Speaking exclusively to The Leaders Council, TimeFinders director Alison Hesketh [pictured] reflects on the challenges that the Covid-19 pandemic has thrust upon the care industry, while highlighting some of the lessons that the UK population, care sector and government can learn from the crisis and use as a springboard for reform, particularly as perceptions of the industry have begun to change over the previous year.
The devastating effects of Covid-19 on the UK care sector have been well-documented. Aside from the trials and tribulations of battling the virus itself, individuals being cared for within residential care settings especially have been forced to contend with isolation from their friends and family, culminating in a deteriorating state of mental health.
Alison Hesketh is no stranger to these issues. Her organisation, TimeFinders, is a provider of practical help and emotional support services for older people in changing circumstances, based in North Wiltshire and operating across the south of England. TimeFinders also offers a full advocacy service to help elderly people make important decisions about their future if they become unwell or lose capacity to make decisions for themselves.
Looking back to when the scale of the coronavirus crisis became apparent in March 2020, Alison believes that at the time, a struggling care sector was also weighed down by negative perceptions of the industry from the British public.
Speaking on The Leaders Council podcast, she said: “I think at the start of this crisis, there were negative perceptions of care among the British public. Residential care in particular is still going to have a big job to do post-Covid in restoring people’s confidence, but one thing that the industry can use as a springboard for that is the dedication of individual care workers that has been recognised by everyday people.
“Carers especially have come out of this crisis with much goodwill and universal admiration for what they have done. Many have stayed at their place of work, not gone home to see their families, and even slept on floors to avoid the risk of taking Covid-19 into care homes and infecting vulnerable people. For the low status that carers currently have in this country, we owe them a huge amount of thanks and the growing public support for carers can be used to incite positive change in the industry.”
Furthermore, Alison believes that some of the less positive perceptions of the sector before the pandemic assumed that the industry formed part of the NHS or was at least a state-controlled sector.
“I think the realisation among much of the public that the sector is actually comprised of a lot of independent care homes, businesses and charities has come as a great shock. It is more understandable for the public now, in light of this dose of reality, that different care organisations with different levels of funding have responded differently to the pandemic. Some have been very much on the ball with PPE procurement, while some have not. What the industry and government must do now is come together to examine the situation, remove a blame culture and have a sensible and intelligent discussion over what has happened. I personally believe there are still some lessons that we can learn and take on board better from the first lockdown starting last March.
“We need to understand why things transpired as they did and gauge what needs to change so that we can deal with future pandemic threats. I think given what the public now knows about how the sector works, there will be more public support to fall back on for this and more pressure for the government to come together with the sector and act.”
Besides the pandemic potentially working as an instigator for change in this sense, Alison also believes that other benefits have emerged from the health crisis, including a heightened awareness of personal hygiene and a greater willingness among individuals to think and reflect on what it is they want from their care when they reach their elderly years.
Alison explained: “Given the increase in health awareness and the campaigns for regular handwashing, we have seen incidents of norovirus just as one example drop by around 85 per cent. Little things like that which come from the pandemic we must not lose sight of. We have also seen a vaccine generating in record time which is a huge victory for medical science, and more people are coming to organisations like us wanting to assess their later life options because they are now much more aware of their own mortality.
“A recent survey that the Associate Retirement Community Operators published has indicated that almost 90 per cent of people think that the government should widen housing options for the elderly, including those receiving care, because of how the crisis has influenced people’s thinking. The same survey also found that over half of older people are interested in moving to new accommodation but lack sufficient local downsizing options. I was not at all surprised by these findings. There isn’t enough suitable housing for older or disabled people and government policy has been focusing more on young people at the start of their housing ownership journey and on helping them to be able to buy or rent suitable accommodation. However, with growing numbers of elderly people sat in housing that is no longer quite right for them, there is a cork at the top of the bottle.”
Alison believes that if the government and the care industry were to collaborate on helping the ageing population of the UK relocate to more manageable settings, it would not only benefit that older generation but also younger individuals looking to embark on the property ladder who are in need of accommodation.
“There are a lot of old people out there who do want to move somewhere more manageable because they realise the more appropriate your accommodation is, the more independent you can remain for longer. People are frightened about moving into care and do not necessarily want to, there is more of a demand in terms of what we have seen over the last year for people to receive care in their own homes, and there are plenty of domiciliary care providers who can help make that happen. But this takes real planning, forethought, and government policy to help make it a reality. In rural communities especially, it is much more challenging to find suitable accommodation for elderly people, and many are finding themselves having to move out of their local communities in their later years.
“If we can act on this lesson from the pandemic, it can solve a great many issues and I think the government is missing a trick if it doesn’t look to integrate addressing these issues into its green agenda. The longer the problem remains unaddressed, the more it contributes to the growing mental health crisis that will be a legacy of Covid: older people who have been confined to less suitable settings during lockdown have been suffering with their mental health during this time, especially those with cognitive impairments, and it has been devastating.”
Alison also believes that the greater willingness of people to talk and engage in dialogue with each other can act as a significant driver for change in the care sector, and she is willing to be cautiously optimistic about the future.
“I am optimistic by nature, and there have been some real positives to weigh against the devastation. People are more inclined to talk about end of life and what they want from end of life care and in our advocacy work it is important to give people a safe space to talk about such difficult issues, record their views and give them piece of mind. Their wishes must be clearly recognised and that takes away a lot of fear that people have about their later years.
“Covid has provided an uncomfortable opportunity for people to look at their living settings and review if it is comfortable for them until the end of their days. The death rates that follow something as simple as a fall down the stairs are staggering, and these things are very preventable. Getting living settings right is valuable for independence and mobility and we have had more people coming to us over the last year to talk about these things and use our services. We are helping them with that downsizing process and helping get them settle into their new surroundings. It is that satisfaction with doing my job and helping these people that gets me out of bed every morning.”
However, for Alison’s hopes to become a reality, the government has its own part to play in engaging with the industry and helping drive the agenda for positive reforms in care forward.
Alison said: “Prior to the pandemic Boris Johnson promised a root and branch review into the sector. We can’t see the review of the care sector kicked into the grass any longer by successive governments. Public understanding that the care home sector isn’t run by the state has been a shock and now there is pressure for something to be done about it. The time is now right to look at the way the sector is run and I can foresee it having something of a shake-up.
“What the sector also has to address is how those receiving care feel about their own personal independence and autonomy. Prior to the pandemic we have seen a lot of people moving into retirement accommodation, for example, who don’t need physical care and are living instead in a retirement community with communal areas and their own private space. What they have now discovered during Covid is that in such settings, there are facilities managers who have the right to keep them out of those communal areas and instruct them to remain in their own accommodation only, and this has come as a difficult experience for some.”
While the impact of Covid-19 has culminated in raised awareness of the importance of people’s later years, the demand for TimeFinders’ services has only grown and Alison is hopeful for a positive future of growth for her organisation, hopefully in correlation with the reform the care sector needs.
“We are very ambitious for our future at TimeFinders. We want to be able to extend the number of clients we help, and indeed the geographical area we serve. More people want to come to us at earlier ages to plan ahead for the end of their lives and remain in control of their fates for longer and we will be here to help. My hope is that growth for our company can happen in line with positive changes in the sector, indeed more people are looking into receiving care at their own home rather than moving into residential care and the domiciliary care industry has its own problems that need to be addressed, particularly a shortage of carers which has not been helped by Brexit.
“With much public goodwill lying with carers now, the government will need to step in to cash in on that and raise the status of carers over the next year. We will need to do this to entice more people to become carers, because it is not an unskilled profession as people are now beginning to understand, it takes dedication and a significant number of soft skills. Doing this successfully will be critical to whether or not the industry can reform as it needs to.”
The extended interview with Alison Hesketh on The Leaders Council Podcast can be viewed below.