Supporting two very old parents, especially when you live some distance away, brings challenges at the best of times.
For the last couple of years, I’ve been ordering Mum and Dad’s weekly online shopping from Sainsbury’s, making sure the pharmacy has delivered their medicines, arranging menus from Wiltshire Farm Foods, checking their care workers have turned up, trying to pop over for a social visit every other weekend, and phoning nearly every day. We’ve often joked I have a second job, as their personal assistant.
But in the current crisis, the safety net I’ve tried to build around them over the years is full of potential holes. Reports from Spain of staff abandoning a retirement home do little to qualm fears, though I can’t imagine that would happen here. But reports that some care homes in the UK can’t get hold of enough food are a little alarming.
So far, my parents have been getting excellent support – Mum in a nursing home, Dad in the family home. But what happens if their care staff get sick?
Last November, my 93-year-old mum spent two months in hospital. She eventually moved to a nursing home in Thurrock, Essex, owned by the Runwood Homes Group, in late January.
The home closed its doors to unnecessary visits on 9 March, ahead of government advice. I managed to see Mum just before the ban came into effect. “There’s not much you can do about it, is there?” she said, with a stoicism that reminded me she survived the blitz.
But what happens if this fragile network of care workers breaks down as staff start to get sick or need to self-isolate?
Mum’s nursing home is doing all it can to ensure highest infection control measures are in place, which is reassuring. Staff have to change into clean uniforms at work and must not wear them outside the homes, says Alyssa Kelleher, spokeswoman for the Runwood Group, which runs 70 nursing, residential and specialist care homes across the UK.
Each home has been issued protective masks by the government and the group is also trying to source more fluid-repellent face-masks and gloves itself. “We would like to have more stock as soon as possible for protection,” says Kelleher. “Currently, masks are only being used in a suspected or confirmed case, which we’ve had none of so far.
“[We] check the temperatures of every resident and staff member daily,” she adds.
Runwood buys food on a group-wide basis, so it can boost supplies to homes where there may be a shortfall. It has also devised a “no-cook” menu of pre-cooked food that any member of staff can prepare if catering staff become ill.
Keeping residents’ morale high is also important. “Homes have seen some external entertainers performing outside their windows,” Kelleher adds, “while local communities have been invited to contact residents with letters, pictures and postcards.”
Both Dad and I feel happy that Mum is as safe as possible, and that she is comfortable. My bigger concern is Dad, 92, who is supported by a team of care workers from Manorcourt Homecare, an agency that has 12 branches providing domiciliary care across the east of England, including Thurrock.
Dad’s care arrangements work well. The morning care workers wash, dress and toilet him, and prepare his breakfast. The frozen meals delivered every week are heated up daily by the lunchtime care worker, who also prepares his teatime snack. He gets an evening visit to prepare him for bed. Dad also has some additional support from Age UK home helps, who clean the house, wash clothes and bedding, and generally offer social support.
But what happens if this fragile network of care workers breaks down as staff start to get sick or need to self-isolate? Will a time come when he doesn’t get the crucial help in the mornings?
And, given the number of people coming through his home, is he – and are his care workers – putting themselves at added risk of catching coronavirus?
So far, so good. Although one of Dad’s usual Age UK home helps had to self-isolate last week, someone else came instead. I’ve made sure Dad has hand gel strategically placed for his care workers to use if they wish. “But most are washing their hands,” he tells me. “They have told me they’ve been given gel to use. And some have started wearing masks.”
“We are closely monitoring all clients and any changes to their health,” says Janice King, operations director at Manorcourt Homecare. “We are also conscious of every client’s mental wellbeing – it’s a hugely unsettling time and our care workers may be the only person they are now seeing day to day. We are doing all that we can to keep our clients and care workers safe during these unprecedented times.”
The agency has always prioritised its clients under a RAG (red, amber, green) system, adjusting services as necessary if staffing levels drop. It continues to do that now.
“If someone is living in isolation and has no family or friends support network around them, or perhaps a client has an urgent medication that needs administering at specific times of the day, they would be rated red and therefore a priority for our care workers,” King explains. “Social visits and those clients with supportive families close by would be rated green.”
Clients with family living nearby or even living in the same household would be approached to see what help they might be able to offer if necessary.
If staffing levels should drop significantly, they would reduce the amount of time spent with a client, or the office-based staff (all of them trained in practical care) will go out on a visit. In Dad’s case, the Thurrock branch has 10 office staff who could provide cover as needed. If care workers need to remind a client to take their medication, they might phone rather than visit in person. Ultimately, says King, they’d call on social services for support if they had to reduce services to a client who was extremely high risk.
While Manorcourt Homecare routinely trains its staff to work with personal protection equipment (PPE), including gloves, aprons, arm sleeves, foot covers and masks, ensuring there is enough of it is a worry, says King. “We are fortunate that we continue to have a supply of PPE equipment in every branch office and all frontline staff have the appropriate PPE for every client they visit,” she says. “Our concern is to ensure that stocks are maintained and so our office team is working hard to ensure these supplies continue to reach us and can be distributed across all of our different locations.”
Keeping staff safe, well and working is a high priority for both agencies. They are keen to promote their increased recruitment drives, as they need to find new staff who can cover should existing staff get sick. Both Manorcourt and Runwood are recruiting new care assistants, and Runwood also has vacancies for nurses, domestic staff and wellbeing/activity leads.
But getting sick is not something these care workers will want to do. No one does this job for the money: the rate of pay is around £9-£10 an hour. Neither company offers occupational sick pay – the care workers are only entitled to the statutory minimum, which is £94.25 a week for both sickness and self-isolation.
No doubt other people like me, who have frail, elderly parents, are wondering what they’ll do if a parent’s care package should break down.
I can’t do much about my mum given she is in a home, but I’ve already told my dad and the team at Manorcourt I’d help out if needed. But restrictions on travel may make it difficult for me to drive the 25 miles to his home each day from London, potentially spreading the virus.
Maybe I’ll just have to move back into my childhood home. I’m rather hoping it won’t have to come to that. But in these extraordinary times, anything is possible.