Melanie Wood is an Independent Living Team Manager for Independence and Wellbeing, London Borough of Enfield. Melanie provides a guide to creating consistency in homecare settings.
My name is Melanie Wood and I am a CQC Registered Manager within Independence and Wellbeing, Enfield.
To understand the critical importance of the work that our staff do, it is helpful to understand their working environment and their role.
Our staff go into people’s own homes after they are discharged from hospital, frequently after clients have had surgery, accidents and ill health. We provide rehabilitation and personal care services. Being a front-line carer is not an easy job – you are dealing with people at a vulnerable time of their life, often frail, elderly and recovering from illness, along with balancing the support of their anxious families.
Entering someone’s home with only basic information is daunting at the best of times – dealing with the additional risk of COVID infection, has posed a level of risk we have not experienced before.
In recognising the importance of this role, it is also important to consider how staff have felt during this time about their work.
This key group of staff had to make choices in relation to their work. We had a mixed approach to these, some staff wishing to remain home to protect vulnerable family members, and those who worked above and beyond, working additional hours at times to ensure our clients remained safe.
I experienced carers being tearful and scared, seeking constant reassurance, and as a manager I had to understand this and have empathy. I had to be a leader and had to view things from the perspective of our front-line workers. I had to listen to them!
The key areas of fear being experienced was:
- Do we have the correct PPE?
- Disposing of PPE safely
- Being asked to support COVID clients
- Risks when going home to family
- Families in the client’s homes not adhering to lockdown measures or social distancing, and having sometimes difficult conversations with them
- Social media information verses government information was confusing
- Lack of testing initially available
It is important to share with you the measures we took to manage this situation, which resulted in all care and support services being delivered and staff being more resilient. When I review this today, I realise how far we have come, and what we have achieved as a service. Staff now have the approach “treat everyone as potential COVID”, which reduces the risk considerably. The staff have adequate PPE, and this has played a vital role in staff feeling safe.
We had no prior experience of such a pandemic across all sectors – we were going in to the unknown.
In those early days we were all adrift trying to find some routine, some structure, some consistency whilst information was being cascaded thick and fast; changing frequently, creating confusion and uncertainty. We went into new ways of working, office-based staff and managers having to work from home, to keep environments safe. I felt vulnerable, fearful and at times irritable. The fears being; what if I don’t get it right, what if I provide incorrect information, or not providing the right support at the right time, we could lose staff, or worst still not have the capacity to meet the needs of those we support.
The starting point was to increase Skype meetings. Moral was low, and no one had immediate answers to all the questions.
The Skype meetings with managers of other services within our organisation provided the backbone and support I needed. We were able to identify key individuals to do specific pieces of work, these being:
- To contact recruitment agencies to obtain additional staff, to manage the reduction in staff available
- Temporary redeployment of other staff teams, into front-line services to increase capacity
- Reviewed the infection control policy, and circulate to all
- Develop a detailed risk assessment, pulling together the government and NHS guidance
- Contacting PPE providers to source adequate PPE supplies
- Consultation with HR to have the appropriate responses for staff experiencing different situations, and options available to them.
I followed on with a daily meeting with my teams. This enabled me to feedback current information promptly and ensured everything being cascaded was understood. This provided a platform for all staff to feedback openly, and without judgement and feel respected.
It was vital everyone was delivering the same message which was current and accurate.