‘My mum has trouble remembering me’ - Covid-19 pandemic takes its toll in Cambridgeshire care homes
The isolation and loneliness of people living in care homes in Cambridgeshire during the Covid-19 pandemic has been laid bare in a new report.
It found isolation caused by safety measures, staff shortages and very restrictive visiting policies had a significant impact on the quality of life of care home residents.
The strict rules on care home visiting forced residents and their families apart during the pandemic, with some families not able to be with loved ones in their final days and no chance to say goodbye.
“My mother now has trouble remembering who I am as she has had no face-to-face contact with me since December 2020,” one family member told Healthwatch Cambridgeshire and Peterborough, which produced the report.
The Life in a Care Home report was shaped by the experiences of more than 40 people living in care homes in Cambridgeshire and Peterborough, which included six homes in Cambridge and South Cambridgeshire.
Between March 2020 and April 2021, there were two waves of Covid-19 infection in which a high number of care home residents died.
There was an increase of 19.5 per cent above the five-year average death rate across England and Wales, with almost one in four deaths (24.3 per cent) as a result of Covid-19, according to ONS data.
Care homes in Cambridgeshire and Peterborough needed to manage outbreaks in their homes, staff absences caused by Covid-19 sickness and implement frequently changing government safety guidance.
This included restrictions on care home visiting, the introduction of PPE and Covid-19 testing, and isolation for residents after trips out of the home for medical and other appointments.
These added to the challenges already faced by the social care sector, which has been under pressure for some time due to a lack of funding and difficulties recruiting enough care staff.
The report found that most people were happy with the care and visiting situation in homes and felt homes had good Covid safety measures in place, although one in six (17 per cent) were not.
There was praise for staff but also significant concerns about staff shortages with some reports of poor care as a result of this, including at the end of life.
“It does appear that they are short-staffed at the moment which has meant that [my relative] often doesn’t get washed until midday, or even later,” the charity was told.
Another said: “They are short-staffed, and the staff I met didn’t even know [the resident’s] name.
“Residents were shouting from bedrooms obviously needing care and staff were too busy to get to them right away.”
There was a lack of awareness of the essential caregiver role within some homes and concerns about some homes restricting visiting over and beyond the government’s guidelines, the report found.
And it recorded concerns about the impact of long-term isolation on the mental health of care home residents.
One visitor raised concerns about communication problems caused by the need to wear face masks when visiting a resident.
“I have to do a lateral flow test before visiting therefore, since the person in residence is profoundly deaf, it is completely stupid to insist I wear a mask when trying to talk with [them] as [they] cannot hear me unless I am really close and not wearing a mask.”
Some families told the charity how residents were cared for in their rooms for weeks with concerns over prolonged isolation and loneliness for residents.
One person said: “Life is still more restricted for my [relative] than before Covid – mixing with other residents is still carefully controlled.”
The report also highlights how the situation was more difficult for residents with dementia, with one person explaining: “[Resident] was very upset with me, not understanding why [they] had not seen me and blamed me for [their] situation.”
The feedback Healthwatch received also raised some concerns over end of life care.
Just less than half the people (49 per cent) said they had discussions about end-of-life care for their loved ones. Most (73 per cent) felt their wishes for end-of-life care had been respected.
But two people said end-of-life wishes were not respected, with one person raising significant concerns about poor care for their friend.
“This lady is at the end-of-life care and there is absolutely no love provided,” they said.
The report has been welcomed by Cambridgeshire County Council and the Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) for providing “valuable” and “important” insights highlighting the challenges faced by care home staff, residents and their families.
Healthwatch will be writing to all local care homes with a copy of the report, and asking them to implement our recommendations.
These include that all homes should implement the government’s care home visiting guidance and take up the new ReSPECT training programme.
This programme is a way of making sure people can plan what they want to happen as part of their care in a health emergency, particularly at the end of life.
The care homes will also be reminded that staffing levels must be sufficient to ensure a good quality of care.
Sandie Smith, chief executive of Healthwatch Cambridgeshire and Peterborough, said: “The past two years have been a very difficult time for everyone. But our care home residents, their family and the staff who work there have been particularly affected.
“This report tells some very difficult stories and these are sobering to read. We hope that care homes will take on our recommended improvements and so take some positive learning from this challenging time.”
Charlotte Black, the executive director of people and communities at Cambridgeshire County Council, added: “The pandemic has thrown into sharp relief the crucial role that care homes and the staff who work in them play and we are very appreciative of the challenges care homes and their residents have faced throughout the pandemic.
“This report brings those challenges to life and provides some really valuable insights into what matters and highlights some great practice as well as some areas where we know improvement is needed.
“The report helps to set the agenda for the next few months as hopefully we start to emerge from the worst of the pandemic and work with and support care homes to move forward.”
Carol Anderson, the chief nurse at Cambridgeshire and Peterborough Clinical Commissioning Group, agreed that care home staff, residents and their families have faced “unprecedented challenges during the past two years”.
And she added: “This important report highlights the challenges the pandemic has brought to all of those who have spent time in a care home as a resident or team member during this period.
“We continue to work hard to ensure that people receive the right care in the right place at the right time, and we will continue to support people to have more control over their health and wellbeing.
“Part of this process is the support we offer hardworking care home team members to undertake the appropriate training, including around ReSPECT processes, to ensure residents and their family or carers are included in decisions about their care.”
