Julie Roche awoke abruptly at 3am on Tuesday. The weekly Covid-19 test results for staff at her Buckinghamshire care home often arrive in the small hours. After Westbury Grange lost 13 residents in a torrid few weeks in March and April, the resurgence of the virus “terrifies” her and her subconscious prods her awake to check.
Her phone brought bad news: nine of her staff had tested positive, along with one resident. Roche’s care home was back in outbreak. “You can’t print what I said,” she says. “I am devastated.”
Roche scrambled into her car and got to the home at 4.30am. Two of the staff who had tested positive were on shift and she had to get them out. Now with one resident isolated and showing minor symptoms, she is waiting for test results on all the residents. More bad news is the last thing Roche needs.
She last spoke to the Guardian in April and told the heartbreaking story of a window visit in which a dying man’s wife, denied the solace of touch, brought her perfume for Roche to hold beneath his chin. Covid-19 took a quarter of her residents.
“We are on automatic,” she said at the time. “We haven’t had time to grieve. Once we get through this we will sit and reflect and deal with it.”
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That has not yet happened. “We’ve parked it,” she admits nine months later. And now the virus is back.
“We just have to keep positive,” she says. “It’s terrible out there and people need to be mindful when they walk out the door, what they are doing and who they are mixing with.”
The sound of Led Zeppelin throbbing from a bedroom is proof that even after a terrible year, life goes on. Roche recalls looking in on a new resident recently and seeing a headbanging session in full swing: a lady in her mid-60s living with dementia, and her carer, rocking out to Jimmy Page’s guitar.
“Vera Lynn and all that has gone – it’s heavy metal now,” says Roche. “She was loving it. Her face was beaming.”
There have not been enough smiles in Britain’s care homes this last year. In the first wave, Covid-19 tore through largely unprotected facilities across the UK, killing 19,394 people – close to 30% of all care home deaths.
“It’s far from over,” says Roche. “We have had a few staff test positive through no fault of their own and it just scares me. That is how it’s going to be. Our anxiety levels are quite high at the minute.”
In objective, clinical terms, things are better in care homes than in the spring – for now. Testing is running smoothly, cases of Covid-19 at Westbury tend to be asymptomatic, and lockdowns nationally mean care home deaths are far lower than in April and make up a smaller proportion of the overall death toll. But stresses remain.
“There have been a few more tears, crosser at times, a little bit angry,” says Roche.
Now, under the national lockdown, visits have been stopped altogether.
They try to keep their spirits up. In the week before Christmas, staff organised festive car park karaoke with marshmallow-topped hot chocolate and workers dressed as reindeer.
But fears of a repeat of the spring trauma are never far away. Inconsistencies in government policy and public behaviour trigger high emotions.
The government’s prevarication over Christmas mixing angered Roche. “It’s totally insane,” she says. “People will do stupid things; people will party and they just don’t think of the consequences. We are going to be living with those consequences for a long, long time. We are not going to forget what we’ve been through.”
Westbury Grange, which is operated by MHA, the UK’s largest provider of not-for-profit care homes, bore the brunt of the first wave of Covid-19 when protections that Matt Hancock, the health secretary, claimed amounted to “a protective ring” were negligible.
Hospitals discharged untested patients into care homes and there was no testing even in infected homes. The government faces a court hearing to answer a legal claim from a grieving daughter, Cathy Gardner, who alleges that the government’s care home strategy was “one of the most egregious and devastating policy failures of recent times”.
By early summer, policies had changed: discharges had to be tested and Westbury’s 60 staff were part of a testing pilot. The storm had passed, but it left a trail. “We were snappy with each other, we were exhausted,” Roche says.
So after the “traumatic” spring, watching the lifting of lockdown in the summer was hard. “Simple things like in supermarkets: in the first lockdown it was two-metre distancing, organised queues,” she said. “When lockdown ended, bang, it was gone. It made me very, very angry, and it still does.”
Tears sometimes flow. “My moments are usually when I’m driving home at night,” Roche says. “Little things pop into your head. You look at these residents and it just breaks your heart.”
My moments are usually when I’m driving home at night. You look at these residents and it just breaks your heart
Then, last month, the Pfizer/BioNTech vaccine arrived, offering a “light at the end of the tunnel” for most of the 60 staff. But some have resisted.
Some carers are worried about the speed with which the vaccine was developed and its long-term effects. “It’s frustrating,” says Roche, as is the decision not to administer a second dose until later in the spring.
Now they are waiting for the local GP surgery to come and vaccinate the residents.
Finally, says Roche, the last year has brought clarity about where care homes and the elderly stand in the UK’s “pecking order”. “We were the forgotten people. The profile of social care needs to be raised. The staff here will say, ‘Do you know what? I’m only a carer.’
“But they’re not only a carer. It is the hardest job ever. You have to really want to do it and really want to care. I don’t think that is recognised. That needs to change.”
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