Social Care and COVID-19: Kathryn Smith

Featured article - 09 April 2020
By Kathryn Smith, Chief Operating Officer at Alzheimers Society and incoming SCIE Chief Executive

I first entered a care home when I was just short of 13 years old, as a care assistant in a fairly small home for women. It’s not legal for a 13 year old to do this kind of work any more, The Care Standards Act 2000 saw to this, and for this and many other reasons we may think standards of care have improved in the last 30 years. In some respects they have, and we should rightly be proud of the difference this will have made to people’s experience of living in care homes. However in other respects, the very care and support that is so essential is no longer available. For example, we used to do shopping for people living in the community that couldn’t get out and about, and people could get either home care or into a care home if they needed one. Due to decades of governmental cuts to social care budgets, for many, access to the right support to stay at home, or a good quality care home, is now not available.

A social care crisis

Social care was already in crisis - COVID-19 is now showing the devastation that years of underfunding and lack of a clear strategy have caused. We must not forget that the NHS is entirely reliant on a well-functioning social care sector to ensure that only those that really need health care are admitted to hospital.

Indeed, the success of the NHS Long Term Plan is predicated on solving social care, as Simon Stevens has recognised. We will not reduce the ‘revolving door’ situation, inappropriate admissions, poor discharges or an overburdened NHS, not to mention an impact on the wellbeing and mental health of informal carers, without the right investment in social care.

Unfortunately, the response to COVID-19, however unintentional, has once again shown social care for the poor relation that it is. It is entirely accepted that this situation is unprecedented, people are doing their best and everyone is learning as we go along. While the NHS must take priority, neglecting social care’s key role cannot happen or the Government will let down some of its most vulnerable people.

A worrying time for the sector

In just the last week, I have spoken to a care assistant who has been off work due to illness and is now scared to go back to work as she is worried she might bring the coronavirus back to her children. She knows that at least half of the residents in her care home are showing symptoms - this while feeling under immense pressure to return as she recognises how much she is needed right now. I have spoken to a care home manager who could not get the Personal Protective Equipment (PPE) they needed for the home and so have had to borrow goggles from a secondary school. I have seen a home care assistant crying on social media as they were unable to do the shopping they had promised for one client due to not being recognised as a key worker. I have had a children’s social work team manager sat at home in tears by the end of the day as she is still trying to manage the most incredible caseload, in difficult circumstances, with her own toddler demanding her attention simultaneously. Most frighteningly, I have had a care home manager express her horror and upset at the possibility that she could be asked to provide blanket Do Not Resuscitate (DNAR) orders to all of her residents.

These are the very people that, alongside the NHS, are keeping services going and people alive just now. The coronavirus has and will hit the elderly and vulnerable the hardest, as we are seeing clearly with reports of 13 people dying in a care home in Glasgow, and then today reports that 15 people have died at a care home in Luton, and yet the vital support to these people is not there.

Ensuring equal access to care and protection

The government must make sure that all care staff have access to appropriate PPE equipment in the quantity that it is required and they must make sure that people are tested before leaving hospital, and that testing is available in care homes and to care staff.

Finally, when we reach a position where we think it is reasonable to issue blanket requests for DNARs, with no account of a person’s own circumstances or wishes, or we are telling care homes that their residents won’t be admitted to hospital if they need medical support, we have definitely gone back more than 30 years. Everybody deserves equal access to care, treatment and support; we cannot let the Coronavirus cause us to forget that.