Care Home Workforce Challenges Examined at COVID-19 Inquiry
Staffing shortages and budget constraints left Northern Ireland’s care sector vulnerable during pandemic, an official has told the inquiry
Northern Ireland’s residential care sector faced significant workforce pressures and financial constraints when the COVID-19 pandemic began, according to testimony given to the UK’s ongoing COVID-19 Inquiry.
Professor Sean Holland, who served as chief social work officer with the Department of Health during the pandemic, described a sector struggling with recruitment challenges that required approximately 1,400 new workers annually just to maintain existing staffing levels.
The inquiry, which is currently examining how adult residential care responded during the health crisis, heard evidence about the structural challenges facing the sector at the start of 2020.
Professor Holland outlined how social care had developed characteristics that made it less attractive as a career choice, including lower wages, frequent use of zero-hours contracts, and high staff turnover rates. He explained that efforts had been underway to improve the sector’s appeal as a long-term career option.
When questioned about the sector’s readiness for the pandemic, Professor Holland noted the interconnected nature of funding and staffing challenges. He explained that budget limitations directly impacted service delivery capacity, which in turn affected workforce sustainability.
The inquiry examined issues around isolation facilities within care homes, particularly for residents being discharged from hospitals. Evidence from the Regulation and Quality Improvement Authority indicated that fewer than 80 of Northern Ireland’s 480 care homes had adequate isolation capabilities available.
Professor Holland suggested this figure may have been conservative, noting that the assessment was conducted as a desk-based review rather than through physical inspections.
He emphasised that isolation protocols should be a key consideration in pandemic preparedness planning.
Looking toward future preparedness, he highlighted the importance of reviewing care home infrastructure standards to ensure buildings can better support effective pandemic responses.
The inquiry heard that Northern Ireland experienced lower care home death rates during the pandemic compared to other UK nations, with Professor Holland suggesting this should inform future outbreak responses. While acknowledging the tragedy of all care home deaths during the pandemic, he noted that residents were statistically less likely to die in Northern Ireland care homes compared to those in England, Scotland, and Wales.
However, he emphasised that the reasons behind these comparative outcomes remain unclear and require further investigation to inform future pandemic planning.
During the pandemic’s height, authorities explored the possibility of creating enhanced protection measures around care homes, including arrangements where staff would remain on-site for extended periods. This “Safe At Home” model was proposed but received no expressions of interest from care providers.
Trade union representatives raised concerns about such arrangements, particularly regarding adequate staff compensation, working conditions, and the availability of personal protective equipment.
Professor Holland described significant difficulties in securing adequate supplies of personal protective equipment during the pandemic’s early stages. He told the inquiry that he had instructed all Northern Ireland health trusts to remove barriers between public and independent sectors when distributing PPE supplies.
This approach aimed to ensure that protective equipment was treated as a shared resource for the entire care sector rather than being restricted by organisational boundaries.
The inquiry continues to examine lessons learned from the pandemic response in residential care settings, with findings expected to inform future emergency preparedness planning.
