Thousands being turned away from care due to staffing crisis

Thousands of people are being turned away from care services due to the staffing crisis engulfing social care.

A survey by the NCF and The Outstanding Mangers Network estimates that approximately 5,000 people have been turned away from care since 1 September.

The survey, which covered 340 registered managers running services that employed 21,314 staff and supported 15,450 people across a broad range of care services, found an average staff vacancy rate of 17%.

More than two-thirds (67%) of respondents said they have had to limit or stop admissions into care homes or refuse new requests for domiciliary care.

This includes 33% who said they had limited or stopped admissions from hospital.

Vic Rayner OBE, CEO of National Care Forum, (pictured) said: “These findings make uncomfortable reading and offer evidence of the stark reality being experienced by care providers and registered managers on the ground, and of the pressure they are under every day to provide care and support to the people who rely on them.

“The significance of this data means that people are not being discharged from hospital when they need to, to continue care and treatment at home or in residential care settings. And providers are having to make very difficult decisions about who they can support – sometimes resulting in people with high or complex needs not getting access to the care and support they desperately need. This cannot continue – it has to stop now.”

The NCF is calling on the government to act now by: paying a retention bonus to recognise staff who have worked tirelessly over the last 18 months; fund a pay increase for all care staff to improve recruitment and reduce the numbers leaving; add care workers to the Shortage Occupation List for a limited time; create a new fully funded, flexible dedicated workforce; and delay the implementation of mandatory vaccinations in care homes.

A Department of Health and Social Care spokesperson said: “We appreciate the dedication and tireless efforts of care workers throughout the COVID-19 pandemic and beyond. We are providing at least £500 million to support the care workforce as part of the £5.4 billion to reform social care.

“We are also working to ensure we have the right number of staff with the skills to deliver high quality care to meet increasing demands. This includes running regular national recruitment campaigns and providing councils with over £1 billion of additional funding for social care this year.”

21 Oct 2021

QCS supports therapeutic device for people with advanced dementia

Cutting-edge research revealed by QCS’s Dementia Care Champion, Jackie Pool (pictured), strongly supports the wellbeing benefits of a therapeutic soft, comforting device for people with advanced dementia.

HUG, which is being released today, is the brainchild of the Cardiff Metropolitan University’s LAUGH team. It has also been supported by a number of key stakeholders, including the Alzheimer’s Society, the Welsh Government, the Arts and Humanities Research Council (AHRC), who, between them, have funded the research and development of the therapeutic device.

The QCS Pool Activity Level instrument (PAL), created by Jackie Pool and with the continued support of QCS, the leading provider of content and guidance for the social care sector, has been contributing to the validation of the therapeutic soft, comforting device for people with advanced dementia.

A landmark study using the QCS PAL Instrument, which assesses the level of functional ability of people with cognitive impairments, revealed that 87% of those with dementia who used the HUG device over a six-month period saw an improvement in their wellbeing.

In addition, Jackie Pool, QCS’s Dementia Care Champion, has developed a set of specific QCS HUG PAL Guides, which ensure that people living with dementia are supported at ‘just the right’ level and are enabled to engage with HUG in the most meaningful way possible.

The HUG device, which can be purchased on the HUG by LAUGH website and Alzheimer’s Society’s online shop for £125, increases wellbeing in a number of ways. Its weighted limbs, soft body and simulated beating heart, help mimic a human hug.

With a vast body of scientific research validating music as a powerful medium, which helps people to express themselves and unlock past memories, the therapeutic device has also been fitted with a music player. The MP3 player, which is linked to a hard drive, has been specially built to make it easy for carers to upload music onto HUG, via several different platforms.

Over the last three years, HUG, has been trialled in a number of settings across the entire health and social care spectrum, as well as homes, where it has been shown to consistently provide comfort and reduce anxiety.

Now that it is being launched, Professor Cathy Treadaway of Cardiff Metropolitan University, said: “It is incredibly exciting and rewarding to know that people with advanced dementia can finally enjoy the wellbeing benefits that HUG brings. We are also incredibly fortunate to have received funding for our research collaboration from Welsh Government, the AHRC and Alzheimer’s Society, and we are indebted to Jackie Pool and QCS for validating the therapeutic merits of HUG.”

Jackie Pool, QCS’s Dementia Care Champion, added: “When I was first approached by Professor Treadaway and her team at Cardiff Metropolitan University, I jumped at the chance to be involved. HUG may not provide a cure for dementia, but I strongly believe, and the evidence supports it, that this soft comforting device has the power to profoundly improve the wellbeing of those living with dementia at all levels and to provide the means for care givers to make a meaningful connection with individuals. That in itself, makes it a game changer.”

20 Oct 2021

New figures on self-funding in care homes show that 'many local authority rates are untenable'

The Office for National Statistics (ONS) has released figures on how many people were self-funding their stay in a care home in England before the pandemic.

The statistics on care homes and estimating the self-funding population in England found that around one in three people, or 36.7%, were self-funding care. The figures also show that there was a regional divide: While the south-east had the highest proportion of self-funders with 45.4%, the north-east had the lowest with 24.6%. And while care homes located in the least deprived areas had a statistically higher proportion of self-funders, at 53.8%, care homes in the most deprived areas had only 21.6% self-funders.

The statistics also show that homes providing care for older people had the highest proportion of self-funders with 49.6%. Care homes providing care for younger adults had the lowest proportion of self-funders with 4.8%.

Health and social care expert Joanne Ellis of Pinsent Masons, the law firm behind Out-Law, said that the figures throw into stark relief what care home operators have been saying for years.

"Many local authority (LA) rates are untenable in their own right and they are dependent upon the ability to charge self-funders more to make LA funded rates work. These statistics show the extent to which operators are forced to rely on the cross subsidisation from self-funders who are being provided with exactly the same service," she said. "These figures will play a key role in informing the serious changes that are needed to create a sustainable care system that is fair for everyone. This is particularly important with the introduction of the new cap - a lifetime limit of £86,000 - on an individual’s contribution as the true cost of care is going to have to be faced."

This is the first time that the ONS has published figures on self-funding of care home residents, relying on data collected by the Care Quality Commission between August 2019 and February 2020 and analysing it using a new experimental method.

Ellis said it was the first time the full extent of the phenomenon of cross subsidisation will be understood: "Currently the only way for many care home operators to make the local authority funded rates work is to charge self-funders up to 40% more. These stats are likely to throw that dynamic into stark relief."

She also said that the report may only cover residential care rather than home care but that this was just as significant to understanding the extent of self-funding: "With the current shortages of care workers, operators have understandably had to shift their focus away from LA funded to self-funded service users in order to prioritise those paying the higher rates. This cannot be the right message for a fair society in general. Currently the self-funders mask the extremely low and in many cases unworkable LA rates."

Only recently, changes to the way in which healthcare and social care in England are funded, including a cap on the lifetime amount payable by those requiring care, have been proposed by the UK government.

20 Oct 2021

GUEST COLUMN: Avoiding malnutrition risk

Best PracticeBusinessCare home groupsFood and NutritionOperatorsSolutions by Lee Peart on October 18, 2021

Marking UK Malnutrition Awareness Week (October 11-17), Leni Wood, Nutrition and Wellness Manager at Nellsar, looks at the different complexities and solutions to ensuring care home residents get the nutrition and hydration they need to avoid malnutrition.

According to the British Dietetic Association (BDA), malnutrition is a major public health issue costing the NHS over £19bn per year in England alone. There are approximately 3m people in the UK who are malnourished or at risk of malnutrition; 93% are living in their own home, 5% are living in care homes, and just 2% are in hospitals.

In addition, the NHS reports that those who are 65 years and over are particularly at risk of malnutrition. (1) The consequences of malnutrition include increased risk of illness and infection, slower wound healing, increased risk of falls, reduced quality of life and reduced independence among others. (2)

Working as a nutrition specialist in social care means that I come across many people over 65 who are at risk of malnutrition. Particularly those living with conditions such as dementia, dysphagia, a history of eating disorders, or depression. I work closely with residents and teams on individualised menus and therapeutic meal planning to support those who need a boost in nutrition.

Dementia and appetite

Malnutrition doesn’t happen to everyone with dementia and each person living with it will experience symptoms in a different way. The disease is as unique as the individual and can be unpredictable.

Families, care teams and nutrition teams can support all factors affecting a person’s appetite by focusing on the individual rather than the condition. Knowing someone’s favourite foods, or foods which hold a positive memory, can really help encourage them to eat.

Knowing what kind of portions someone prefers or their preferred cups and plates, for example, can make a big difference. It’s also important for some people to have a routine as they enjoy having their meals at set times throughout the day.

Encouraging social engagement and tailoring leisure activities to suit individual needs can also help a person living with dementia increase their appetite. For many people, eating socially really helps them to enjoy their meals better. For others, eating alone is preferred as they are sensitive to busy environments or might feel embarrassed to eat in public. It really does depend on the individual which is why it is so important to know their life history.


Another condition that can be a risk factor for malnutrition is dysphagia. This is when a person experiences swallowing difficulties and might be prescribed a texture modified diet or thickener in their drinks by a GP or Speech and Language Therapist.

A person is usually prescribed a textured diet when they have a neuro or cognitive related illness such as Alzheimer’s or dementia or have had a stroke. When experiencing swallowing difficulties, a textured diet can be the most comfortable and safe way for a person eat.

Furthermore, those prescribed a textured diet such as puréed food shouldn’t become malnourished. However, when a food is puréed, calories and nutrients can be lost because the surface area of the food is increased and less is served per portion. As well as protein and calories, flavour and visual appeal can also be lost when puréed.

At Nellsar, our catering teams use food moulds, piping, and other techniques to remodel puréed food to make it look more appealing and resemble its original appearance. Our chefs use sauces and gravies to add flavour and protein powder to fortify lost protein.

References: 1.;

Leni Wood is the Nutrition and Wellness Manager at Nellsar, a family-run group of 13 care homes throughout Kent, Surrey, and Essex. Built on strong foundations, Nellsar has worked hard to build the trusted reputation of its homes and prides itself on being approachable, accountable, and empathic in its relationships with the families it supports.

19 Oct 2021

Care worker and eco-scientist face Home Office deportation

A leading renewable energy scientist and a care worker, who are married with three children, are facing deportation to Sri Lanka where the academic escaped torture.

Scientist Dr Nadarajah Muhunthan was awarded a Commonwealth Rutherford fellowship to work to develop thin-film photovoltaic devices used for solar energy generation, but he faces deportation along with his wife Sharmila Muhunthan who had been working at a care home.

Escape from torture

The couple came to England with their three children in 2018 to enable the scientist to develop renewable energy technology, as part of his fellowship.

The family are Tamil and a return trip to Sri Lanka to visit Dr Muhunthan’s ill mother in November 2019, led to his arrest and torture by the Sri Lankan government, the Guardian reports. The scientist succeeded in escaping and returned to the UK, where he claimed asylum.

A year later, Dr Muhunthan was given permission by the Home Office to work because his expertise was listed on the government’s Shortage Occupation List (SOL).

Care home's letter: 'We are in dire need'

However, after his scholarship expired in February 2020, Mr and Mrs Munhunthan were prevented from continuing work. The decision led the manager of Mrs Munhunthan’s care home to plead with the Home Office to allow their staff member to continue working for them.

The care home manager wrote: “We are in dire need of trained healthcare staff and we urge you to consider Mrs Sharmila Muhunthan’s right to work for us as a matter of urgency.”

Despite the care home’s intervention, the request was refused.

Care home providers and home care agencies have been urging the government to include all care workers on the Shortage Occupation List used to grant visas. They also want it to reduce the qualifying salary level from £25,600 - which is currently required for the recruitment of overseas care workers.

The SOL is a list of job roles in the UK that according to the British government is in short supply. Currently the list includes only care managers and senior care staff.

John Penrose, Conservative MP in Weston-super-Mare, where the family lived, wrote to Home Secretary Priti Patel on 1 October to tell her: “This looks like a wholly avoidable situation which has been caused by UK visas and immigration working too slowly.”

The family’s lawyer has launched a legal challenge against the Home Office.

Naga Kandiah of MTC solicitors told the Guardian: “There is growing concern over the state of human rights in Sri Lanka, with the UN high commissioner, Michelle Bachelet, noting that ‘surveillance, intimidation and judicial harassment of human rights defenders, journalists and families of the disappeared has not only continued, but has broadened to a wider spectrum of students, academics, medical professionals and religious leaders critical of government policies’.”

In the UK, waiting lists for care in England have risen to 300,000 (26 per cent) in three months, according to the Association of Directors of Adult Social Services. There are over 100,000 job vacancies in social care at any one time.

Serious staffing shortages mean some care homes have stopped accepting admissions from hospitals, health and care leaders have warned. UK care homes are in "crisis" over staff shortages, Karolina Gerlich, the chief executive of the Care Workers’ Charity has said.

In a statement she made earlier this month, Karolina Gerlich said: “The social care sector is facing the biggest recruitment crisis in its history. A series of catastrophic decisions and policies have meant we continue to face an uphill battle to retain those we have in the sector, let alone recruit desperately needed workers into the workforce.

“The crisis continues to deepen. Providers have lost a huge pool of talent previously accessed from outside the UK.”

In response to the couple's case, a Home Office spokesperson said: “All asylum and human rights claims will be carefully considered on their individual merits in accordance with our international obligations.”

19 Oct 2021

Skills for Care provides ‘stark reminder’ of social care recruitment challenges

A new Skills for Care report has provided a “stark reminder” of the recruitment challenges facing social care.

The annual ‘State of the adult social care sector and workforce in England’ report reveals that on average, 6.8% of roles in adult social care were vacant in 2020/21, which is equivalent to 105,000 vacancies being advertised on an average day. The vacancy rate has been persistently high at above 6% for the previous six years.

Turnover rates across the sector remain high, at 28.5% in 2020/21. This figure had decreased during the pandemic, but since March 2021 many employers report that retention is now more difficult than before the pandemic. The rate was higher for registered nurses at 38.2%, much higher than for their counterparts in the NHS (8.8%).

Since May 2021, vacancy rates have steadily risen as the wider economy has opened back up. As of August 2021, vacancy rates are now back above their pre-pandemic levels.

Skills for Care also noted a decrease in jobs (filled posts) of around -1.8% – the first time the number has fallen. At the same time vacancy rates are increasing.

Skills for Care said: “This indicates that providers are struggling with recruitment and retention, rather than a decrease in demand, which we know from our market insights. This is even more pertinent in registered nurse jobs, which have fallen by 5% to 34,000 in the last year.”

In 2020/21 the number of adult social care jobs increased by 2.8% (45,000 jobs). The vast majority of this increase was in domiciliary care services which increased by 7.4% (40,000 jobs).

The total number of direct payment recipients employing staff has remained stable (at around 70,000, and 130,000 jobs) since 2014/15.

Occupancy rates of care homes also fell during the pandemic from 86% pre-COVID to 77% in March 2021.

The National Living Wage (NLW) contributed to a 6% increase in the median nominal care worker hourly rate from March 2020 to March 2021. However, employers have found it more difficult to maintain differentials for more experienced workers, care workers with five years’ (or more) experience in the sector are paid just 6 pence (1%) more per hour than care workers with less than one year of experience.

Social care workers from a Black, Asian or minority ethnicity make up 21% of the total workforce with 82% female and 27% aged 55 and over. The report shows social care is a growing market currently contributing £50.3 billion to the English economy.

Skills for Care CEO Oonagh Smyth said: “This report is a stark reminder that our recruitment challenges continue, and to help tackle that we need to properly reward and value care workers for their high skill levels and dedication. We know that this is a priority for the new Government White Paper expected on adult social care this year and look forward to seeing the measures contained.”

A Department of Health and Social Care spokesperson said: “We appreciate the dedication and tireless efforts of care workers throughout the COVID-19 pandemic and beyond. We are providing at least £500 million to support the care workforce as part of the £5.4 billion to reform social care.

“We are also working to ensure we have the right number of staff with the skills to deliver high quality care to meet increasing demands. This includes running regular national recruitment campaigns and providing councils with over £1 billion of additional funding for social care this year.”

18 Oct 2021
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