The Impact of COVID-19 on Home Care: Lessons Learned

COVID-19 was one of the biggest public health challenges faced in generations, quickly spreading to cause a worldwide pandemic. It’s been associated with the deaths of over 150,000 people in the UK and nearly 5 million people worldwide.

At the start of the pandemic, the UK homecare sector struggled to meet the increased demand on care services as hospitals overflowed and families sought safer alternatives to care.

Several research studies have discussed the impact of COVID-19 including: Exploring the Impact of COVID-19 on Home Care Workers [Southern Gerontological Society].

With this research in mind, we explore the social, economic and mental health impacts of the pandemic on the homecare sector and key lessons learned.

The Social Impact of COVID-19 on Home Care

Local authorities initially struggled to meet their commitments for domiciliary care due to staff shortages, lack of sufficient testing, and rapid hospital discharges to free up beds for COVID-19 patients. This meant many caring tasks were initially taken on by family, friends and neighbours.

Frail elderly care clients were at higher risk of contracting the disease and becoming unwell or dying as a result, which is why some care clients cancelled homecare during the first wave due to concerns about carers potentially coming into their homes carrying the virus.

• Safety and PPE Challenges

  Homecare agencies had to cope with a shortage of personal protective equipment (PPE) directly affecting the safety of both care clients and care teams. Some tasks using PPE created communication difficulties, particularly for clients with hearing and cognitive impairments. The UK government issued stringent safety guidelines including infection prevention and control actions, social distancing and correct use of PPE causing additional challenges for caregivers.

• Social Isolation and Its Effects

  The impact of social distancing was particularly felt by elderly patients separated from family and friends. Care staff were forced to take on a greater element of social and emotional support for clients, especially if they had experienced bereavement during the pandemic. In some cases, homecare workers were the only people clients had contact with and understandably, some clients became overly dependent on their caregivers.

The Economic Impact of COVID-19 on Home Care

Pre-pandemic, financial security and opportunities for career progression were limited for home support workers. Largely made up of a female workforce, they received lower salaries compared to healthcare professionals with similar roles and responsibilities.

During the first COVID-19 wave, some clients refused to let carers into their homes and public health measures around self-isolation resulted in staff being unable to work. The financial element was an additional source of stress for staff already under considerable strain. Increased fuel costs particularly affected home care workers based in rural and remote locations.

Many caregivers felt their contribution was largely undervalued and unrecognised by the UK government, referring to the Department of Health’s one-off pandemic recognition payment given to certain frontline healthcare workers. The low priority attached to social care illustrated a longstanding failure to afford it the same attention as the NHS.

The Mental Health Impact of COVID-19 on Home Care

• Mental Health of Caregivers

  Home care workers faced significant emotional and practical challenges around their personal lives during the pandemic.

  Pre-pandemic, the sector faced challenges with poor recruitment and retention, low pay and morale and the pandemic served to highlight these challenges. Difficult working conditions due to management, funding and staff issues resulted in increased stress, a low sense of well-being and overall dissatisfaction with their role.

  Caregivers felt lonely and unsupported due to home care services being cut or reduced with limited or no contact with colleagues. Many carers were concerned about the risk of transmitting COVID-19 not only to vulnerable clients but to their own family members.

• Supporting Clients’ Mental Health

  There was a greater need for caregivers to provide social and emotional support for their clients due to social isolation from family and friends. Home care staff were often the main and only source of social contact for their clients, and they felt a strong sense of duty and care often putting their clients’ needs above their own fears and concerns.

Lessons Learnt and Looking Forward

• Decisions about living and dying well: The Care Quality Commission (CQC) conducted a review of how ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions were made in the early stages of the pandemic without involving people or their families and being applied to groups of people, rather than looking at each person’s individual circumstances. The report highlighted support needed for healthcare providers to discuss DNACPR decisions as part of a holistic approach to advance care planning.

• Preparedness and Flexibility: The pandemic put strain on a social care sector already under huge pressure, particularly caring for elderly people at greater risk of death from COVID. Planning for future pandemics should consider the intense interaction between the NHS and social care. The Department of Health and Social Care’s 10-year vision ‘People at the Heart of Care’ outlines how the government will transform support and care in England and is a step in the right direction.

• Investing in Staff and Training: The homecare sector suffers from high staff turnover and significant investment is needed for effective recruitment and retention strategies. The UK government allocated £2.8 billion to adult social care in 2023/24 and £4.7 billion is predicted for 2024/25. Ongoing training is needed in how to use digital care technologies and infection prevention and control techniques. Additional support for home carers emotional and mental health in highly stressful frontline situations is vital.

• Embracing Technology and Innovation: Telehealth and dedicated person-centred home care software became increasingly important during the pandemic as homecare agencies shifted to offer remote monitoring and communication solutions. Digital care management software should comply with CQC standards and mirror how your care teams like to work. Dedicated features for everyday tasks such as staff scheduling, care planning, updating MAR charts and real-time patient monitoring, help your care teams to focus on providing better care rather than trying to keep on top of paperwork.

Essentially, the pandemic had significant social, economic and personal impacts on both caregivers and care clients. We’d urge homecare agencies to consider the lessons learnt to be fully prepared for future challenges, enhance care quality and support their staff and clients better.

To discuss how our Tagtronics homecare software solution can help address some of the challenges highlighted in this blog, call us on 01254 819205 or email: howcanwehelp@tagtronics.co.uk.