Leading in isolation during Covid-19

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Part of Leading through Covid-19

Leading through Covid-19

Since the beginning of the pandemic I have experienced an overwhelming shift in the world. People are kinder, they ask me how I am, they really want to know. Knowing I work as a manager in an independent residential home at the centre of a community, friends and family ask how Covid-19 is affecting us. They ask whether there are cases, symptoms, or if staff are off sick.  

The perception portrayed by the media is that coronavirus is ravaging care homes, residents are dying and our care workers are struggling to cope. The reality is that both the virus and the implications of lockdown are having a detrimental impact on the emotional and mental wellbeing of both residents and staff. Leading in isolation is a lonely place to be, without the support of a large organisation, like the NHS it is difficult to sound out ideas and implement change, this has been a major challenge.  

Challenges

During the Covid-19 crisis, there have been many challenges for myself and my staff:  

  • pressures from residents’ families worrying about their loved ones  
  • staff concerns about deaths in local care homes, and the devastating consequences 
  • staff dealing with the high-pressured environment, increased workloads, new routines, changing guidelines 
  • staff feeling stressed about testing and self-isolating due to symptoms or family with symptoms 
  • personal protective equipment – both the initial lack of equipment and the physical discomforts of wearing it when it did arrive.  

Some of the challenges have had a more direct effect on residents: masks making it difficult for residents who are hearing impaired and those with dementia and some residents who have suffered trauma, react badly to staff wearing masks; lockdown, with no visitors, has caused a deterioration in residents’ physical and emotional wellbeing; and residents who do not understand the current climate have felt abandoned. 

Actions

While external circumstances are beyond our control, we have implemented some strategies to address and support the emotional and mental wellbeing of staff and residents.  

  • Having an open door policy for staff and residents to speak to managers who can reassure or listen, with kindness, empathy and compassion. 
  • Being honest about changing information and guidance and the challenges of implementing this. 
  • Having regular checks ins with staff, especially those not able to work. 
  • Using group chats, both messenger and WhatsApp as a support network for staff and a forum for resources. 
  • Creating WhatsApp registered managers groups and online meetings and webinars to voice concerns, worries, share good practice and ideas.  
  • Using social media and phone to communicate and share with families. 
  • Tackling lockdown by implementing strategies, including garden activities, facetime, telephone calls, doorstep and window visits, so relatives and friends can visit residents. These are welcome opportunities, but emotionally challenging for all involved 
  • Finding new ways of working with other professionals to ensure best outcomes. 

What have we learnt?

The Covid-19 crisis has changed people’s understanding of the vital work of carers, with a resultant improvement in staff self-esteem, pride in themselves and their role. It has highlighted the professionalism, skills and knowledge that exist within the sector, with staff taking on challenges and tasks that would normally be undertaken by NHS or primary care staff. And this experience has strengthened the team – they have been a great support for each other, especially on the more difficult days, covering shifts for those off sick etc. But we need to recognise the emotional and mental health needs of both staff and residents in the wake of Covid-19 and strategies need to be put into place to support their wellbeing.  

Technology has been crucial when dealing with many practical tasks and some tasks and interventions put in place during the crisis need to be strengthened and continued. For example, practices we’d like to continue include: 

  • remote hospital visits wherever possible – a physical visit to hospital is not always needed to discuss test results  
  • prescriptions sent to mobile devices for quicker access to medication 
  • working with other professionals using images and online platforms, such as Zoom, to improve the experience of care for the residents.  

To capitalise on this shift in ways of working, staff need to have training and be familiar with the technologies used. 

Our experiences of the pandemic so far have been extremely challenging, but we must continue to improve and build on new ways of working to ensure that staff and residents are supported.  

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