A Dilemma for Care Homes

Care Home Dilemma

Anyone with a friend or family member in a care home over this turbulent past year has had to endure, more than most, the pain of being isolated from those they love. Residents in care homes have experienced a degree of isolation and separation from their own friends and families, that few of us can dare to imagine. In this chaos, the homes they live in have been at the centre of Government guidance and regulations designed to protect both staff and residents from this invisible, but potentially deadly virus.

Quality of Life

Here, Relative Matters seeks to explore some of the inherent tensions that exist between the Government’s unequivocal requirement to, on the one hand, protect its most vulnerable citizens and, on the other, their right to a family life. Under both the Care Act and Article 8 of the ECHR, this includes the right to create and maintain social relationships with other people. Yet, for practitioners in the field of social care, this is side by with a requirement to incorporate best practice principles of alluring ‘whole family approaches’ and ‘Think Family’.

Even during normal times, supporting residents to have a quality of life many of us take for granted in our busy, daily lives, is indeed challenging. When you add into the mix, a deadly virus which impacts most significantly on our most vulnerable of citizens, for those in care homes, the challenges can seem almost insurmountable.

John’s Campaign

It is, perhaps, little wonder that a petition under the auspices of ‘John’s Campaign’ has been launched to take action against Government Guidance, which is preventing care home residents over the age of 65 from leaving their care homes. The petition, perhaps unsurprisingly, has expressed that many of our loved ones have had a different set of rules applied to them, than those in the general population. As Julia Jones (Co-founder of John’s Campaign) has remarked, “People are treated like a different species in care.” Jones further argues that care home residents are effectively bundled together as one homogenous group and treated all the same, unable to balance risk and make decisions.  The Government’s ‘one size fits all’ approach, Jones argues, is not legal. She reminds us that the law says to treat each person as an individual. Moreover, the Equality Act (2010) adds yet more weight to the campaign’s argument that “you must make special arrangements for people who need it.’ It’s no good, for example, offering a window to someone who is blind.

The impacts on our most vulnerable

How, then, has this played out ‘on the ground’?  For both residents themselves and care home managers, saddled with the very challenging dilemma of having to weigh up the risks, and to balance such risks of those in their care with the rights of fellow human beings to perhaps meet up with a husband or wife at home, or take a mere stroll on a day out with their loved ones, this has been the most trying of times. Many family members feel that, with often only a very finite time left for their loved ones, perhaps a 30-minute visit between a couple who may have been married for 70 years or so is a cruel way for care homes to respond. Just how far does the mantra have to be,” It’s in the guidelines”? – This would feel idealistic to many.

‘Visits out’ rules

Take the ‘visits out’ ruling, for example, requiring residents over 65 to be prohibited from doing so without then having to self-isolate for 14 days upon their return. This is regarded by some as a step too far. We at Relative Matters were fortunate with one of our clients, an older gentleman who we were practically supporting in transitioning from his own home and into residential care. He had full mental capacity. Whilst his care home was clearly judicious in trying to keep covid infections at bay to protect those in their care, they understood the importance to this individual of enabling us to take him back to his property to finalise the clearance of his belongings. Whilst the care home in this case had to balance the risk of letting him out, then allowing him to not have to isolate in his room for a further 14 days, a key driver for them was a focus on knowing how much it meant for this resident to get his house sorted, to have some sense of autonomy and independence, surely a hallmark of person-centred care?

How then, by way of conclusion, do we even begin to make sense of the aforementioned dilemmas inherent within the patchy, under-resourced and, frankly, oft messy world of social care during this pandemic and its impact on our society’s most vulnerable citizens? In acknowledging that different care homes interpret the guidance differently, where a duty of care to protect their residents from this potentially deadly virus has also to be balanced with a duty of care for their staff, many of whom have sadly died themselves over the past year, there are no easy answers. This is real world in which we are all learning together, and class is in session.

Roger Moon, Retired Social Worker

On behalf of Relative Matters