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How do we provide better mental health support for care home staff?

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Previous research has highlighted the risk factors associated with high stress amongst care home staff, including high staff turnover and absenteeism and staff malpractice.

Throughout August 2020, staff in the Corporate Psychology division of the Maudsley Hospital spoke to several care home staff and Registered Care Home Managers (RCMs) in South East London to find out how their work impacts on their mental health and how to better support this vital workforce[1].

What did care home staff and managers say?

Those working in the care home sector face a multitude of stressors that include working long hours for low pay, difficulties in managing the behaviour of residents, not having enough time for self-care or to “reboot” and feeling that, despite the difficulties, you are expected to “just get on with it”.

Most of the managers we interviewed described unmanageable workloads consisting of a myriad of organisational demands that often led to working well-above contracted hours. Several described being on call and available 24/7, including during periods of leave. Some described feeling that they constantly have to ‘cover’ themselves and make sure that they are always prepared for upcoming checks. Many of the RCMs spoke of feeling in the line of fire and being the first to get blamed when things go wrong because “it is easier to blame one person than an entire system”.

During the pandemic, managers were left feeling physically exhausted and emotionally depleted. They described dealing with various logistical pressures, such as sourcing food for residents and PPE for staff, not being able to get hold of GPs, and having to accommodate residents who had been discharged from hospital with COVID-19. There were also emotional demands, such as reassuring anxious staff and keeping morale up by role modelling calmness and confidence.

Similar challenges were described by care home staff, including long working hours, restrictions on when to take annual leave, managing challenging behaviour of residents and, during the pandemic, having to manage with a lack of supplies. Staff felt that their role, often complex and comprising aspects such as enabling residents and upholding their human rights, was overlooked by the public, especially when compared to health workers.

Neither RCMs or frontline staff felt that there was adequate support to help them cope with the highly emotive material and pressures they are frequently subjected to, both on a day-to-day basis and during the pandemic. The majority of those we spoke to felt that that the culture in the sector does not generally invite staff to discuss the emotional impact of their work and reflect on how they are coping.

I work in social care and I need help with my mental health

  1. Keeping Well online portal. Keeping Well SEL is an online portal for health and social care staff in South East London. Visitors to the site can find support and information on a range of issues, as well as make a referral for free psychological therapy. Users can also use the live chat and phone function to speak to an assistant psychologist Mon – Fri between 9am – 5pm.
  2. Free access to psychological therapy. Health and social care staff working in SE London are being prioritised for free psychological therapy via IAPT*. Staff can make a self-referral to one of six boroughs in SE London and don’t need to live, work or be registered with a GP in that specific borough (as long as they work within one of the six boroughs).

*Anyone living in England and aged 18 and over can access free psychological support via IAPT: https://www.nhs.uk/service-search/find-a-psychological-therapies-service/



[1] If you would like to access the full report of this work, which provides information on our rationale for conducting this research, as well as sample sizes and organisational context, please contact maya.haddad@slam.nhs.uk.

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