Background
Methods
Participants and recruitment
Data and data collection
Data analysis
Public involvement
Results
N (%) | Care home staff (n = 16) |
---|---|
Gender | |
Female Male | 13 (81.3%) 3 (18.8%) |
Ethnicity | |
White British White other BAME Prefer not to say | 13 (81.3%) 1 (6.3%) 1 (6.3%) 1 (6.3%) |
IMD quintilea | |
1 (least disadvantaged) 2 3 4 5 (most disadvantaged) | 3 (23.1%) 3 (23.1%) 3 (23.1%) 1 (7.7%) 3 (23.1%) |
Job role | |
Activity coordinator Care home liaison Care quality Care assistant Senior care assistant Night care assistant Housekeeper Matron Manager | 1 (6.3%) 1 (6.3%) 1 (6.3%) 4 (25.0%) 2 (12.5) 1 (6.3%) 1 (6.3%) 1 (6.3%) 4 (25.0%) |
Ageb | 41.8 (±16.6) [18-62] |
Years of education | 15.7 (±2.7) [11-20] |
Care home capacity | 42.2 (±15.8) [12-64] |
Years working in a care home | 9.3 (±10.6) [1-35] |
Theme | Subtheme |
---|---|
1. Practical implications of working in a care home during the COVID-19 pandemic | Variable and unequal responses to new guidance and restrictions |
Feeling unsupported in complying with new measures | |
2. Staff values and changes to their roles | Adopting the role of external agencies |
Adopting a greater emotional/familial role | |
3. Impact to care home staff and concerns for the care sector | Increased workload, stress and burnout |
Changes to perception of job | |
Concerns over the future of the care sector |
Theme 1: Practical implications of working in a care home during the COVID-19 pandemic
Variable and unequal responses to new guidance and restrictions
it [the care home] was on immediate lockdown so entertainers, hairdressers, chiropodists, relatives etc. we all of a sudden then had to lockdown our offices so that teams weren’t coming…it’s been quite a lonely, a lonely place the last sort of seven months ID41, male care quality manager
we were allowed to have indoor visits once a week… and then just recently those indoor visits can be extended so they can be in for longer and they don’t have to be physically distancing as long as they’ve got full PPE on, they can have a visitor up to 4 hours…its only once a week ID06, female care home manager
we’ve got this new, it’s a huge iPad on wheels…one resident had a zoom call, I think he enjoyed it…I think we might be encouraged to do it with the residents but I don’t really know… how to set zoom on there so I’d have to be shown how to do that ID13, female care assistant
We increased our cleaning procedures… we increased the frequency of cleaning. Day and night… you’re trying to compartmentalise and keep staff separate, we had to take communal areas out because that was a high-risk zone. ID18, male care home manager
“we didn’t have enough [PPE], we didn’t have any masks, we had enough aprons and we had enough cloves initially. Then we couldn’t get gloves and we couldn’t get aprons” ID04, female housekeeper
“we get a test every week now, we didn’t at the start [of the pandemic]but as I say the last, probably about the last two months, we’ve been getting tested once a week” ID40, female night care assistant
Feeling unsupported in complying with new measures
“the guidelines changed so much to the point that it was like everyday new guidelines, sometimes twice a day it would change” ID38, female care assistant
I did think about working from home for some time but then I thought about the team I support… I saw that the staff were quite appreciative of the fact that, as a manager, if I can come in then they can come in as well ID37, female care and compliance manager
those care homes that had coronavirus at the beginning were not supported. It was an oversight from Governments, there should have been a 2-pronged approach…care homes have vulnerable people in them… those care homes didn’t have PPE, they weren’t able to get PPE and yet everything was focussed on the NHS… ID06, female care home manager
Theme 2: Staff values and changes to their roles
Adopting the role of external agencies
Our staff actually are doing more and more activities on a one-to-one with people, so they’re getting more time spent with them so really, they’re the surprise in all of this, because they have adapted really well ID16 female care home manager
Biggest thing [impact] I think for the ladies [residents] was the [loss of] hairdressing… luckily some of the care workers can actually pick up a pair of scissors and work their magic ID42 female care assistant
it was hard as well trying to find activities to do every single day in the afternoon where they’d normally have the family there…people don’t want to do the same thing so that made it difficult ID09 female care assistant
we’ve got people here who are visiting patients who are end of life, who are at the end of their life, and I can’t say to them you can’t go to the toilet…it’s just absolutely ridiculous ID25 nurse matron
Visitors weren’t allowed to come… [but] we had a room…at the very end of the building, you could access it from outside so that [visitors] didn’t have to walk through the home…I got a call from the Council saying this is contrary to what Public Health England are saying, you must stop it, and they were reporting me to Public Health England ID25 female nurse matron
Adopting a greater emotional/familial role
We can give hugs and touches but we’re not their family, as much as we try to be, we can’t replace their family. ID32, female activity coordinator
we had a couple of people who started to withdraw from actually not being able to physically see the family and that’s when we got in touch with the relatives and said look we want to bring visiting back are you ok with this…it was a case of right we can’t be doing this anymore…we won’t restrict visiting ever again, a lot of the government guidance is too reactive ID41, male care quality manager
Theme 3: Impact to care home staff and concerns for the care sector
Increased workload, stress and burnout
it was like being lost at sea, actually that’s how it felt …my working week went from, well its normally about 50 hours to probably 70… so just generally the day became a lot harder and the anxiety and stress became a lot harder. ID06, female home manager
Personal stress is an issue….my management of my stress was going to the gym and just winding down, but of course that can’t happen…I’ve talked to managers and deputy managers from other homes and it’s pretty similar, the stress doesn’t stop ID18, male care home manager
…I contracted COVID myself and then I was off for couple of months…I was in tears, I had loads of negative thoughts…when I was going back to work I was really feeling nervous and lack of confidence and thinking oh my God what if something again happens to me and how will I survive and what will I do and how will I provide the care ID36, female senior care assistant
Changes to perception of job
I dislike my job intensely…I wanted to walk away from my job in June. I was incredibly stressed and felt anxious continually. My GP actually was phoning me once a week… I personally was at the point where I was like I don’t want to do this job anymore because it’s just not a job that’s doable ID06, female care home manager
I do love my job, I suppose it’s made me see it different, I think it’s been hard, it’s been harder…my sister and my daughter are constantly like [we are] really worried about you ID40, female night care assistant
Concerns over the future of the care sector
the problem is that care homes got such bad press at the beginning of COVID that I think a lot of care homes are frightened to let relatives in, in case COVID comes in and then they get the blame... ID06, female care home manager
…at the worst we had ten empty beds which probably [in a] 62 bed home doesn’t sound much but you’re talking about a lot of money every month and if we were private, we might have decided to cut our losses and close or sell up as a number of homes around here have ID18, male care home manager
I don’t feel like people will want to work in care after this, I think it’s frightened a lot of people off ID09, female care assistant