ONCE social care could have been said to be the hidden essential service. Now our reliance on predominantly female, under-paid staff in care homes and in the community – and those struggling to access the care they need – is laid bare in the midst of Covid-19. What is emerging is the story of a crisis within this crisis.

So talk of a “new normal” to those relying on, or working in, social care hits a raw nerve.

To Tressa Burke, chief executive of Glasgow Disability Alliance (GDA), the impact of the virus on social care has been bleak. “Our chronically underfunded and already fragile social care system has effectively crumbled under Covid-19, leaving those most vulnerable to the virus at even greater risk,” she told the Sunday National.

Many of GDA’s members have had support such as help to shower or access the toilet pulled for the foreseeable future, sometimes with just a day’s notice, leaving them feeling abandoned. Glasgow City Council has said staff shortages mean it has reduced care to “critical” and sign posted people to other sources of help. But Burke insists there is an urgent need to ensure people have their essential needs met by qualified staff and to make better use of the “incredible” number of people enlisting to volunteer to free up homecare capacity.

“This social care vacuum needs to be urgently addressed, and even more so if many disabled people are going to have to shield for the long-haul,” she added.

“Our survey findings show that isolation is as much a concern for our members as accessing food and essentials. Acute mental health services, already severely reduced under austerity, have been similarly purged to feed the ‘war effort’.

“If we value Scotland’s disabled people and older people we must value social care and invest in and protect it accordingly. “

Donald Macaskill, chief executive of Scottish Care, claimed it had been difficult to look ahead when social care workers are still in the midst of saving lives. But he said there was now a vital need to address the wellbeing of the most vulnerable, including those in care homes who had already been in lock down for six weeks with no visitors permitted.

“We are now seeing profound signs of psychological harm and my concern is that our decision to isolate may have failed to recognised that this is a unique population who are typically unwell and distressed,” he said.

“We now need a grown-up debate about how to balance physical with psychological health.” About 90% of those in care homes have dementia and 70% are receiving end of life care.

Considerations should include upping staff ratios and ensuring one-to-one support for the most vulnerable, making use of communal spaces or re-designing care homes and seeking ways to enable socially distanced visits, he said.

He also insisted that lockdown restrictions must not be relaxed on the basis of age alone. “Any exit strategy predicated on everyone over 70 remaining cocooned would be entirely wrong,” he said. “We need to be non-discriminatory and someone of 74 could be in as good health as someone else in their fifties. Some will still be shielded but this should be on an individual basis.”

Stephen Smellie, co-convener of Unison, also said care workers were still in the thick of the crisis, wondering how they would get through the next shift, where their PPE was coming from and when they might be able to take a day off.

But he agreed there was now a need to think through how they would navigate the pandemic on a longer-term basis. “The new normal has to mean upgrading our capability and that includes better access to PPE,” he added. “There are also issues about how services are delivered if day centres stay shut, for example.”

IF shielding was to continue, he said carers also needed adapt their practice to show warmth to those struggling with isolation. “If we can’t touch someone’s hand we need to find new ways of communicating that solidarity and love,” he said.

Almost all agree more staff will be needed. “Care workers can’t sustain what we are doing now – the extra hours and shifts,” said Smellie. “It’s just the adrenaline keeping them going. So we need more people and that means we need to invest in recruitment and pay.”

GMB Scotland organiser Rhea Wolfson is in fierce agreement about the need to address pay.

“The majority of workers are going through hell for less than £10 an hour,” she added. “It’s a scandal and a chronic undervaluing of these essential workers.

“How can it be right these workers – predominantly women – are paid as much as £5 an hour less than the UK average hourly wage of £15? When we get through this crisis, is there a politician or an employer that thinks it will be acceptable to tell these courageous workers their skills and sacrifices are worth less than average?

“We can’t go back to “business as usual” or be satisfied with a living wage rate that is solely designed to keep people just above the poverty line. This is what we mean when we talk about a reckoning.”