4123980557 g eT tING CLEa R On c A rE Revealing the hidden heroes of the pandemic and the cracks in the private care system causing the next care crisis!
Society NOW
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ISSUE #94 / DECEMBER 2021 / £1.99 / SOCIETYNOW.COM
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Private care homes have been quiet behind closed doors throughout the pandemic, they have been suffering in silence. Society Now reveals the cracks, exposes the care crisis and gives care workers a voice. There is a high chance that you have seen care workers during the day, whether they are visiting a service user at their own home, taking someone shopping or to an appointment, or working in one of the thousands of care homes situated across the country. We may not give this much thought and carry on with our day or we may wonder what it is like to be a care worker. Over the last two years, the NHS has received a lot of coverage on TV about the working conditions and struggles they have faced during the pandemic, which has made it feel like it has been a shared experience, but what has been going on behind the closed doors in care homes of the private sector? Have they had the same experiences and struggles? What has it been like working during the covid lockdown? And what is the current situation in the private care sector now? Society Now has ‘opened the doors’ on private care homes, investigating these questions and getting to know the
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care worker. Society Now has reached out to them, helping to give them a voice by allowing them to tell their story so that we can discover their personal views and experiences, as well as the victories and struggles sustained by homes. Currently, according to www.carehome.co.uk (figures correct as of 24 March 2021), there are 17,598 care homes in operation across the UK. A workforce of nearly 700,000 staff look after and care for 490,326 service users 24hours a day, 7 days a week. Since the beginning of the coronavirus (COVID19) pandemic, there were 173,974 deaths of care home residents in England and Wales, this is an increase of 19.5% compared with the five-year average (145,560 deaths); of these, 42,341 involved COVID-19 accounting for 24.3% of all deaths of care home residents.
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on behind the closed doors of care homes, which have had to close to society during the lockdown
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The death rate in care homes was highlighted by the government during the pandemic and created anxiety within society over families’ relatives in care homes, whom they were unable to visit during the lockdown, and impacted the decisions of families who were considering whether their relatives should be moving to care homes or not. Care homes operate as a business and so this also impacted funding that homes required to survive. A lot has been going on behind the closed doors of care homes, which have had to close to society during the lockdown. They have had to adjust to many new policies and procedures issued by the government to safeguard the health of service users and staff. These have adjusted over time as the government have understood Covid better.
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When the covid pandemic hit the UK it severely affected the care sector. Stringent policies and procedures were implemented to ensure safety for service users, staff and to safeguard homes from the risk of outbreaks as much as possible. PPE (Personal Protection Equipment) became mandatory to wear throughout 13 hour shifts, which enforced this safeguarding but also made, often intense, jobs much more difficult and time-consuming to perform. The NHS were highlighted as heroes and shown how much they were valued by the public throughout lockdown. Care workers in the private sector were seemingly forgotten about. It was realised that more people were working on the frontline than just those belonging to the NHS and so the blanket term ‘essential workers’ was added later on. Care workers remained anonymous due to this ambiguous label. Care workers were left feeling unappreciated while struggling to work through the demands of the pandemic. Indeed the pandemic made the work of the care worker more stressful due to constant covid cleaning, PPE requirements, as well as the stress and anxiety of contracting covid themselves. Furthermore, some care workers with existing health issues and those from ethnic minority backgrounds who were at risk of getting more severe covid symptoms but had not been told to isolate by the government, experienced an inner conflict between continuing to work in care and protecting their health. PPE proved to provide only a limited level of protection as new research revealed how easily covid transmitted through the air. These pressures caused some carers to become burnt out and leave the care sector altogether. Yet more carers, who were against receiving any form of the vaccine, were consequently prevented from working in care homes due to new government laws. This has led to a sector-wide shortage of staff, making a difficult working environment even more challenging because of the extra workload for the staff that remain. It has also affected care homes’ ability to keep service users safe when staffing levels have dropped to critical levels and has threatened homes with the prospect of having to shut down. Statistics from the government about the covid death toll being high within care homes had a knock-on effect of families not wanting to send their relatives to a care home. And so, this also threatened homes with being forced to shut down because of a lack of service users, which prevented homes from sustaining enough funding to remain a financially viable business.
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P.P.E. b Ec AM ma nDatoRy t wea r cons t AN T throughOUT 1 hoUr ShiFt James is a 58-yearold care worker and one of the hidden heroes who cared for the vulnerable during the lockdown. James has been working in the private care sector for 12 years. Society Now talked to James to give him a voice, allow him to share his experience, story, and to help society gain the right view on the private care sector. G eT tiNg CLEa R On c A rE
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# SOCIETYNOW How have these factors affected you?
How has care work in the private sector changed during your career? Looking at the positives, the role of the care worker has become more professional with higher standards and expectations being set, new policies and procedures put into place and more training is required for staff. More paperwork has been introduced and homes are checked more regularly with much more scrutiny. Looking at the negatives, the population have been getting older and more people have been migrating to this country, which has put more pressure on the care industry in general. The minimum pay has increased, there have been fewer permanent staff members present and management has been poor. The company I work for is a large company with private care homes all over the UK. It has taken over several homes from other companies and, consequently, they have adopted other companies values and working methods which has had the effect of wages being reduced. The service users that the company now accepts are those that they would not have before, for example; these individuals are more violent and so the home, other service users and staff have the potential to be put more at risk of being harmed. The companies newer policies are those that protect the company more and have had a knock-on effect on the staff negatively. These policies I talk about are those that safeguard the company from blame, in specific situations, to a larger extent than before and therefore the blame is more likely to fall on staff instead.
What are the factors that have affected you the most? I am affected by my low wages where the national minimum wage rate has almost caught up with my hourly rate. Lower numbers of permanent staff to rely on and work as a team with has meant that the company has needed to rely more heavily on agency staff, they don’t know our service users and have no immediate rapport with them which can cause problems with behaviour. They also tend to be a lot less trained and operating from different standards and ‘hymn sheets’ than us. Also, our management can be out of touch with the problems regular staff see and highlight (most likely because of the higher paper-based workload they have to handle these days) and are slow to deal with the issues, if at all.
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potentially bringing a death sentence back to their homes for all the other residents
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They have affected me by causing me not to enjoy my work as much because I am doing more each shift despite agency staff being present. They don’t know what they are supposed to be doing and don’t use initiative, and this has caused me a lot more stress. This creates tiredness and unwillingness to cover more shifts than my set hours. It also generates a level of resentment towards agency workers because it is often apparent that permanent staff are having to work at least twice as hard, and most likely for a lot less money. This can lead permanent staff to become burnt out and off sick more, which also affects staffing levels and increases the need for more agency staff. Incidently, care workers don’t get paid sick pay so it can leave them in financial hardship. Low pay affects my quality of life/ work balance and prevents me from being able to enjoy myself, at times, more than it should.
What do you see as the view of carer workers in the private sector by society and the Government? I think we have less respect from society than is warranted, an attitude of us being “only carers” and an “anybody can do it” attitude. I think we are seen as unskilled workers and undervalued by the government and our company which is reflected in our pay and the loopholes afforded by government law for private companies to have the potential to exploit and abuse staff. For example, in offering zero-hour contracts and not having to adhere to such strict regulations as staterun organisations. There have been some damning reports on care homes that have involved abuse as well as how covid has got into many homes and killed a lot of service users. The latter issue was caused by the government policy effectively allowing service users to return home from hospital with covid. The policy was to have a covid test, which took four days to get the results of, and then send them home. Obviously, in this ‘test result waiting period’ they could have contratced covid at the hospital. They were potentially bringing a death sentence back to their homes for all the other residents. I think this has hurt the view of care homes and has caused anxiety over families moving their elderly relatives into a care home lately. The carer workers I have worked with are caring people and this bad stigma of carer workers being untrustworthy certainly doesn’t apply to them.
How would you like society and the Government to see care workers and what changes would you like to see? I would like recognition; that we are skilled workers. I want society to know that we do care about the people we look after. We might be the only people that residents see every day; we get them up, take them into the community, share birthdays with them, take them to hospital appointments and, sadly, are often the only ones with them when they pass away. I would like to see wages increased to a much higher level so that care workers are paid what they deserve, especially as they are much more highly trained these days compared to twenty or thirty years ago.
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What is your opinion of the privatisation of health care? It honestly should not be a privatised sector. In doing so health care has become commercialised and monetised. Why should anyone see someone’s health or disability as something to make a profit from? It is disgusting and I feel the government should turn privatisation around and invest much more heavily in health care.
Do you think this is possible for the Government to achieve? No, I don’t think this is achievable by the government because they don’t understand the industry and the inherent problems, nor do I think they are interested in knowing, especially as it saves them so much money for service users to remain being cared for by their families or be placed in private care instead of state-run care homes.
During the ‘Help for Heroes’ initiative (including the weekly public applaud) what was the reception and perception from you and your colleagues? It was right to acknowledge the hard work and commitment from so many during a very uncertain time. However, this was aimed at NHS staff, whereas private care workers were doing these jobs too. We are also ‘heroes’. There was no sense of jealousy towards NHS staff but it was felt by care workers in the private sector that they had been effectively forgotten during this time. Later on, the slogan was changed to accommodate all manner of workers under the banner of ‘essential workers’. Again, though, it was a shame that private care workers were ‘lost’ under this blanket terminology.
What do you see as the difference between care workers in the private sector and the NHS? I think NHS staff are held in high esteem, and rightly so. Private care workers are seen more like unskilled factory workers and this is reflected in recognition and the differences in pay between NHS staff and private staff. I think care workers, regardless of private or NHS, can be seen by a percentage of people as low-value employees and can have a bad stigma associated with them since the news and documentaries have exposed care workers who are bad examples.
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As you know, there was a long period when everywhere was locked down. This meant that clients couldn’t go out and families couldn’t visit them. This caused them to display more challenging behaviour as they struggled to cope mentally with being confined for so long. I know it was difficult for everyone but it was enhanced because of learning difficulties and mental health issues in our clients. Staff have had to wear PPE constantly (wearing a mask and goggles for a 13-hour shift has been the most frustrating factor for me). It also made every one of my jobs slower and more painstaking than usual. Not only was it a lifethreatening time for clients who were suffering badly with covid but it was also for the staff that were caring for them. It was a source of stress and anxiety if, like myself, you had health conditions of your own and the uncertainty if you would survive if you contracted covid yourself.
What is your view on the covid vaccine? I have no problem with the vaccine and have received the two jabs plus the booster jab.
Have the vaccine and vaccine passport requirements had any effect on care workers? Yes, indeed; one of our staff refused to have the vaccine and eventually, as laws came into place for staff working in care homes, they were no longer able to work there. There have been several agency staff, whom we now rely on constantly, who are no longer allowed to work there either because they choose not to have the vaccine. It has caused even lower staffing levels and, at times, the number of staff present on a shift are dangerously low. I think this also makes it harder for companies to employ new staff because there are smaller numbers of people who have the vaccine. It is stretching companies and all of the staff who are left are having to hold everything together. Some big cracks have appeared in the private care sector and are becoming obvious by the day.
What do you see as the current state of the private care sector? There has been an enlightening within society of the view of care workers; there is sympathy for them since covid was allowed to affect care homes (the Government allowed service users who had been in hospital to return to their care homes without being tested for covid first). This is likely the key cause of covid running rampant through so many care homes.
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What are some of the greatest challenges about working in care? The greatest challenges are performing routine, everyday tasks which can become mundane. It can be hard having the same conversations each day with some service users, with mental health issues, as if you’ve heard them for the first time. I would guess that most people wouldn’t want to do the job, and not everyone has got what it takes to be a care worker. It is more a calling for those who care; who have a heart. And it can be a great job when you embrace it, then you begin to see that you can make a difference in someone’s life.
What are some of the best moments from, or things about working in care? The best thing about working in care is being able to go home knowing that you’ve made a difference to someone’s day, however big or small. It is very rewarding and puts a smile on your face. When you see service users achieving and progressing, for example; a client, who was eighteen when they moved to the home, had a mental age of a three-year-old and liked to play with toys appropriate for a three-year-old. They are now in their late twenties and have progressed to playing with toys suitable for an eight or nine-year-old. This is rewarding to know that they can find even more enjoyment in their times of play.
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What was your experience of working during the pandemic?
‘‘ It ha s c a us eD even loweR s ta Ffing leVeLs And the numBer of Sta fF pres en t on A shift Are dANg erous LY Low a t Times
SoMe Big crACks ha ve apPearEd in tHE priVa Te c aRe secTor It is interesting to hear about the experiences of someone who has worked within care, especially through the pandemic, and to see the current state that it has left private care homes in. It is safe to say that it has been a stressful time for everyone involved and there are still challenges to face.
Many people need caring for and the staff levels to ensure this have hit critically low levels. It is a time when service users face uncertainty whether they will be able to be cared for, have their everyday needs met and, ultimately, know whether they will remain safe and healthy or not. We are on the brink of a care crisis and despite everyone’s best efforts, cracks are appearing. We need more care workers. Just as when the NHS was becoming overwhelmed because of covid patient admissions, the situation in the private care sector also raises the same need for a call to action. It needs those who are able and willing to answer it, to stand up and be counted. Without the TV coverage the NHS received, it is not such a widely known need, but still a real one.
Because of covid, people have lost their jobs and are looking for employment. The private care sector needs caring people to help make a difference in individuals lives, who are perhaps not as fortunate as ourselves.
A career in care can be rewarding, where you can make a difference in another person’s life. Not only are there jobs available but as a care worker, you don’t need any qualifications to begin with, only to care. You will need to be willing to work towards completing an NVQ level 2 in care while working and it can provide a stepping stone into a nursing career. It is a job where you don’t take the work home with you which allows you quality time for family or other interests. And with flexible full-time and part-time shifts, it can work around you and your life. It allows time to be able to study if you are pursuing any further learning too. Flexible working hours also offer you the choice of doing another existing job alongside which could make this an attractive choice. Consider a career in care and apply today by getting in touch with a local care home. Be a hero, be a carer.
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