A ‘national disaster’ if care homes are closed for good
A CARE home boss who has lost 11 residents to suspected Covid-19 in one of his facilities has called for more urgent support from the Welsh Government amid warnings of mass closures across Wales.
Sanjiv Joshi, the managing director of the Caron Group, which has 14 homes across south and mid Wales, including Treetops Residential Care Home, Brynmenyn, and Anwen Care Home, Pant-Yr-Awel, in Bridgend, warned the coronavirus pandemic was pushing an already fragile sector over the edge financially.
Mr Joshi is a leading member of Care Forum Wales, which has warned that up to half the 650 care homes in Wales are threatened with closure unless urgent action is taken.
Each of the deaths, he said, was a “terrible tragedy” that had been a traumatic experience for his “heroically dedicated and caring” staff.
It also added up to a “national disaster” in the making because he feared many care homes would not survive the pandemic, particularly the smaller stand-alone family-run homes serving rural communities.
The company provides care for 600 residents and employs around 1,000 staff at care homes across Swansea, Pontardawe, Cardiff, Barry, Bridgend, Brynmawr, Rickeston and Rhayader in Powys.
The occupancy level at the home where the Covid-19 deaths had occurred was down from 89% to 46% and was losing £10,000 a week as a result.
According to Mr Joshi, the Caron Group had taken the decision in March not to admit any new residents for fear they might be importing the virus into their homes.
He said: “What we’re really worried about is the financial support that is needed to meet this unprecedented challenge.
“We as providers are making sure resources are available for our staff to get on with the real challenge that is at hand, which is to protect the homes from the virus entering and containing the situation when it does.
“We have unprecedented challenges, How do we manage our residents who get infected and at the same time, how do we also continue to deliver the high quality of care that we must for the other residents. Similarly, how do we protect our most valuable asset which is our staff ,who are equally susceptible to the virus?
“To try do that we need exceptional amount of resources in terms of PPE (personal protection equipment), other equipment and most importantly an increase in staffing to deliver on all the additional measures being implemented. Also, we cannot avoid the measures needed to ensure that our staff remain safe.
“We’ve had 11 residents passing away from suspected Covid-19 at one of our homes along with others who had a natural death. So we’re down from 89% occupancy to 46% at this home.
“Our staff have risen magnificently to the challenge. They are brave, highly skilled, professional individuals but the situation is having a huge emotional impact. Losing residents who they cared for and treated like family is a traumatic experience.
“We had decided not to admit because when we did admit, we realised we were importing Covid-19 into the home because we would have residents coming from exposure in hospital and were carriers. Being asymptomatic they were bringing the infection in unnoticed. As a result, we’ve had this huge spread in our home.
“We’re not blaming hospitals because I don’t think even the hospitals realised that they were carriers because they were asymptomatic.
“The shock caused by the pandemic is so great and so big, that you run out of money very quickly. Our immediate focus has been in providing and mobilising resources for our homes with the sole purpose of protecting our residents and staff. This is at a substantial financial cost, which has to be secondary in the current battle.
“However, the financial fragility gets exposed very quickly and a provider cannot sustain the programme for long. We are losing £10,000 per week at the care home where these deaths occurred. If the authorities stepped up and covered it, we can go on for longer.
“Our company is one of the larger providers in Wales. I worry about the majority of care homes in Wales which are smaller, community-based homes and they are particularly vulnerable.
“If the support coming through is insufficient, it will hasten their decision to close and once they are gone, they’ll be gone for good.
“My biggest fear is that the closures will be indiscriminate and unfortunately will be the ones that are the most needed.
“There are rural based homes which are at the heart of their local community. They not only look after the elderly vulnerable citizens but are significant employers to those communities.
“Covid-19 has woken the public awareness that a profession which was sadly termed “unskilled” until recently is now recognised as valued, skilled profession.
It will be an irony and a disaster if Covid-19 now leads to the same skilled staff being made redundant if care homes close.
“Care homes were in a very fragile state before we went into this crisis because economically the fees were already inadequate.
“These care homes are now irreplaceable. Building a new care home costs in excess of a £100,000 per bedroom due to the high specification required.
“No new build is likely in areas where the home has to rely on state funded fees as its primary income.
“What nobody has been able to answer is how we are going to be able to provide care for vulnerable people once these care homes disappear from our communities.
“This is something that we need to address as a matter of great urgency.”
It was a fear echoed by Mario Kreft MBE, the chair of Care Forum Wales, who says many care homes are already having to take out loans and consider imminent closure because of the “perfect storm” of spiralling costs and falling income.
The sector was already fragile before the coronavirus crisis began and the pandemic threatened to put many providers out of business.
The scale of the problem, he said, was illustrated by the fact that Welsh care homes provided 20,000 beds which was 8,000 more that the number of beds in hospitals.
He feared that mass care home closures would lead to the NHS being “completely overwhelmed by a tsunami of need”.
Mr Kreft said: “We have members who are increasing their staffing costs. They’re increasing other costs like buying their own PPE.
“And of course we’re seeing falling occupancy as people pass and as other homes choose not to admit people, because they’re terrified that it’s going to introduce the virus into those homes and obviously affect the residents they have.”
“A typical care home needs to have 90% occupancy to be viable and anything below 85% is not sustainable but some homes are down 25 to 30% occupancy.
“We have got people that are seriously talking to their banks, seriously talking within their organisation, whether the best thing and the safest thing for everybody is simply to close the doors,” he said.
“We’ve never, ever encountered anything quite like this in the history of the care sector in Wales, and the UK.
“Unless urgent support is forthcoming we will be seeing care home closures week on week over the summer months.”
Welsh First Minister Mark Drakeford was asked about the concerns of Care Forum Wales at yesterday’s daily press briefing.
Mr Drakeford said: “We work very closely with care homes sector and particularly with Care Forum Wales.
“Care homes are private business on the whole in Wales and their business model depends on them being occupied to a very significant extent - and if they are not having new residents arriving you can see the challenge to that model.
“We announced £40m worth of help specifically for the social care centres a week ago, channeling that money through local authorities.
“We are talking with local authorities about whether we can change the purposes for which that fund can be used. It was initially intended to help care homes with rising costs of food and other supplies, rising costs of agency staff to cover people who were ill and so on.
“We are talking with local authorities to see if they can use some of that money to help care homes where occupancy levels have fallen but where we and local authorities know we need those care homes to be there the other side of coronavirus, when the call for their services will grow again.”
What nobody has been able to answer is how we are going to be able to provide care for vulnerable people once these care homes disappear from our communities
Care homes boss Sanjiv Joshi