Care home staff give a firsthand account on working through Covid-19

It is here that people are dying – the most recent figures show almost 60% of deaths from coronavirus in Scotland have been in care homes. Mortality rates for those receiving homecare are unknown but many in that group are older or have underlying health conditions.

A group of five social care workers – two home carers, a first responder and two care home staff – agreed to speak to the Sunday National about their experiences over the last two months. We’ve only used their first names to protect identities.

Social care is low paid, low status work – a Scottish Government pay rise in April meant they were guaranteed a real living wage of £9.30 an hour. Yet not only is this work critical, it now comes with very real risks.

Yet as authorities grappled with how to control Covid-19 in those early weeks, guidance stated that gloves and aprons were the only PPE home carers needed, unless clients were displaying symptoms of a cough and a fever. While the fight for adequate PPE by union paid off, some have linked the delays to lives lost.

Catherine Sweeney, 64, was the first health care worker to die from Covid-19 last month after working for weeks without full PPE. She was due to retire next year.

Mick Gallagher, who did night shifts in a care home, was just 34 when he died. Janet Livingston, a home care worker who initially tested negative, died earlier this month.

“There was a real fear factor,” said home care worker Bernadette as she remembers the start of the outbreak. “We still had to do our job. We couldn’t choose to work from home.

‘‘What was coming on the news was scary but for the first week or so we were out in the community and not having a clue what was going on, or what was safe, or how easily it was passed on.”

She has been off work for four weeks after developing a throat infection, which worsened with Covid symptoms developing. She tested negative but her doctor suspects it may have been positive if she had been tested earlier.

Access to testing is still patchy, according to Scottish Care. Last week some home care workers were told to drive hundreds of miles to get tested – the Scottish Government is now investigating. And while in Tayside results come back within the day, it can take four days elsewhere.

The experience has left Bernadette shaken. “I have to say I’m terrified about going back to work,” she admits. Like others we spoke to, she can’t wait for the antibody tests currently in development to reach the market.

The fear goes both ways. John says of the early days: “I was worried about carrying the virus about. What if I went to someone’s house and they’ve got the virus and I could potentially be catching that and passing it on to someone else?”

Liz, a care home worker whose name we agreed to change, explains: “Staff kept saying to us, how could they live with themselves if someone vulnerable ended up getting ill and not surviving? I was concerned too about bringing it home to my family but also not passing it on to residents who had immune systems that were so low they weren’t able to fight it off.”

Chloe, who works in a residential care unit where there have been no cases so far, remembers the paranoia as she tried to follow the constantly changing guidance. “There was so much guidance and so much instruction and changing so rapidly that you started to panic about whether you were getting it right,” she says.

BUT the PPE, while potentially life saving, comes with its own difficulties. “You went from being John, the carer, to going in to someone’s house with full body armour – your apron and your mask,” the home care worker says. “They are like: “what’s going on here?” It makes them feel worried.”

He has felt that same worry niggling at him throughout. He’s been caring for some people on his list for 16 years. “They become part of your family. You buy them birthday and Christmas presents. Now you are maybe the only person they are seeing. You take that home every single night with you. Even before Covid, that’s part of being a carer. It doesn’t get left at the door. This is not just my job.”

And as the pandemic broke – some staff with long-term health conditions went into self-isolation, others becoming unwell – many councils changed their eligibility to home care overnight.

Vulnerable people had their packages radically reduced or even removed with just hours of notice. John still calls those he’s been told he can no longer see – to check-in and to chat – in his own time.

The emotional aspect of the job takes its toll. Liz and Chloe say staff in the care homes where they work are going above and beyond to make up for the lack of visitors. In Chloe’s home they wheel people out to the pond in the grounds where family can wave from the road or join in a chorus of happy birthday on special days. “We’re working hard as a team to keep morale up,” she says.

Meanwhile for Liz, additional staff redeployed from leisure services means she has more time to chat, and redesigned rotas that put her on 12-hour shifts give continuity for residents. “But it is difficult,” she says of the situation.

Several residents with dementia find it distressing to be told to return to their rooms, as is the guidance. To her, that doesn’t feel fair. And for family – some of whom used to visit daily – having to stay away when their parents are at the end of their lives is hard to watch.

“There was a lady that passed away the other week – not Covid related – and her family didn’t get the time to spent with her in the weeks leading up to that and it’s really heartbreaking,” she says. “They had been there every single day [until lockdown]. It’s very upsetting for staff too. If you didn’t get attached you wouldn’t be doing your job.”

All agree it’s far too early to be talking about getting back to normal. “The UK has the second highest death rate in the world,” says John. “It’s not safe to start lifting restrictions.”

But they are looking ahead to what might be achievable, too. “How do you start looking towards a bit of normality without putting people at risk?” asked Liz. “I do think it would be nice for family members to be able to see their mum rather than just banging on a window for a special birthday. Sometimes she doesn’t even realise who it is.”

ALL agree that valuing care is a fundamental change that must now come. Bernardette says: “People need to have awareness of the job that we do – we hear too often that carers have it easy, that all they do is make cups of tea when we do so much.” She wants the training she thinks carers need and deserve to do an increasingly challenging role.

John agrees how much the job has changed over the years, with carers now fulfilling the role that district nurses might have done previously – doling out medication as well as feeding, washing and changing, and being there when someone feels so low they don’t want to be here anymore.

“We are allowing people to live independently,” he says. “15 years ago people might have been institutionalised but with the right care people are able to stay at home, which is what they want. We are here from cradle to grave.”

Chloe lists off the roles of care home staff – physiotherapist, occupational therapist, nurse and more. “The fact is that we are registered professionals and that has been over-looked,” she says. “We need more recognition.”

Stephen Smellie, deputy convenor of Unison Scotland, says: “We are talking here about a professional group of staff who are being too often treated as skivvies. That has been reflected in low pay, low status and poorly resourcing them.

“What’s evident is that these are highly skilled people, not just in the care aspect but also in the compassion part of the job, in the social solidarity they are given to people who might not have anyone else to talk to throughout the week. That needs to be recognised, and not in a crisis. Things need to change.”

A Scottish Government spokesman said: “Scotland’s dedicated social care workers are on the frontline of our national pandemic response. Their work is always hugely valued, never more so than now.

“We would welcome a discussion with employers on how we can support them to offer more training and development opportunities to their employees, together with other further support.”