This is the 2020/21 edition of State of Care
The pandemic has reinforced how vital adult social care is for the many people who rely on it. Services have faced massive challenges in keeping people safe during the pandemic, while supporting them to live fulfilling lives through person-centred care.
The impact of the pandemic on people who draw on and work in adult social care services has been devastating and, despite the best efforts of staff, COVID-19 has contributed to a significant increase in the number of deaths in nursing and residential care homes in particular. Our data on the notified deaths of people living in care homes in England conveyed the tragic loss of life of people using adult social care services to COVID-19.
Based on our programme of infection prevention and control inspections of care homes, we reported that most care providers that we have inspected have demonstrated that they have faced their challenges well. They have been supported by staff who have showed resilience under unprecedented pressures. They have gone the extra mile to keep the people in their care healthy, active, and as independent as possible, while keeping family members and carers informed and engaged.
Trusted home-care throughout the pandemic
Claire has a pacemaker, fibromyalgia (a long-term condition that causes pain all over the body) and chronic obstructive pulmonary disease. She has received home-care support for seven years, which is arranged by the council.
Claire’s carer, Michelle visits every day, and helps with personal care, as well as housework and shopping. She stays as long as needed. If Claire does not need anything, she will phone the agency to cancel, but if this is unexpected Michelle will pop in to double check everything is alright.
Michelle continued to visit during the pandemic. Claire felt very confident and trusted that Michelle was doing everything to keep her safe, such as wearing all the personal protective equipment and washing her hands regularly.
Very occasionally, Michelle was unable to visit because she was extra busy with clients due to COVID-19. Claire would be offered an alternative carer, but she refused because she has built up such a trusting relationship with Michelle that she only wants support from her – particularly with personal care, such as showering. In these cases, she would put off tasks until the next day or ask her family to help.
Claire became quite anxious about the pandemic, resulting in her not wanting to leave the house. Michelle understood this and, as well as carrying out her usual tasks, took time to try and relieve some of Claire’s anxiety. She encouraged Claire to sit with her in the porch with the front door open while they chatted. This helped Claire a great deal and she now leaves the house.
Michelle continues to be a trusted carer and great support to Claire.
Interview with a member of the public
Holistic, person-centred care has always been important, but during the pandemic it has become even more critical as adult social care staff have taken an even bigger role in the lives of people in their care during periods of lockdown.
Where people using services have had less contact with people during the pandemic that understand and affirm their culture, such as family and friends, it has been important that care staff have been alert and responsive to people’s beliefs or conventions. In May 2021, we supported care providers, managers and staff with an online resource that details some key aspects for supporting culturally appropriate care, and provides examples of good practice, including many that we have seen when we've carried out inspections of adult social care services.
It is work like this that highlights the importance of a career in adult social care in enhancing the day-to-day health, wellbeing and experiences of people using services, as well as providing support and comfort at the end of their life.
‘The best possible care’ during mother’s final months
“The recent lockdown has really made me appreciate the outstanding care and compassion that the team at her care home provided for my late mother during her final months after her short battle with mouth cancer.
The care team became her closest friends and they helped her to overcome her anxieties, as she started to interact more with others. Consequently, she actually became more social than before she came!
The dedicated team of nurses, carers and staff were extremely friendly and approachable. We were always kept informed and involved in developing her care plan.
I was also humbled by the way all the major Hindu festivals were celebrated at the home in an inclusive, safe and enjoyable manner. Unfortunately, my mother was not well during Diwali, which is one the biggest festivals in the Hindu calendar. However, the team made special efforts to celebrate it in her room, which the family were invited to. It turned out to be one of the most special and memorable Diwali's we had as a family. It highlights how the team always went the extra mile to make residents happy.
The wide range of activities played a huge part in my mother's physical and mental wellbeing. It is always hard to see a loved one deteriorate, but the team motivated not only my mother, but also us, to participate in key activities, such as karaoke, yoga, cooking, bingo, board games and much more.
The home manager was exceptional. She was very approachable and available to speak with us anytime – even out of hours if we had any concerns.
While the past year has been a very distressing and anxious time for many families, on reflection following my mother's passing, I have been comforted to know that she was fortunate to receive the best possible care during her last few months.”
Account of a family member, received through our Give Feedback on Care service