/ Health

How people in care are still living with restrictions after lockdown

The social care sector has been under strain after a hugely challenging 18 months. Our guest, the Relatives & Residents Association (R&RA), explains what it’s doing to help in England.

This is a guest article by Helen Wildbore. All views expressed are Helen’s own and not necessarily shared by Which?. The Relatives & Residents Association is a charity championing the rights of older people needing care in England.

The past 18 months have been the most challenging period ever faced by the social care sector. People using care services have been among the hardest hit by the pandemic and the measures taken to manage it. From the early stages the sector was left to cope without adequate PPE, while policies such as the discharge of people from hospital into care homes without testing remained in place.

The government then swung dramatically to the other extreme, imposing severe restrictions on movement in and out of care settings. We believe both approaches put lives and people’s rights at risk. 

Whilst the rest of the country has seen restrictions lifted, people living in care are still subject to detailed guidance setting out which kind of visitors they can have and how much contact they can have with them – this is causing significant harm to older people.

Mental and physical health affected

The R&RA Helpline hears daily about people’s mental and physical health declining as a result of isolation from family and friends. The disparity in treatment is now vast. I can jet off on holiday, go nightclubbing, meet with whomever I want and have as much contact as I want. On the other hand, someone living in a care home is still told by the official guidance “handholding is acceptable if handwashing protocols are followed”.

For those who have faced stricter rules over a longer period of time and don’t know how long they have left in this world, the loss of control, contact, relationships, and precious time has had a terrible impact. 

It has been an incredibly challenging period for care staff too, expected to step in and fill gaps left by other professionals who have kept away from care settings during the pandemic. Consistent themes coming through our helpline are of closed cultures becoming embedded across some care settings, and of legal rights being overlooked.

That’s why we developed an information tool for care providers explaining which of their legal duties are relevant to decisions about visiting. Visiting and the Law aims to support care staff to meet their duties to respect the rights of those they care for.

Ensuring care and health needs are met

After 18 long months, we are still hearing from families being refused precious end of life visits until the very end, despite guidance saying they should be facilitated in the final year of life.

We hear from families facing strict time limits on visits, making them too distressing for the person in care. If a person has dementia, it may take them the whole allotted 30 minute slot to ‘settle into’ the visit before it abruptly comes to an end causing confusion and distress. Government guidance says each resident in a care home can nominate an ‘essential caregiver’ to provide companionship, support and help with care, but too many relatives are being refused this.

Yet in other care homes, staff have been welcoming relatives and friends back in with open arms, recognising the vital role they play not just in providing love and emotional support, but also practical support and advocacy to ensure their care and health needs are met.

Let down by the regulator

To end this ‘postcode lottery’, we called on the regulator for England, the Care Quality Commission (CQC), to start taking a proactive role in monitoring compliance with the Government guidance on care home visiting.

We believe it’s unfair that it should fall to families to push for compliance, straining their relationship with staff at a time of unprecedented challenges.

Our helpline hears daily from families too afraid to raise issues with care providers for fear of reprisals, given the vulnerable position residents are placed in.

At a time when people needed their regulator the most, the R&RA believes the CQC retreated to the side lines. We want them to now emerge and support people using care, their families and care staff out of this crisis. 

This was a guest article by Helen Wildbore. All views expressed were Helen’s own and not necessarily shared by Which?.

Comments

Forget the legal restrictions, some of us are so severely disabled it means nothing but appalling restrictions all your LIFE, like no work, no social life, no courting, no marriage, no kids, no holidays, no days out etc. And EXclusion to the maximum made worse by far too widespread gross ignorance in our society at just about every level, especially those in authority and the media and even disability campaign groups who constantly ignore those like like me which is only causing more exclusion and this needs to be far more well known, there must be far more awareness because at the moment there is nothing but total lack of any awareness and if anything it’s only being suppressed. Why should one section of society be singled out for such exceptional exclusion? It absolutely infuriates me as the worst exclusion is being forced on those who absolutely LEAST need it, those who’s lives are already far too ruined through no fault of their own, and such people are not even included in statistics, despite being registered to vote.

It is sad to hear tales that can be so distressing for people. During lockdown the priority was to protect people and inevitably that led to restricted or no contact. I experienced that with a relative. Even now we are still in a tricky situation, with many not yet vaccinated. I take precautions, wearing a mask indoors in public places, washing hands thoroughly, greeting less intimately than before.

Providing care is not always easy, no more than is providing medical help, particularly when a crisis arises. I personally think all those in contact with vulnerable people should be vaccinated out of respect for the health of their patients.

I do not understand why the CQC has not provided guidance on this for all care homes. Our sports governing body gave rules to follow and agreed with government that activity, in a more limited way, could continue provided each club submitted, and had approved, their plans for protecting participants. It worked well.

Care homes are generally commercial enterprises. They should have seen, in my view, the need to have suitable equipment available to protect their staff and their inmates and set about sourcing and purchasing it. As for “policies such as the discharge of people from hospital into care homes without testing” maybe someone will explain why care homes did not refuse to accept people unless and until they had been tested (negative) or, failing that, ensure proper isolation if they were positive and accepted. I am sure there is a simple explanation.