How we’ve supported our clients throughout the pandemic
You might find it hard to believe, but we’re coming up to a year since the UK first went into a nationwide lockdown. In the lead-up to the 23rd March 2020, when Boris Johnson announced the restrictions, we were already busy helping our clients navigate the challenges and opportunities that we knew the pandemic would inevitably bring to those in the care home sector. We’ve been looking back at this unprecedented year and highlighting some of the moments that we’re particularly proud of as a company, and some of the key ways in which we’ve helped.
A year in numbers
It can be hard to put into words the exact nature and quantity of work that we’ve done throughout the pandemic, so one way we’ve been encapsulating it is by looking at the figures behind the work we’ve been doing, to try and summarise a year into a snapshot:
- Care groups: 35+
- Care homes: 65+
- In-home audits: 40+
- Independent investigations into whistle blowing allegations: 5+
- Webinars: 3
- Online support sessions: 10+
- HR support for care homes: 5+
These numbers highlight how much we’ve been up to, but they don’t detail the specifics in what we do when working with our clients, so read on for a more in-depth analysis into Fulcrum’s year.
Innovative service offerings
It was clear to us at the start of the pandemic that there was going to be a real issue in freeing up enough hospital beds to care for COVID-positive patients, with the government resorting to setting up emergency ‘Nightingale hospitals’ to meet the increase in demand. We were therefore asked to set up a step-down unit by care homes in Southern England, to release beds from local hospitals.
We were able to set up and staff the unit within 10 working days, an impressively quick turnaround for such a large task. We also oversaw the management of the unit for the first three months in operation, before we handed over the duties to the group’s operations team. Initially, the unit was commissioned for a six-month period, however, given its success, the contract with the CCG was extended for a further six months so that it could continue to provide such a vital service for the local area.
And we didn’t just stop there! Following the success of the designated settings for COVID-positive residents, we managed two further units. We were thrilled to have our contribution to the care industry during the pandemic gain regional recognition after we were invited to feature on BBC South East Today on 22nd January 2021.
We’re immensely proud of the success of the units; they’ve played a pivotal role in enabling care home residents with coronavirus, who were no longer in need of intensive care, to be able to leave hospital so that those who were more in need could take their place.
Lifting embargos to enable resident admissions
One of the ways in which the CQC has sought to manage Infection Prevention and Control (IPC) throughout the pandemic is through monitoring admissions to care homes, especially from hospitals. These admission bans were also put in place amid fears over staffing levels, care planning and overall management of care homes. Although it was necessary to put in place stricter controls over admissions in light of the pandemic, the absolute bans were having a negative impact on care homes with the ability to admit COVID-positive patients safely, and also on the pressures faced in hospitals.
We worked with our clients to create action plans and supported them in implementing them in their homes. This support was vital in helping the homes to get their admission bans lifted and admit residents safely.
Interim management support
As you may well know, staffing levels have been a prominent issue throughout the pandemic, with the government advice being to isolate for two weeks if an individual comes into contact with another person with coronavirus. The chances of being in proximity to a COVID-positive patient, however, are much greater for people who work in care homes, which are more prone to outbreaks of the virus. As a result, many care homes have had staff being forced to isolate for two weeks, and even more worryingly, managers have had to stay away for the same period of time.
Consequently, through the pandemic, we’ve had numerous requests for short-term management support from care homes where the manager or senior team was isolating. Often, this means that we’re managing a team of purely agency staff, as whole sections of the regular staffing team are in isolation. In this sort of situation, a care home provider has two options: find a different care home for residents or enlist a suitable management cover.
We’ve been helping care homes across the UK avoid the first option by offering short-term management cover during staff illness. This has meant that the residents and relatives haven’t had to undergo the distress of changing homes in the middle of the pandemic, as well as saving local authorities from the increased workload associated with relocating hundreds of care home residents.
Simplifying guidance and promoting good management
Let’s face it, the government’s guidelines during the pandemic have been prone to lots of changes, sometimes resulting in confusion. The same can be said of the CQC, who changed the way they monitored care homes to the Emergency Support Framework (ESF), at the start of the pandemic, leading some care home providers to need further clarity over how they would be assessed in the future.
To help our clients understand the new regulations, we held two webinars and several one-to-one sessions which clarified what was going to be expected on them. Although the CQC later held its own series of webinars around the new changes, we reacted quicker, which enabled our clients to get ahead of the game and start putting in place the necessary protocols ahead of other care homes.
Created an IPC assurance framework for care homes to use
We created The Responsive and Safe care and Treatment (TRST), which focused on IPC, assuring all stakeholders that their respective care homes were safe places; crucially, we made TRST free of charge to any care home that should need it, enabling countless providers to seek reassurance around their IPC measures.
We also created a new service to audit the IPC status of homes before the CQC published their revised IPC guidelines, these audits helped homes prepare for IPC focused audits.
Assurance services
Understandably, many care home providers felt uneasy about how they would fare under the CQC’s new guidelines and whether they would be deemed to have maintained – or even exceeded – their quality of care during the pandemic. That’s why we’ve been offering on-site compliance audits to help reassure providers that they were still on track to gain the CQC rating that they were after and, most importantly, to get the most out of their inspection.
Where we felt that the care homes we worked with could improve, we produced action plans and made recommendations to ensure that the homes took proactive action to address areas of concern. We’ve been asked by a lot of our clients to carry out further follow-on audits to ensure that the measures we put in place are still being used effectively, therefore averting service failures.
Averting enforcement action
When lockdown measures started to decrease somewhat in July, the CQC increased the number of inspections it was carrying out on care homes dramatically. As a result, we saw a marked increase in requests to support homes facing different enforcement actions from notices to cancel registration and cancel local authority contracts to warning notices.
When care homes in this position contacted us, we wasted no time and supported them in preparing action plans, gathering evidence to respond to enforcement actions and helping them to stay open and keep looking after their residents. We were able to introduce systems that promoted good practice and, as a result, we’ve been able to ensure that many care homes stay open and, importantly, that the changes we’ve helped to put in place remain for long after we leave them.
Factual accuracy challenges
We’ve helped numerous care homes in preparing Factual Accuracy Challenges (FAC) of CQC reports. When the CQC ramped up its inspections of care homes, we had a lot of enquiries from homes that weren’t happy with their draft reports. We helped them to prepare their FAC, in conjunction with their legal teams, to ensure their home was presented in the best light and in order to achieve material changes to their inspection reports.
Rising to the occasion
The last twelve months have been incredibly challenging for our industry, but we’re proud of how the sector has risen to the occasion and provided excellent care for some of the most vulnerable people in our society. We’re also delighted with how the Fulcrum team has risen to the occasion and has implemented countless innovations to help care home providers with the effective management of their care homes.