Tag Archives: residential care

Safeguarding in social isolation: how social care teams are adapting to the new normal

Posted on by

We are all adapting to life in “lockdown”. For many of us this is a period of transition which will require some changes to our normal daily routine, perhaps working from home or socialising less. But what if you are a vulnerable person who is already socially isolated or if the place you call home is not safe?

The First Minister of Scotland Nicola Sturgeon in a briefing to the media stressed that life shouldn’t feel normal, but for many people who work in social care or social services they are trying to carry on as normal, providing key services to some of the most vulnerable people in our communities.

Social care teams across the county are working flat out to ensure they can maintain vital services and provide support and care to vulnerable adults and at risk children. Advice has been published by the government and by professional bodies like the BASW  (British Association of Social Workers) to try and provide some guidance to frontline care staff. But the reality is that care workers, both in social work and residential care are having to adapt to new and unprecedented circumstances to keep vulnerable people safe in our communities.

Funding for councils announced to support continuity of care

Councils have been allocated £1.6bn of funding by the Chancellor, designed to help them manage the impact of Covid-19 on services, including social care. Additional measures also include £1.3bn which is designed to help the discharge of patients from hospitals to continue their care in a community setting, to free up vital NHS resources over the coming weeks.

Councils have been advised to use this money as they see fit. However, one key priority is the continuity of care for service users, particularly as the virus spreads further into the community and there is a greater chance of care staff having to self-isolate and remove themselves from the workforce for a period.

Another measure designed to help ease this pressure on frontline staff are the social care clauses included in the emergency Coronavirus bill which temporarily remove the duties placed on councils to provide adult social care to all who are eligible. Instead councils will be able to prioritise care for those they consider to be most at risk in the event that adult social care services become overwhelmed. However these measures have been met with criticism from some charities who have said they will place already vulnerable adults at even greater risk.

Concerns raised for vulnerable children

The Children’s Commissioner for England has raised concerns about children who live in chaotic households, impacted by domestic abuse or substance abuse, and the effects that social distancing could have on their physical and mental wellbeing. For many children who are on the radar of social services, lockdown could be an especially isolating and difficult time. Additional concerns have been raised about vulnerable care leavers and young homeless people.

Government plans have ensured that some places have been kept in schools for vulnerable children to continue to attend. The definition of “vulnerable children” outlined by the government advice includes all children supported by social care, including those on child in need and child protection plans, looked-after children, children with disabilities, and children with education, health and care plans. However, the plan has drawn some criticism, including around its potential for heightening stigma experienced by children, and for putting the health of foster and kinship carers at risk.

How staff are adapting to new ways of working

It is not news that even before the outbreak of Covid-19 in the UK, the social care system was under significant stress.

Increased demands on those who work in residential and domiciliary settings include the practical challenges, increasing use of PPE, infection control and refresher training regarding contingency and emergency plans for residential care homes and challenges with supplies, including food and medication for residents. Additional challenges include the social and emotional stress of residents who may not receive visitors and must, where possible, socially distance from others.

Those who work in child and family social work are having to be increasingly flexible, managing many more cases and where possible managing elements of their work remotely via telephone or videoconferencing. Essential services are being prioritised.

In some instances there have been discussions around inviting final year social work students, or students studying social care to help support staff with additional tasks, or – as has been the case with the NHS – inviting retired colleagues back for a period to help already stretched teams.

An uncertain next few weeks

Many social workers and care staff have raised concerns around continuing to carry out their statutory duties as the population enters a lockdown phase and the additional risks this not only places on them as frontline staff but also the additional risks it may present to vulnerable children and adults.

Many are calling for explicit guidance from government on how social carers and social workers can be best supported to safeguard people at particular risk of harm, isolation and neglect. This includes practical support like the allocation of protective equipment, the enabling of improved sharing of information via digital channels and professional support, including the implications for registration if they are unable to meet duties, timescales or usual legal compliance during this crisis.

As the care system and its staff begin to feel the strain caused by this outbreak, calls are being made for social care to be recognised and acknowledged by government and others as a vital service. While one charity, the Care Workers Charity is launching a scheme to provide grants for those care workers who need to self isolate, many of whom will do so without pay, the GMB union have warned the coronavirus crisis could lead to the total collapse of the care system. It said care staff were being left with no protection against the virus, no childcare and poverty sick pay if they become infected.

Staff safety and continuity of service are clearly the priorities for the social care sector as we begin this period of unprecedented “lockdown”. It is clear more guidance and support is needed for staff who are on the frontline as they continue to deliver vital care and support services to some of the most vulnerable people in our communities.

If you enjoyed this article you may also be interested in reading:

Joining the digital revolution: social workers’ use of digital media

‘Digital prescribing’ – could tech provide the solution to loneliness in older people?

Follow us on Twitter to find out what topics are interesting our research team

Intimacy and sexuality in care homes

Posted on by

Talking about sexuality and intimacy can be an awkward and, for some, taboo subject, particularly when the people we are discussing are parents or elderly relatives.

However, in a care setting, where a relative has been moved into care, sexuality, sexual needs and questions around intimacy often remain un-talked about and un-catered for, and can create an awkward situation for residents, relatives and care staff.

For many people, intimacy is a ‘normal everyday’ part of life. But when moving into residential care, for many people, that is lost. They feel their privacy is taken away and their ability to conduct life as they had before needs to change as a result of moving from their home. The onset of conditions such as dementia in later life can also make other people uneasy about the idea of continuing with intimate relationships, or indeed starting new ones later in life. One of the aims of the research conducted by a team at Manchester University on older people’s understanding of sexuality (OPUS project) is to look at erotophobia, or a fear of older people’s sexuality (within the remit of feelings and beliefs on sexuality more generally).

The loss of identity through sexual expression can be even more explicitly felt by members of the LGBT community, many of whom, studies have found, have felt the need to ‘go back into the closet’ upon entering residential care.

In 2010 the World Health Organisation (WHO) published a set of sexual rights. In this the right of the individual to choice is key and something which care homes must still respect.

Sexual rights in older people was also the subject of a report by the Royal College of Nursing who commented that “when someone moves into a care home, to all intents and purposes the private space of their room is exactly that, their private space and provided any acts are consensual care homes should facilitate the wishes of residents to the fullest extent.” Within a human rights context, adults living in residential settings, unless they have had certain rights and freedoms curtailed or restricted by the law, generally have the same basic rights and freedoms as any citizen to live their lives as they wish. This includes possibly doing things that others might consider to be unwise or inappropriate.

In addition, although many decisions about care within a care home setting are taken in consultation with the family of the resident, carers and care home managers must also remember that they have a duty to their patient, and there is a level of patient-carer confidentiality which carers should be mindful of when discussing topics such as sex, sexuality or intimacy.

However, in that context it is also the case that care home workers have a duty of care, to protect vulnerable people from abuse, exploitation and situations which they might find distressing. The International Longevity Centre have produced a guide which contains advice around intimacy and sexuality in care homes, looks at intimacy in older people, (particularly older people with dementia) and the position of people within the LGBT community who move into residential care.

Many within the LGBT community have expressed a feeling of discrimination or anxiety about their sexuality on entering residential care and as a result there are suggestions of LGBT only residential care homes being created, with one proposed for either London or Brighton in the next few years.

The legality behind many of the decisions taken in care homes is set out in law, including definitions of consent, abuse, exploitation, violence. However, the individual practices of care homes regarding policy is often set out and implemented at the discretion of care home managers and staff and it is their responsibility to ensure that they have an effective and consistent policy in place when it comes to sexuality, intimacy and relationships more generally.

They also have a responsibility to ensure that staff are suitably trained to tackle any issues which may arise, answer any questions from residents or family members and recognise boundaries and levels of appropriateness while still delivering care to residents. Care workers must balance delivering effective care with promoting personal emotional and mental well being, allowing residents a level of freedom and personal choice while ensuring adequate safeguards are in place. This is not an easy task. However, more research is currently being conducted, and improved training for staff is also being increasingly offered as the norm.

Our popular Ask-a-Researcher enquiry service is one aspect of the Idox Information Service, which we provide to members in organisations across the UK to keep them informed on the latest research and evidence on public and social policy issues. To find out more on how to become a member, get in touch.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.