce. These include (1) training social worker students and those on a career break, (2) recalling retired staff to join the workforce again, (3) sharing workforce and volunteers across NHS and social care and (4) considering a reduction in the eligibility barriers to work in the social care sector. 

The changeover in carers, sometimes multiple times a day, can be tough for residents. Care homes need to ensure continuity of information (both medical as well as care provision) to help maintain the residents’ daily activities. 

Social distancing: Some care homes are isolating the residents to their rooms as much as possible. The risk associated with a care home is the spread of virus between residents through communal areas such as lounges and dining areas. Meals are provided in the resident’s individual rooms and there has been reduced time for them to gather in communal sitting areas. 

The second aspect of social distancing is limiting the number of times and the duration that family and friends can visit their loved ones. This has been reduced down to just the essentials. 

Although social isolation will help with the current situation and help reduce the spread of COVID-19, it has previously been a major problem within this sector. Implementing social distancing measures comes with its own set of complications. This includes increased immobility and a higher risk of falls, as residents stay in their beds and rooms for long periods of time. It can also result in low mood and boredom. 

Things like NHS Near Me technology are being implemented to help reduce the number of visits whilst still having access to GPs and community teams so that residents get the support they need. Other solutions care homes are introducing include spiritual care, access to music, and the ability to virtually stay connected to family and friends. Care homes are also working together with volunteers and charities to coordinate activities that adapt to the situation, so residents are still engaged.  

Adapting care management tools: Companies are adapting the capabilities of their care management software solutions to help reduce the chances of infection, for identification of symptoms and to decrease the spread of the virus. One such company has a software that now allows for a comprehensive digital assessment via a mobile or tablet at the point of care. Staff can also record their observations and medical notes. High temperatures and other symptoms of COVID-19 will be flagged up by the system. This allows staff to identify and manage residents who are suspected of COVID-19 as well as react faster to ensure the safety of the care home staff and residents. This is nowhere as accurate as AI-based coronavirus diagnostic softwares being deployed at hospitals, but it’s a start. 

The software also has adapted scheduling and rostering functionalities to track details of the health status of their staff in regards to COVID-19. Because these are all software changes, the companies can build and implement the improvements without entering the premise of the care home. 

Data platform: The government has commissioned NHS England and NHSX to develop a data platform that can collect, coordinate and use data to inform strategic decisions. The data will come from NHS, social care, and partner organisations. They look to collect COVID-19 test result data and related emergency calls to start with. 

It will help understand the spread of COVID-19 and the capabilities of the healthcare system to cope with it. Specifically, the occupancy status of beds, A&E waiting times, duration of stay of COVID-19 patients, deployment of resources to hotspots, and to drive patients to facilities that have the staff and resources to do so.  

We don’t know which parts of the social care this includes and if the social care system has the capabilities to capture all the data and capture it digitally. 

What else can be done? 

  • Could the thousands of people who have been laid off from the hospitality industry be targeted to join the social care workforce? 
  • Could care homes ensure ALL residents are able to go online – this allows them to stay social(video conference family and friends), stay physically fit (ie. learning from chair exercise videos to do in their own room), and mentally active (ie. online games) ?
  • Most of us are confined to our house, so why not volunteer our time to the residents by giving them a call?
  • Care homes can have care cards in each resident’s room that outline their routine, preferences and tasks to help with continuity of care
  • There are many softwares for training and management that can be used by care homes to make the onboarding process of new staff easier. These technologies allow most of the training to be carried out at home by watching videos and having an online Q&A session so that the current staff aren’t tasked with all training
  • Robots for care, for the most part, have not been adopted widely and sometimes even mocked for their inability to be compassionate and show empathy. But could now be the time to embrace it? Both Japan and France have tried it for monitoring, doing guided exercises and providing entertainment for the vulnerable and elderly communities, before COVID-19. 

If you found this informative, keep an eye out for the next blog covering the impact of Coronavirus on the care at home sector. 

Sources:

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