Into the Fire – Life on the frontline of Social Care after 6 months of Lockdown

Vulnerable adults – many living with dementia, in social isolation – are highly dependent on their caregivers.  Without them they may have no company, nothing to eat and may miss medication.  They need support 365 days a year, come rain or shine.  Coronavirus may have shut down the economy and seen almost 10m UK workers furloughed but it did not stop an army of caregivers continuing their amazing work.

Apart from the fear of infection, Coronavirus has caused great stress and disruption for everyone.  Save for those aged over 80, who can remember the last war, none of us have experienced such disruption to our lives before.  We have all become accustomed to enjoying a settled pattern of life, free to do what we want, when we want – enjoying holidays abroad, large social gatherings, low unemployment, and generally easy access to all the usual NHS services.

Since March however so much has changed.  For us, providing home care in the community, we have had to quickly adapt to new PPE guidance and working practices, all subject to change and additions as Public Health, England refined their thinking.

At Right at Home we work hard to keep settled work patterns and minimal changes to our care rota.  This is for the benefit of both clients and carers.  During “steady state” although a challenge for us all, we manage minor changes to the rota to allow for carer holidays and sickness as well as changes due to new client requirements.  During the pandemic however many more changes have been required with carers unwell or self-isolating.  We have also had to deal with clients cancelling companionship visits altogether; clients and/or family members shielding or being themselves unwell.  Many staff have also had to deal with the schools being closed and well as other disruption to their everyday routines.

We have recently written to our carer team thanking them for sticking at their jobs, supporting our vulnerable clients with the same excellent care as provided prior to the pandemic.  Without the support of our dedicated caregivers, many clients would have no visitors, nothing to eat and for some no medication.  When the lockdown started – as a team our caregivers came together – with no thought, no hesitation, no question that they would do anything but carry on.  Apart from great courage, this confirmed to us what we knew already – that is, the total commitment they all share in doing everything humanly possible to support all of our clients in the community, in the best possible way they can, every day of the year.

Winter 2020

Sadly, it is clear now Coronavirus will not be over by Xmas.  A second wave of infection appears to have started.  All carers have been reminded once again to take care and be ever vigilant about the risk of infection.  They are reminded to tell us immediately if they feel unwell personally.  They are instructed to wash their hands whenever they can and continue to use the sanitiser provided.

Safety First

At Right at Home we are committed to providing a safe service.  Infection control and food hygiene have always formed an important element of caregiver training and supervision.  Now, more than ever, all caregivers must take great care to do all they can to minimise the risk of spreading infection.

In practice this means they always where personal protective equipment (PPE) when within 2m of:

• a client when providing close personal care (for example, touching) or
• anyone in the household who is coughing and COVID-19 PPE.

They wear disposable gloves and plastic aprons which must be disposed of immediately after completion of a procedure or task and after each client.  Hand cleansing is required before an after each visit.  Masks must be worn for all visits.  A mask and visor are required if you the caregiver is providing personal care.

They are instructed that PPE is only effective when combined with:

1. hand hygiene (cleaning hands regularly and appropriately)
2. respiratory hygiene (‘Catch it, bin it, kill it’) and avoiding touching their face with their hands
3. following standard infection prevention and control precautions
4. correct technique for putting on and taking off PPE
5. safe disposal of used PPE.

If any client develops symptoms, such as persistent cough, temperature or develop loss or change in normal sense of taste or smell, or is otherwise unwell, caregivers must inform our manager immediately.

Caregivers are further advised to change their clothing when they get home and launder the same:

1. separately from other household linen if heavily soiled
2. wash in a load not more than half the machine capacity
3. at the maximum temperature, the fabric can tolerate, then ironed or tumble-dried.

All caregivers are expected to help with Risk Assessments for each visit – to take account of the risk that a client or a fellow resident could be infected by COVID-19.

Caregivers must tell our manager of any change in the client’s condition. This will determine when and for which clients or duties the caregiver needs to wear items such as eye protection and fluid resistant masks.   If practical caregivers should call clients ahead of a visit to check on their symptoms and then discuss these with our manager.