Tens of thousands of care home residents face losing vital support as unvaccinated carers clock off for the last time before double vaccinations become mandatory.
About 50,000 care home staff who have not had two doses in England will not be allowed to work from Thursday. Analysis by the Guardian suggests that on current staff/resident ratios and without other measures to tackle the problem, the care of about 30,000 people could be affected.
On Wednesday, care leaders pleaded with the health secretary for an 11th hour reprieve, urging Sajid Javid to allow unvaccinated carers to keep working at least until NHS staff face mandatory vaccines from next April. In what looked certain to be a futile demand, Nadra Ahmed, executive chair of the National Care Association, which represents independent providers who are expected to be worst hit by staff shortages, said: “There is still time to bring the deadline in line with the NHS and support the sector to have a fighting chance to get through the winter months. It may avoid the closure of essential beds when we most need them as a nation.”
Care operators and health leaders have warned that staff shortfalls could prevent thousands of people from being discharged from hospitals this winter, limiting admissions and clogging up wards. They say it will increase pressure on remaining care staff to work longer hours, despite many being already exhausted.
One of the largest not-for-profit operators, MHA, estimates that about 750 care homes may have already stopped taking new admissions because of the staffing crisis. Seven of its homes are closed to new entrants and it is losing up to 150 staff because of the vaccine policy this week.
“It is scary as we head into winter and the concern is there will be a buildup of people in hospital who can’t be discharged,” said Sam Monaghan, MHA’s chief executive. The National Care Forum said providers are running at 17% average staff vacancy rates.
Matthew Taylor, the chief executive of the NHS Confederation, which represents healthcare organisations, said people who were medically fit to leave risked longer hospital stays than necessary at a time when capacity was crucial.
“As we head towards what could be the most challenging winter on record, we hope the government has assessed the possible knock-on impact of this policy,” he said.
The Department of Health and Social Care has said councils will help care operators with staff shortages, that it has provided town halls with over £1bn of additional funding for social care this year, and that it is running a TV recruitment campaign.
The National Care Forum, which represents not-for-profit care homes, said a snap survey last week showed that on average 3.5% of operators’ staff have already left as a result of resignation or dismissal, and estimate a further 4.4% might leave. Care operators fear remaining staff may be so stretched they will have no choice but to limit help with all but the most essential services, meaning trips out, games and entertainment, which create the sense of living rather than merely existing, will be reduced.
On Wednesday, the Relatives and Residents Association warned that care home residents’ human rights continue to be breached as “the only group still living under stringent government restrictions whilst the rest of the country gets back to normal”.
Amid anger at ongoing visiting restrictions, it has told an investigation into the issue by parliament’s joint committee on human rights that it “hears daily [on its helpline] about the devastating impact measures to manage the pandemic have had on the lives of older people”.
Mandatory double vaccination for care workers in homes for older and younger adults has boosted vaccine protection, with close to nine out of 10 staff getting both jabs. But in areas including Thurrock, Nottingham and Manchester, a fifth of staff are still not fully protected. NHS staff and domiciliary care staff who look after people in their own homes will not need to be fully vaccinated until 1 April 2022, the government announced on Tuesday.
The Care Quality Commission, which regulates care homes, will enforce the vaccine mandate with “a proportionate approach, to ensure the welfare and safety of people who use services”, it has told operators.
“We will always treat each matter individually and consider the individual circumstances when undertaking an assessment and deciding on any possible next steps,” it said.
