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Alzheimers patients with carers. Source: Flickr: Senior Guidance

Alzheimers patients with carers. Source: Flickr: Senior Guidance

Behind the rising death toll lies a care system hanging by a thread, says care worker Victor Davis

The mounting death toll in care homes, largely unreported by this government, has been one of a number of appalling scandals around how they have handled the coronavirus crisis.  Having finally factored these deaths into the official data, the government now reports a figure of over 26,000 deaths from coronavirus. 

But numbers come nowhere near conveying the scale of the crisis, since an estimated two-thirds of all care homes have reported coronavirus cases, with some homes losing as many as a quarter of their residents to the disease.  Another home reported that three-quarters of its residents were showing symptoms. The persistent lack of testing means that the true size of this scandal could still be largely hidden.

The 14,700 home tests made available on Wednesday, which ran out within 90 minutes, is yet another case of too-little-too-late.

Around 400,000 people live in care homes in the UK, 100,000 of whom could potentially die from the virus according to modelling reported by the Financial Times.  The social care workforce in Britain is over 1 million, and the availability of appropriate PPE is no better than it is in the NHS.  The staffing shortages which already exist in many care homes is also being exacerbated by the need to self-isolate even with the slightest symptoms, or simply by staff refusing to turn up for work for fear of their own lives, as is reportedly happening in one home in the North East.

Those who live in care homes and other similar support services include not just elderly residents, but people with learning difficulties which, in many cases, exist alongside an array of other underlying conditions.  Both these groups are very susceptible to infection even at the best of times, and they can decline very quickly when hit with a serious illness.  

The negligence in failing to provide such a vulnerable population with the protections they need can only be described as criminal.

PHE's medical director, Prof Yvonne Doyle says "I think there are possibly more fundamental and structural issues about how care homes are run in an epidemic." But I would argue that it goes deeper than that.  Care services in the UK have been left at the mercy of the private sector for decades, and this has left the care profession in an almost permanent state of crisis.  Privatisation is so deeply embedded in the care system that in many cases service users are astonishingly referred to as ‘customers’ – as if they are shoppers picking out their favourite brand of soap, rather than vulnerable people who rely on essential support to get from one day to the next.

This has always been unsustainable.  It seems hardly a year goes by these days without another story of turmoil for vulnerable residents because the business providing their care has either run into financial trouble or has collapsed altogether, as in the cases of Carillion and Southern Cross.

The popularity of the NHS is due to a widespread belief that the provision of care to the sick is an essential service that should never, for one second, be determined by profit margins.  The same ought to be true for the provision of care for the elderly and disabled. No little green badge will change the fact that Britain’s social care system is in the hands of a chaotic array of private providers who often compete with one another at the expense of the vulnerable people who rely on them and the staff who work for them.  As Ken Loach argued in last week's People's Assembly meeting, care services should be integrated into the NHS and run as a service for public need, not private profit.

Most people who have worked on a social care front line will also tell you about the incredibly high staff turnover.  The poor pay, the lack of secure hours and the stressful conditions, due to understaffing and lack of resources, mean that many care staff find it hard to consider the job as a long-term option and soon move on – a scenario not unfamiliar to many teachers who have dropped out of their profession.  

This, of course, exacerbates staffing shortages in care homes, which is often filled by staff provided by agencies - again for profit. Not only is the constant change in faces unsettling for those being cared for, but also increases the risk of infection, since agency staff often have to work across multiple services.

A recent training session on barrier nursing in one home did not tell staff anything they didn't already know about infection control and appeared to be simply an exercise in covering the company's back. This sort of box-ticking is not good enough.

When the staff asked about visors, they were simply told there were 'none available'. Then that very same day, delivery was arranged on the initiative of one staff member of some visors which, apparently, had been made in a local school!

The systemic failure of provision this highlights has been a problem for many years in the care sector, but now it is having fatal consequences.

A cause for optimism comes from the initiatives of ordinary people to support and protect each other. But, as well as championing what people are doing, we should continue to shine a light on what the government and private companies are not doing. It ought to be time, finally, for unions to take measures to organise care workers and lead a fightback.

Thursday night's People's Assembly meeting at 7 pm will focus on the crisis in social care, followed by the weekly clap for carers at 8 pm. But, as Julie Hesmondhalgh says, we should also 'roar with rage'.

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