Lessons from Covid-19: The Default Model of Care Must Change

By Peter Seldon, CEO, Consultus Care and Nursing

Despite herculean efforts of front line carers, the Covid-19 crisis has shone a spotlight on the nation’s care system and shown how urgently reform is required to bring the sector up to standard. Nobody was prepared for the pandemic, and as a result the entire healthcare system was put under immense pressure almost overnight. Hospitals focused on ways to free up capacity and in turn many older and vulnerable patients were discharged into care homes as the default solution – arguably in many cases, too soon and without proper testing.

This had a profound effect as hospitals reported having nearly four times the normal amount of free acute beds in preparation for the pandemic’s peak. But this came at a price – care homes became overrun, short staffed and faced a serious lack of PPE and testing. Cross infection was near impossible to prevent, and with a stretched workforce the level of care was compromised, with 30,000 more care home resident deaths during the Coronavirus outbreak compared to the same period in 2019. Sadly, many of these deaths could have been prevented with live-in care as the default option – having one nurse or carer to return safely home to and live in iso- lation with, after being discharged, has proved to be the safest option with very few Covid cross infections.

Peter Seldon, CEO, Consultus Care and Nursing argues that the current care model needs to change if we are to protect and prevent our loved ones from experiencing the same failures that we have wit- nessed during this pandemic.

OPENING UP OPTIONS

At the peak of the Coronavirus pandemic, statistics released by ONS revealed that there was a care home resident death almost every minute.

The tragic number of cases and deaths has meant that trust in these facili- ties has fallen, and care homes will continue to need support in managing the consequences of the pandemic. As such, more information on live-in care should be available as an alternative option so families facing the decision on how to manage a loved one’s care don’t feel cornered into making a decision that isn’t necessarily right for their situation.

Many families are unaware of the possibility of live-in care, or assume that 24×7 bespoke support would be significantly more expensive. However, families can access live-in care for the same price as a standard care home and reap the benefits. And with lifetime mortgages and equity release products now far more competitive and flexible, the family home doesn’t need to be sold to put a loved one into care. The debt can be serv- iced on a simple interest model, year by year. So, essentially the estate is rolling up the overall debt borrowed against the house – but it is not being compounded. Furthermore, the debt being built up offsets Inheritance Tax above the nil rate bands that apply to potentially both parents. Critically, in the meantime, unlike cash in a low interest savings account, the house is almost certainly appreciating in value.

Moreover, in many cases, familiar home environments, one’s happiness and even pets are taken away from the older person when the family home is sold. This can lead to significantly decreased independence and wellbeing, and a myriad of issues for the family. The option of staying in one’s own home means that stability of surroundings can be maintained contributing to overall improved health and quality of life.

A DIFFERENT APPROACH TO CARE

There are many positives of live-in care, not only does the individual receive care on a one-to-one or one-to-two basis 24×7, they retain their familiar surroundings and comforts, and importantly, their memories. In typ- ical situations (without pandemic restrictions), families and friends are able to visit at all hours and without limitations, with an extra layer of privacy compared to group home visits.

This approach also helps to reduce financial and resource pressure on the NHS too, preventing bed blocking, allowing for earlier discharge and ensuring better patient safety and wellbeing at home. Live-in care has been shown to reduce the rate of the person’s decline in health; for instance, compared to care homes, live-in care has a third fewer falls and a quarter of the hip fractures.

Live-in care ultimately provides an environment where the person can enjoy their regular routine with that dedicated, personable support they need – whilst importantly being protected from any potential contamina- tion. With this bespoke approach, carers have more time to develop mean- ingful companionships, learning which activities and tasks their client enjoys most. Take the case of live-in carer Julie who went to great lengths during lockdown with her client Rosemary by creating wonderful dishes decorated with flowers and herbs from Rosemary’s beloved garden. These small touches can mean so much to those who are experiencing later life care.

Independence is incredibly important for everyone, so why should this be taken away from the older generation? Making sensible use of the fami- ly home, which typically grows in value over time, means the person can maintain their independence in the way they want, whilst supporting their family’s future too.

THE REVOLUTION

Coronavirus has shone a light on how important the role of the carer is, the nation came together to #ClapForCarers to show widespread recogni- tion for their tremendous efforts. No longer being labelled as ‘unskilled’, perceptions have changed for the better and deservedly too. However, the pandemic has also shone a light on the catastrophic failings of the current social care model – there is no ‘one size fits all’ approach that should be taken with care, and there is now a rare opportunity to embark on a social care delivery revolution, to combat the negative headlines of social care and care homes.

It’s clear that the national care landscape needs to change to better suit the needs of the older population, with one survey showing that 60% of Britons would be happy to pay more taxes in order to fund the NHS. Furthermore, more than one million people will no longer consider living in a care home after Covid-19, and therefore pay to be cared for in their own home. It’s time to listen to the people and make live-in care the default option. The benefits from all standpoints – financial, health and wellbeing are too great to ignore. We must not return to a model we know has failed.

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