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Khadija Kachra, manager of Bromley Park Care Centre on the Kent-London border, tells us about the long term impact of the Covid-19 crisis on her staff and residents.
Care homes have suffered some of the most devastating consequences of the Covid-19 pandemic. A catalogue of mistakes including lack of testing and regional differences has led to one in 20 UK care home residents dying of the virus, according to the latest analysis by the London School of Economics.
Specialist nursing and dementia care home Bromley Park Care Centre has been one of the more fortunate care homes with only one diagnosed case, albeit since tests were made available to them in mid-April. However constantly changing information and the lack of clear guidance has had serious consequences for the emotional health of both the staff and the care home’s 38 residents.
“The biggest impact of Covid in our care home has been anxiety” says home manager Khadija Kachra. “The pace at which everything was changing over such a short period of time - dealing with new reports being published every few days, different guidances, how things were portrayed in the news, and dealing with questions that we didn't really have answers to, created a rollercoaster of emotions.”
“Every day felt so long because we were dealing with so many different things. We were told to isolate residents who were coughing, and then anxieties built up because the unknown about this virus played into the gaps in people's knowledge. There was no real information, just people hearing lots of different things.”
Throughout March reports of cases creeping up were making headline news, so Bromley Park closed the home to non-essential visits ahead of the official guidance, which didn’t arrive until April 2. “As soon as we shut the home we knew it would be safe, but as a manager the hardest thing is managing the rhetoric and people's anxieties.
Isolating people with dementia in a care home is going to have a very big impact on them, because keeping them in contact with their relatives is so important.”
“Communicating with the relatives was important too because everything was changing daily. I can manage the care home well, it’s what is going on outside that’s more difficult and that's where the stress comes in.”
With no tests available, they were told to isolate residents if they showed any symptoms. Staff had to self-isolate too, even after test centres opened, because they are only accessible by car and most of their staff don’t drive. When home tests finally became available these were problematic too. “There were so many logistical errors. Sometimes there were delays with the home tests, and some people never got results” Khadija says.
All of this was taking its toll on people. “From the beginning I thought the mental health side of things was going to be much more complicated to manage than anything else. You can get PPE, and you can wash your hands, but it’s the things you can't control like people’s emotions, that's where the difficulties start. And staff have their own families too, what if they’ve got something happening at home?”
Time will tell if the Covid-19 crisis will deepen the staff shortages the care home sector is already experiencing. “We might see a lot of people leaving the industry, and we might see people not wanting the stress of managing care homes, because managing this has been very tough” Khadija says. “Saying that, I think we'll also have a new breed of people wanting to come in to the sector, as we’ve found some people want to leave hospitals after the pandemic and come to work in care homes.”
“For me it comes back to mental health. Is the stress of working in care and healthcare too much? That's the question that we need to ask across the board. I've been very clear from the beginning that we need to plan three months ahead, and that also involves the strain that all of this is going to have on mental health services. When services do start to reopen, mental health services in particular will be even more strained than any other service.”
Occupancy in care homes is likely to decline however, she says. “The way care homes have been portrayed doesn’t apply to all homes, and now we're going to have a large proportion of people in the community who perhaps should be in care homes and aren't going to be, because their relatives are too worried they’re going to catch Covid-19. You will end up with potential safeguarding issues due to people looking after their relatives who are struggling themselves with their own health issues, and who haven’t been trained in care.”
The pandemic has certainly put care homes in the spotlight, which Khadija believes is positive. “People are talking about it a lot more which is obviously a good thing because it’s been neglected for so long. It needs to be identified either as an independent service or as one that’s parallel to the NHS. Community care as a whole is forgotten about.”
Despite being an extremely tough few months, there are achievements they can draw from. One of these is that staff are now able to do a multitude of roles, having taken on new tasks while their colleagues were self-isolating. “It’s given them this drive to want to do more, and they’re thinking about where they are in life and how they want to move forward” Khadija says.
“They’re also looking after each other even more than they already did. There's a lot more of the “are you okay? Do you want me to swap a shift?” kind of support going on, which is obviously very important.”
“We’ve got some brilliant relatives of residents who have been so kind, offering to volunteer, drop off food and all sorts of lovely things. There's a lot of gratitude from them as well, and that’s been very important for the staff to see because you don't always see the positive side of things. Whether you're in a care home, a hospice or a hospital, sometimes it's very easy to focus on everything else. You have to take some gains from such a negative experience, and I believe these are the gains.”
