Can COVID-19 be a catalyst for change in social care?

Innovation and Change in Social Care: Learning from the Pandemic

Notes by Ertugrul Polat

Green Templeton College hosted the first Care Initiative virtual event of the 2020-21 academic year on 18 November. Welcoming Rosalind Pearce, Executive Director of Healthwatch Oxfordshire, Penny Thewlis, CEO of Age UK Oxfordshire, and Rachel Pirie, Acting Deputy Director of Commissioning for Adult Social Care in Oxfordshire County Council, the session focused on the positive learning from the pandemic so far in terms of innovations and change in social care.

Social care and COVID-19

Professor Mary Daly opened the event by setting out the context for discussion, which was designed as a follow on from the previous Care Initiative session held in May 2020, when the impact of the COVID-19 pandemic on care homes in the UK was highlighted. 87,000 people died in care homes between March and the end of October, 15,000 of whom comprised certified COVID-19 deaths. Professor Daly reminded the audience of the relative disadvantaging of care homes vis-à-vis care hospitals, which was observed in different ways during the pandemic – such as care homes and other social care providers not being able to get access to the distributional channels for resources such as PPE and testing that operated for the NHS. This is a sector, she noted, that was a victim of the austerity policy in place in Britain for the last decade.

Care home residents during the pandemic

Rosalind Pearce presented the findings of Healthwatch Oxfordshire’s survey conducted with care home managers between May and October 2020. The findings show that there have been a number of important problems in care homes. There has been a huge amount of ever-changing information from multiple sources that care home managers have to deal with, making the crisis management extremely time consuming. There were delays and restrictions on testing for care home staff and residents. Care homes also experienced COVID-19 related staff absences, and it was difficult to bring in additional capacity. Staff absence was a problem not only for the care homes, but also for staff themselves, as they were anxious about getting reduced working hours and pay. But there are also positive developments that need to be acknowledged. According to Rosalind Pearce, managing the crisis highlighted the strengths of staff management and teamwork, and brought in new approaches to team management and implementation of working practices which she hopes will continue beyond pandemic. For example, when the care homes had to shut their doors to visitors, the staff found creative ways (use of iPads, telephone, written communication, etc.) to ensure that communication between the residents and their families would continue.

COVID and older people living in the community

Penny Thewlis switched the focus from care home residents to older people living in the community more generally. Findings from Age UK’s research on the impact of COVID-19 on older people indicate that many experience declining physical and mental health which has been exacerbated in the pandemic: They report suffering from lack of motivation and energy, anxiety, loss of confidence, loneliness, and isolation. For example, 1 in 3 older people are less motivated to do things they used to enjoy; 1 in 3 have felt more anxious; nearly half feel less confident going to a hospital appointment; many feel they are missing out on important family milestones and are concerned that life will never return to normal again. But can COVID-19 be a catalyst for change in social care? Penny Thewlis thinks there are some rays of hope and opportunities for learning and signposted a number of new – often locality-based – developments. For example, there is now much more emphasis on prevention. Another ray of hope relates to the promising community developments in the COVID period. One such example is Oxford Together, a volunteer programme in Oxfordshire that helps those in need with tasks like shopping and makes regular phone calls to socialise with isolated individuals.

Working closely with different types of social care providers, Rachel Pirie too observed that local community responses are springing up to provide support to shielding residents. COVID-19 seems to have created an environment in which local groups can develop their own initiatives. In Oxfordshire, the local authority runs the Making it Happen programme, an initiative aiming to empower these groups of social entrepreneurs that create support networks for people living in their local area. From this perspective, the pandemic is also changing the ways of working. Pirie identifies this as ‘the new phase’ in how the statutory partners work with communities – in a more inclusive, supportive and proactive way. Another initiative mentioned was Home First, which is the Oxfordshire delivery of the country-wide ‘Discharge to Assess’ programme. The aim of this initiative, which pre-dated the COVID-19, is to help people return home earlier when there is no need for medical support in hospital, to both protect the capacity of the NHS and give people the comfort of their home, which is seen as important for their well-being. Pirie noted that the pandemic has been one of the biggest catalysts for change that drove them to deliver this service at significant pace.

The role of integrated services and research going forward

Optimism notwithstanding, in the Q&A the feasibility of some ideas as innovative solutions was queried. One such example is the idea that care homes and other care organisations share their staff with the NHS. Rosalind Pearce suggests that in order to have an integrated system and workforce, one needs to knock down walls to see new ways of doing things, noting that there is a perception among care home managers that perhaps an innovation could be to have a pool of carers who can work in any facility, be it a care home or hospital. The Q&A also underlined the potential of research activities going forward. There seems to be an emerging research environment where researchers are increasingly encouraged to engage with questions relating to innovative ways in which social care services can be delivered. The speakers agreed that there is a massive role for researchers, especially in a collaborative way, together with public, private and voluntary partners, to capitalise on the learning from the pandemic, in terms not only of what can be improved but also of what is already good.

In the closing remarks, both the audience and the speakers reiterated that, although the COVID-19 outbreak brings massive challenges, it also paves the way for innovative solutions in the social care sector that will hopefully last beyond the pandemic.

Contact the Care Initiative

Further information can be requested from:

Professor Mary Daly, University of Oxford
Email: mary.daly@spi.ox.ac.uk

or

Ruth Loseby, Green Templeton College
Email: ruth.loseby@gtc.ox.ac.uk