It would be lovely to write an article that was positive and supportive of the industry, after much thought I can only think of one thing we can do to help, but I’ll get back to that.
Where to start? It didn’t start with Brexit but the impact of it has been well documented, and everyone is aware of the effects on all low paid sectors. This sector needs Nurses, unfortunately so does the NHS! This has led to auctions for their salaries, between several Nursing Homes and Health, which Health – having deeper pockets – will always win. There are also Overseas Visa schemes, but they are costly, time consuming and limited by allocations, which will probably have already been taken up.
Which leads us to the levels of salaries, these are monitored by those paying for the Care Services and Care Providers are told it’s up to them what they pay their staff, but fees are set and paid based on minimum wage. There is a good portion of the market, which is private, but fees again are often based around what the Local Authority pay and most Providers have both Private and Public funded Clients/Residents. There are a few examples where Councils have tried to do something different, but it has been tricky to fund in the long term for them. Ten years ago, in Sandwell, they gave all Learning Disability Providers additional funding if they would prove it would all go on salaries. This was welcomed by the sector and did a lot of good, however since then Learning Disability Providers have not had an increase at all. There are also tax and benefit rules which cause issues where it is not worth people working in the sector or doing more than a few hours a week.
Attracting new staff into the market has always been a challenge as it is not just about learned skills it is also about the right aptitude. There has been some fabulous work, not least with Neil Easton’s book on “Saving the Care Industry” with lots of ideas on how to get new people, but we have still not been able to keep pace. We believe that currently there is approximately a 20% vacancy rate before we look at new issues. The industry is full of fabulous long-time workers who are coming up for retirement and we are forced to congratulate them and hope they can be replaced. Who can blame people after the 18 months of hell we have had. Care workers have come into work when everyone else was stopping at home, when Homes caught Covid (whatever the cause) they came into work scared and stopped there to protect their families. Many worked long hours, and many did 7 days a week for months to ensure the people they cared for were looked after. But now, they are tired and weary, still working the long shifts to cover for the staff shortages. Not only are staff doing the jobs they did before, they are also covering others…… trying to make up for a loss of visitors, day centres and entertainment, doing blood pressures or podiatry to stop health professionals having to come in. On top of this is the additional Infection Prevention ever changing rules and the masks which restrict the communication which is so vital to the people they care for.
Am I still going? What about Vaccinations? Not that we think as a sector that this is not a good thing, but why just the Care Sector? Still, we are where we are and by the 11th November we need to stop some of our valued carers from working. We don’t know if we are going to have to keep paying them for garden leave or if we can terminate their contracts, that’s up to the Government we are still waiting for the advice. We asked Providers in the West Midlands about how many staff would not have the vaccination and it looks like it will be about 4%.
What will be the implications of this?
Speaking to Local Authorities and Health and Care Providers we found Care Providers being bombarded with requests to provide care, unfortunately there are no staff to pick up the packages and Providers do not know how to provide the Care they have already committed to or looking after the people who are already in their Homes. Many Nursing Homes have either changed to a residential home or are seriously considering that as their only option. Homes and Home Care that provide temporary rehabilitation packages are not able to move them into more permanent care or settings which means that Hospitals are struggling to discharge their patients. Many services are considering closing and at least 11% of West Midlands Care Homes are expecting to decommission beds.
A Perfect Storm?
The Care Industry has never faced a crisis like this. As well as the problems I’ve highlighted above we also hear of problems obtaining insurance or banks deciding they no longer want to support the sector, it has got to the point where we start to wonder whatever will happen next?
So what can we do to help? We need everyone to understand the situation Care Providers are in and make sure they are not forgotten. As a Care Association we try to make room for Managers and Owners to talk and share their fears, so they know that they are not alone. Knowing that others are in the same situation can be a powerful coping tool.
But let’s not be too negative. The Care Sector has responded to this crisis in a way that we are incredibly proud of and should never be forgotten. Let’s just hope that the powers that be in government have the same long memories.