By Ailsa Colquhoun, Care Home Management
As the UK grapples with the ‘new normal’ of life with COVID-19, it’s possible to look back over the past few months and think about the many changes we have had to make in our lives. For many people, changes have revolved around getting to grips with home working: how to manage staff working in remote locations, how to ‘switch off’ from work when you can’t close the door on it, or, perhaps, how to quickly hide the detritus of family home life from your background on Zoom.
For care homes which are now eligible to open to visitors, one of the many necessary changes has been how to manage pent-up demand from visitors but in a safe, and socially-distanced way.
Of course, for the Government – which has come in for some criticism recently (in particular from the Public Accounts Committee which recently condemned the Government’s “slow, inconsistent and at times negligent approach” to the social care sector in COVID-19 pandemic) – there are many eyes on the changes it plans to make to the sector post COVID-19.
During the pandemic, when all eyes were on the Government’s handling of infections in social care, there were rushed promises of a long-awaited Green paper. Among those eager to hear what the Government has in mind is the Association of Directors of Adult Social Care Services (ADASS). Recently, this Association published nine statements to help shape adult social care reform, chief among which are the need for a conversation about the types of care and support we want for ourselves and our families, today and in the future and, the $64 million question: How do we pay for it?
For care homes the ideal outcomes of the Green Paper are more funding and more integrated, seamless partnerships with the NHS. However, it is clear from ADASS’s think-piece that reform of social care could go in another direction entirely. In fact, in one of its statements it calls for a complete review of how our care markets work, saying: “For too long care has been built around organisations and buildings such as hospitals, day care centres and care homes”. Its suggestion is for a new model of care that “works for us as individuals and our families”. This, it says, will likely to be provided in our own homes, integrated into specialist housing and care packages akin to current extra care provision.
It’s true, of course, that a move into care is a big step for families as well as the recipient of care. Research published in Care Home Management’s July/August issue suggests that people view a move into residential care as a sign of failure, and as bringing challenges to privacy, independence and autonomy.
So, is there actually a role for care homes in the future?
Certainly, many former office workers will remain home workers after COVID-19, but this does not imply a sudden increase in the number of informal carers available to care for their relatives. Research tells us that people move into residential care for a variety of reasons, such as a decline in personal health or the health of a care-giver; difficulties with shopping, cooking, medication and transport; pressure from family members; and a need for more or different care or support services. Many of these drivers will be unchanged by COVID-19.
Nor does increased demand for domicilary care equate into a sudden influx of formal domiciliary care workers. Pay constraints, immigration controls and competitive employment opportunities will all serve to keep this, and other care staff vacancy rates high, and given the current political position on immigration, there is little sign of these pressures abating. What is certain, however, is that the population will continue to age, and with that age, there will be age-related health conditions that need specialist care.
It’s easy to find faults and weaknesses in the current system but it’s far less easy to suggest the solutions. Put simply, social care is not an easy problem to fix, particularly, when public funding is squeezed. That’s possibly why it’s already taken the Government over three years and counting to publish its Green Paper on Adult Social Care.