Inside care homes: learning from COVID

How care homes are overcoming fear and finding the positive during the pandemic 

For Linda Graham, while the pandemic has been a cause of great sadness and fear, it’s also provided opportunities to improve care for residents. 

“We’ve taken the learning out of what was done well and what wasn’t done so well, in case we have another outbreak,” says Linda, a qualified nurse for more than 30 years, who has been regional manager for Spa’s six care homes in Northern Ireland for the last two years. 

“It’s been a very stressful time,” she says. “Emotions have been up and down, and every nurse has gone through similar fears and apprehensions. But some very positive things have come out of the experience, seeing us working in some different ways.” 

Sadly, one of the organisation’s homes lost two of its residents to the pandemic, with six of the 20 people living there testing positive, although three had no symptoms. Two members of staff also contracted COVID-19, but again were asymptomatic. “It was very tough for the staff working in that environment,” says Linda, who has worked in the care home sector for the last 17 years. 

To support staff, they provided daily contact, with a meeting that encouraged everyone to share their feelings, once the home reopened. During the outbreak, they invested in extra personal protective equipment (PPE), going further than the guidance recommendations.

“It wasn’t particularly that we felt they needed it, but it was reacting to the fears of the staff, who felt more reassured by being better protected,” explains Linda. “It helped them when they were going into residents’ rooms because they were fully covered.” 

They also brought in the use of monitors, with residents’ consent, which enabled staff to keep an eye on individuals without having to repeatedly go inside their rooms. “It was ground breaking,” says Linda. “It helped us protect staff, while still providing high levels of care for our residents. We’re already having discussions about carrying on using them into the future.

To see a smile on your mother or father’s face is worth a 1,000 phone calls

“Technology also helped speed up consultations with speech therapists, dieticians and local GPs who were able to assess residents without face-to-face contact. “I think this will continue too,” she says. 

Video calls helped residents stay in touch with loved ones. “Maintaining family contact is so important,” says Linda. Activity therapists were redeployed to look after relatives. Videos were also put on the group’s Facebook page, so that loved ones could see their relatives were happy.

“To see a smile on your mother or father’s face is worth a 1,000 phone calls,” says Linda. “Staff priorities were very much about communicating with the families.” 

For those residents who understood more about what was happening, anxiety levels increased. “They were calling on the staff much more,” she recalls, admitting she also felt very fearful at the outset of the pandemic. “I’m asthmatic and I thought, am I going to die from this? Are all my staff and residents going to die? It felt like a hurricane coming towards us.

“It was the first time in my career that I’ve had a breakdown. I started to cry and I just couldn’t stop. It was the fear overtaking my emotions and I needed to release them. I carried on because I’m a strong person and I knew that people needed me. I also have an extremely understanding husband, who was been very supportive throughout,” she says.   

She also found invaluable professional support by networking with colleagues via the RCN, with weekly calls sharing experiences and ideas. “It was a real lifeline for me in my role,” says Linda. 

With much of the focus on hospitals, she feels the care home sector was overlooked and left behind. To share experiences, Linda is part of a government initiative reviewing what has been learnt from the pandemic’s first surge.

We have to protect those who are the most vulnerable

“We’ve raised the lack of PPE that was there for care homes and the problems with access to it,” says Linda. Now there is a much better system in place, she believes, with stockpiles in case of a second surge.  

At her homes, they refused to take patients leaving hospital who had been treated for respiratory problems because of the risk of COVID-19. “We were very vocal about it. The fear of bringing the virus into our homes over-rode everything. We have to protect those who are the most vulnerable,” says Linda.

“We said we would take them if they were tested, but were told they didn’t meet the criteria. That’s changed now, with individuals tested 48 hours before being admitted to a care home.”

Local communities also played a big part in boosting staff morale, making masks and delivering treats.

“We’ve been overwhelmed by people’s generosity,” says Linda. “We’ve seen the goodness coming out and we’ve also felt valued more. One day a big package arrived and when we opened it, it was a kilogram of sweets with a note saying, ‘I’ve seen your rainbow on the window and it cheers me up’.” 

Far away families 

For Mirela Paun, a deputy manager at one of Spa’s nursing homes, being away from family members who live in Romania has been another difficulty of the pandemic. 

Mirela moved to Northern Ireland from Romania in 2013 and has worked at Cregagh nursing home in Belfast since May 2018, which cares for up to 40 residents over two floors.  

Fortunately, the home avoided any outbreaks of the virus. “We were very lucky,” she says. As some of their patients are being discharged from hospital to the home - which provides interim care, home from hospital, rehabilitation and post-operative care on the ground floor - they ask for a test 48 hours before admittance. 

While her immediate family is also in Northern Ireland, other family members are in Romania, where she was able to visit for five weeks this summer. “It was a relief to be able to see them and make sure they are safe and well,” says Mirela, who qualified as a nurse in 2001. “I had to quarantine for 14 days on my return, but I was able to work from home during that time.” 

With staff coming from several other countries, including India and the Philippines, managers have worked hard to be able to accommodate their wish to see their families. “They have all understood that we need to go home,” she says. “We’ve prioritised those whose families are far away, when two weeks leave just isn’t enough.”  


Words by Lynne Pearce. Pictures by Aaron McCracken

Read next...