One Year On: Care Sector Challenges Arising from COVID-19

COVID-19 has presented a number of challenges for all walks of life, including the care sector. According to data published by the Office for National Statistics (ONS) and the Care Quality Commission (CQC), 28,975 care home residents in England and Wales were reported to have died from a COVID-19 related death between 10 April 2020 and 9 April 2021. Tragically, ONS data also reveals that by the end of December 2020,

COVID-19 had claimed the lives of almost 900 care workers.

In this article, the first of three in a series, we focus on how the vulnerability of the care sector population, the availability of Personal Protective Equipment (‘PPE’) and comprehensive testing, and chronic workforce pressures have contributed to the scale and severity of the impact of COVID-19 in the care sector.

VULNERABLE POPULATION GROUP

Care sector service users make up one of the most vulnerable population groups in society. Older people are more likely to present with underlying health conditions and weakened immune systems, making them particularly susceptible to developing serious manifestations of COVID-19. A study published by Lancet Global Health found the risk of severe illness and death arising from COVID-19 is closely linked to frailty and underlying health conditions such as dementia, diabetes, and chronic respiratory disease. Coupled with this, care homes present a vulnerable environment with residents requiring personal contact with others on a frequent basis to meet their needs.

WORKFORCE PRESSURES

The care sector has for a long time struggled with chronic workforce pressures in the form of inadequate funding and pay, leading to high employee turnover. The pandemic has made these challenges even more acute. In response, the Department of Health & Social Care (‘DHSC’) established a Social Care Sector COVID-19 Support Taskforce in June 2020 to oversee the delivery of two support packages for the care sector: the Social Care Action Plan and the Care Home Support Plan. Notably, the taskforce reported an increased risk of transmission of COVID-19 arising from staff movement across multiple sites, and that this was owing to poor working terms and conditions, absence of contractual sick pay and high turnover rates.

On 1 April 2021, the DHSC announced a campaign to recruit an additional 20,000 people into the care sector by July 2021 and pledged up to £3 million to support free rapid online training for new recruits, exist- ing staff, and volunteers. It remains too early to tell how much these measures will alleviate the workforce pressures the sector faces, but they are clearly a move in the right direction.

AVAILABILITY OF PPE AND COMPREHENSIVE TESTING

The early months of the pandemic were fraught with issues around the lack of availability of PPE. In addition to this, many care homes raised concern about service users being discharged from the NHS to their care without up-to-date test results. Further, inflated costs meant that providers were simply unable financially to provide staff with the most basic and essential protection. Free PPE provision to the care sector was introduced in September 2020 as part of the government’s win- ter care plan, and this scheme has now been extended to March 2022. In addition to this, care homes can now access testing for all their residents and staff, regardless of whether they are displaying symptoms, via a new digital portal for care home testing.

WHERE NEXT?

Throughout the pandemic, care sector staff have demonstrated incredible resilience and dedication in their work. Amidst turmoil, they have continued relentlessly to deliver care to the most vulnerable members of our society. This is despite the multiple growing pressures and enduring issues the sector has faced, many of which pre-date the pandemic. As we emerge from the third lockdown, alleviating immediate pressures within the care sector is understandably the focus of the measures introduced by DHSC. We can only hope that the recent poli- cy-level acknowledgment of these issues and the renewed support we have witnessed in this area will continue much further into the future. In our next article in the series, we will discuss the CQC’s evolved approach to regulating the care sector during the pandemic.