Care staff wellbeing

Care homes and supported living: Learning and sharing following the COVID-19 lockdown

The COVID-19 pandemic has been and continues to be a particularly challenging and stressful time for care home and supported housing staff. All staff, including care staff, domestic staff, nurses and managers have been affected.

Stress and anxiety have been high and especially so in homes that have experienced a serious outbreak.

Conversations with care home managers, staff, providers and sector leaders have identified common issues which are negatively affecting the wellbeing of care home and supported living staff. These include:

  • Anxiety around a first or another outbreak in their home
  • Bereavement and grief following the deaths of people living in care settings, colleagues and also those in their own family and friendship groups
  • Physical and emotional effects of wearing PPE, especially masks
  • Pressures of time on managers – particularly the volume of guidance, paperwork and reporting to various agencies
  • Long hours with a lack of breaks and annual leave
  • The negative effects of limited or no visiting into the care setting on those living there and also on staff
  • Uncertainty around the lifting of lockdown and what that means for care settings
  • Uncertainty and stress caused by financial pressures on the organisation

This section contains practice examples from the sector that highlight ways care homes and supported living providers have supported their staff during periods of crisis and in a broader COVID-19 context. In addition, there are links to quality-checked guidance and resources that cover the topics of: general support and wellbeing, supporting staff following bereavement or multiple deaths in a home and supporting Black, Asian and minority ethnic staff.

Practice examples

Emotional support for care staff: safe spaces

Herncliffe Care Home found that staff throughout the pandemic were struggling emotionally with not only the loss of residents, but also with the constant fear of the risk of infection to themselves and to their families. This was having a particularly negative impact on the mental health of some staff, including staff needing time off and having anxiety attacks. The mental health supporter in the home began to offer one-to-one support to staff whenever they needed it. In addition, the home supported a request from staff to be allowed to set up safe spaces on their units, where they could take time out, relax, and get peer support. The staff were able to choose a name and some resources for their relaxation rooms, including aromatherapy, relaxing music and chocolates. These areas and the mental health support have been invaluable to staff wellbeing. The rooms were used frequently throughout the worst part of the breakout in April, and are being used less now. These changes helped to support mutual care and support amongst the team.

Useful learning

Staff benefit from regular and reliable support to maintain mental wellbeing, including time and space away from their everyday tasks.

Wellbeing support line and learning modules

Barchester Healthcare set up a COVID-19 support line for its staff, giving them the opportunity to share any worries they may have with other staff who have more experience of working in a care home environment. Recognising the key role of manager in supporting staff wellbeing, it also created some specific learning modules on leading through a crisis. These were on supporting others with empathy, maintaining morale, building resilience and more. More information can be found at Barchester Healthcare – employee wellbeing in care homes (Local Government Association).

Useful learning

Staff should be offered the time and opportunity to share their concerns with colleagues and experienced care workers.

Being reflexive and demonstrating kindness

Pottles Court in Exminster has been supporting the wellbeing of care staff by managers being more openly reflective about their care and work. This included weekly open forums or team briefings that were used in two ways. The first was to promote relevant news and updates and to share data, facts and virus status. The second was to allow staff to air issues, to discuss coping top tips and to promote kindness in their work with each other as well as with those they care for.

Useful learning

Forums can enable staff to air their views and reflect on the events of their days.

Emotional and practical support

At TLC Care, managers acknowledged both the emotional and practical challenges facing team members. Mental health first aiders were made available in each home as well as support via the Care Workers' Charity. Senior management hosted fortnightly Q and A sessions with all team members to discuss any concerns they had. Feedback reflected how much the team appreciated having the chance to express their views and feelings. Team members have always been provided with freshly cooked meals during their working day, but during lockdown this was extended so team members could take essential food items home to support both themselves and their households. Fruit baskets were sent to each team members home to ensure their families had fresh fruit available.

Useful learning

Providing options for both emotional and practical support contributes to wellbeing and enables staff to access support in a way that they feel comfortable with.

Support for BAME staff

Black, Asian and minority ethnic (BAME) staff may have and continue to experience heightened stress due to the disproportionate impact of COVID-19 on the BAME communities. In the additional context of the Black Lives Matter global movement highlighting ongoing racism and inequalities, it is important to consider the wellbeing of these groups and additional stresses they may be experiencing.

There has been more focus on BAME staff working in the NHS than within social care and care homes more specifically. Whilst it is essential risk assessments consider ethnicity alongside other factors (age, sex and underlying health conditions), there has been less focus on emotional wellbeing for them.

The Local Government Association’s COVID-19: good council practice links to many examples of good practice from local authorities around England. Under ‘Workforce’ there is a section on BAME workforce risk assessments which also includes examples of letters sent to BAME staff with offers of support and counselling.

Other examples of support for BAME staff comes from the NHS. Some NHS trusts sent a letter to all their BAME staff offering reassurance, offers of support and counselling and avenues of communications for any concerns they had. These trusts included Guy’s and St Thomas’ and Somerset NHS Foundation Trust.

Useful learning

Black, Asian and Minority Ethnic (BAME) staff have been disproportionately affected by the COVID-19 pandemic and may well have suffered additional stress as a consequence. It is important this is considered when looking at their wellbeing and ways of supporting them that are targeted and specific.

Note: Whilst conversations SCIE has had with the sector have highlighted concerns around wellbeing for BAME staff, there is little in the way of specific guidance or practice examples at this time. We would welcome links to any relevant resources or examples of supportive practice from the sector. Please contact us.

Guides and resources

  • BAME workforce: COVID-19 recovery and beyond (Skills for Care) Open

    Region: England

    Care settings: All social care settings

    Audience: Care home and supported living managers, care providers (particularly HR staff).

    Format: Webinar recordings

    A series of four virtual events held in July and August 2020 which explored and debated the support for BAME staff across social care.

    Skills for Care webpage

  • Wellbeing and support line for health and social care workers (Samaritans)Open

    Confidential support line from Samaritans for health and social care workers and volunteers based in England.

    Samaritans webpage

  • COVID-19 social care staff wellbeing (Local Government Association) Open

    Region: England

    Care settings: All social care settings

    Audience: Care home managers, local authorities, care providers (particularly HR staff). Some resources for frontline staff

    Formats: Webpages, pdf, poster

    Links to helpful resources for managers, which are tailored to the social care workforce. This includes a guide for managers to help them think about the different ways they can support the wellbeing of their staff both as a webpage and pdf. There is a two-page guide for managers on supporting psychological wellbeing of care staff and a single page guide for frontline staff as well as a poster.

    Local Gov webpage

  • Guidance for managers and decision-makers in supporting care home workers during COVID-19 (COVID Trauma Response Working Group) Open

    Region: UK

    Care setting: Care homes but also relevant to supported living

    Audience: Managers and care providers

    Format: pdf

    Short guidance based on a rapid synthesis of published research, expert clinical opinion and the experiences of care home mangers and staff. It includes a single page of key recommendation for managers in supporting their staff during COVID-19.

    COVID Trauma Response Working Group PDF

  • My Home Life resources for staff (My Home Life) Open

    Region: UK

    Care setting: Care homes, with a focus on older adults

    Audience: Care home managers and frontline staff

    Formats: Webpages; pdfs; videos

    My Home Life has a range of resources for care homes, including Conversations with care homes, a YouTube series of short videos discussing real situations care homes are facing as well as ideas for practice and positive change. Particularly relevant to staff wellbeing are Looking after yourself (episode 2), Staying connected with spiritual and religious needs (episode 4), and Mental Health Awareness week (episode 6).

    My Home Life resources for staff

Bereavement

  • Top tips for tricky times: Supporting staff following multiple deaths in care home environments (NIHR, Applied Research Collaboration, East of England) Open

    Region: UK

    Care setting: Care homes, with a focus on older adults

    Audience: Care home managers, frontline staff

    Format: pdf/poster available via webpage (requires simple registration to download all 8 Top Tips)

    One of eight Top tips for tricky times by a group of care home researchers from two NIHR Applied Research Collaborations. Each topic is presented on a simple single page poster. The Top Tips are evidence based and aimed to support managers in how they can respond to their staff.

    NIHR webpage

  • Bereavement resources for the social care workforce (Department of Health and Social Care) Open

    Region: England

    Care settings: All social care settings

    Audience: Care home managers and frontline staff

    Format: Webpage with links to resources

    Government guidance highlighting resources and help available for social care providers and managers to support staff with bereavement, be that from the loss of those they care for, colleagues or other friends and loved ones.

    DHSC webpage

  • How to manage a grieving team member (MindTools) Open

    Region: UK

    Care setting: All social care settings

    Audience: Care home managers

    Format: webpage

    Web resource to help managers support grieving team members. It is not specific to a care home context, but much of the information is relevant. It draws on different evidence and expertise and has helpful tips on using empathetic language and managing a return to work.

    MindTools webpage

Peer support networks

Managers and care staff have highlighted the important role of peer support, both in practical terms for finding out information and answering questions, but also for wellbeing. Knowing others are having similar issues and stresses and being able to talk openly to others that will understand has been highlighted as supporting emotional wellbeing. This was especially so for managers who are most vulnerable to isolation in their role.

Examples of online and social media groups include:

  • The Queens Nursing Institute has set up a Facebook support page for Care Home Registered Nurses
  • A national COVID-19 online care home community or practice has been established, and care home staff, NHS and social care professionals are encouraged to join by emailing Anita Astle at anita@wrenhall.com
  • There are also various regional care provider networks. Skills for Care can support managers in finding a local network

Care homes and supported living
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