The risk of loved ones contracting COVID-19 in a care home over the coming months is causing increasing anxiety and not without reason. It is now known that between early March and early August, care homes in England and Wales recorded some 26,500 excess deaths.
Bearing this in mind many families are now looking into domiciliary care policies and procedures as an alternative to residential care for an elderly relative who can no longer live independently, either after a hospital stay, or because of ill-health or old age.
Before COVID-19 struck, Archie Ferguson, 82, from Cambridge, had heard through a friend about Care Rooms, a scheme whereby approved homeowners provide bed, board and companionship to people coming out of hospital or needing respite.
Ferguson had felt unable to return straight to an empty house from hospital after a minor operation. “I was at the bottom of the pile, weak in body and spirit,” recalls the 82-year-old, after five years caring for his wife before she was moved into residential care. “It was the first time for 60-odd years that I was facing looking after just myself.”
Julia Hamilton, 55, in nearby Godmanchester, was able to accommodate him for the three or four days he needed to regain his strength. “It was just what I needed,” he says, “great comfort, good food, good wine – yes – and above all a pushing back of the pain and darkness that was within me.”
Does the concept of Care Rooms sound familiar?
If the concept of Care Rooms sounds familiar, that may be because it achieved a fleeting notoriety three years ago when it was negatively branded “carebnb” in the media.
Paul Gaudin, the healthcare entrepreneur behind the scheme, says he and his co-founder daughter, Lizzie Gaudin, considered walking away from the idea, but they were driven on by the conviction that it could meet a real need. Despite the adverse publicity in 2017, hundreds of people came forward to offer rooms.
“We were just a father and daughter trying to do the right thing in a little corner of Essex, based on our own experience of caring for my father,” says Paul Gaudin. “We were probably three years ahead of our time then. Now is the right time.”
Although Care Rooms bookings have been suspended during the coronavirus crisis, with a planned phased resumption from next week it is paradoxically the crisis itself that promises to put the venture on a permanent footing as people in future seek alternative forms of care and support.
Care Rooms says it has more than 600 approved hosts on its books across England and is poised to increase that to 2,000 through formal agreements with five local councils – so far unidentified - that will refer guests when restrictions ease. Under NHS England discharge arrangements, anyone requiring further care post-hospital may have it free of charge for up to six weeks.
Care Rooms finds that many of its hosts are former nurses or family carers who feel they have more to give – although hosts are not expected to provide clinical or personal care. If more support is needed, it is delivered by visiting professionals. Bedrooms that are used are fitted with sensors and 24-hour alarm systems linked to a central control. The guest must have access to a bathroom for their own use. Hosts are expected to offer companionship and to cook three pre-prepared meals – the ingredients are paid for and delivered to the host. The host may go out, however, and their guest may have visitors. The guest pays £135 per day, of which £50 goes to the host, and the remainder pays for food and monitoring equipment and Care Rooms’ fee.
In England, the existing Care Rooms model does not require CQC policies and procedures because it provides only personal support. A spokesman for the commission confirmed that any scheme offering personal care with accommodation would need to be registered. Paul Gaudin says he has been in discussion with the CQC about his proposed enhanced service for more than two years. He admits: “Without regulation it restricts development of the model.”
To someone leaving hospital not requiring care and support, care rooms offers an alternative to returning straight back to an empty house. On the positive side it may help some people to get them back on their feet. However, the problem is no one is overseeing the service that is on offer. It cannot be seen however as an alternative to registered care where residents require 24-hour care 24/7. Without registration it is difficult to see how Care Rooms can be seen as an alternative to the services provided by a care home.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy