Care boss reveals anguish as virus rocks home with third of staff off work and losses of £100,000


A care home owner who has seen a third of his workforce struck down with coronavirus has told of his despair as he battles to protect carers and residents after suffering losses of £100,000.

Richard Nicholas, who owns Emral House Nursing Home in Wrexham, said 23 of his 63 staff had now tested positive for Covid-19 including seven of his 10 nurses while a resident recently admitted to hospital has also now tested positive for the disease.

Richard, who is isolating at home after coming into contact with his manager who also tested positive, said it was the worst crisis to impact the home in 33 years and said he was desperately worried for residents and staff.

The 45-bed home, which has finally been able to arrange testing for all uninfected staff and residents this week, is currently operating at 78 per cent occupancy rate due to a number of natural deaths not currently linked to the disease and is unable to fill them until becoming virus-free for 28 days.

On top of the shortfall in income, the home is facing a huge agency bill for staff cover which will see costs rise by 30 per this month, pushing losses into the region of £100,000.

According to Richard, the financial situation was becoming more precarious by the day and appealed to Betsi Cadwaladr University Health Board to supplement NHS-funded nursing beds to help care providers mitigate the crisis.

He’s now backing a call from Care Forum Wales, which represents 450 social care providers, for an urgent national plan to ensure the survival of the sector.

The organisation has warned that up to half the care homes in Wales are under threat of closure thanks to a double whammy of soaring costs and plummeting occupancy levels.

Experts say a care home needs occupancy to stay above 90 per cent for it to remain economically viable.

Richard said: “The past two weeks have been the most difficult in our 33-year history with the home largely being manned by agency nurses and carers, although the manager has now returned and some of our nurses will be retuning shortly,” he said.

“Those of our own nurses and carers who have managed to avoid infection have been working 12-hour shifts for over a week now in full PPE and they are exhausted.  I am desperately worried about them as they urgently need to be rested.

“When this is all over I am hoping to be able to reward all of these with extra payments.  Our ability to do that however depends very much on our financial situation which is growing more precarious by the day.

“We are burning the candle at both ends with rapidly escalating costs using agency staff and a steadily reducing income as our residents pass away and with no hope of new admissions until this is all over.”

Richard said the home had reacted swiftly to pandemic, closing its doors to visitors on March 14 – almost a week before the national lockdown was announced on March 23 – and bringing forward refresher training for all staff on food safety, hand-washing and infection control.

The home also went to great lengths to secure additional providers of PPE as existing suppliers were finding items more difficult to source.

On April 18, the home received the news it was dreading after a night shift worker called to say both her and her husband were feeling terribly unwell. A few days later further reports of illness emerged.

Many of the staff, particularly nurses, are still recovering from the illness at home while the only resident to have been infected so far remains in hospital.

Richard said testing had been problematic because of the “absurdly complicated” system initially put in place however he said it had begun to ease over the last week with care homes able to contact the health board directly to arrange testing.

However, the financial woes affecting the home were not going to disappear without additional support, he added.

“Our main problem for many years has been that because we are a care home with nursing and take only nursing cases, most of our residents are funded by the NHS rather than the local authority,” he said.

“Whereas over the years our local authority social services department here in Wrexham has worked well with us to support our residents who are funded by them, the health board has shown absolutely no interest in our difficulties because it has always been pre-occupied with its own problems.

“It still owes us substantial sums of money from agreements made in previous years and we are never able to get up to date with what is owed to us.

“The current talk is all about protecting the NHS from being overwhelmed by Covid-19 patients but if care homes, particularly care homes with nursing, were to suddenly cease to exist then the NHS really would be overwhelmed.

“I doubt that there are enough football, rugby and other stadia in Wales to accommodate all of the people of Wales currently housed in care homes. It has been fragile for many years, but this coronavirus is undoubtedly exposing its vulnerability.

“As a general nursing home caring for very sick and terminally ill residents, we expect to lose four or five residents each month in normal circumstances but these are usually replaced at the same rate with new admissions.  We have not been able to take any new admissions for about a month now since we had our first staff member fall ill with the virus so our occupancy is currently 35 out of 45 residents (78 per cent).

“It is still falling with no end in sight.  So we currently have 10 vacancies.  I have not had time yet to analyse the detail but we are obviously running at a loss.

“I understand that we are to receive some additional percentage payment from our local authority for residents funded by them. The problem is that 70 per cent of our residents are funded by the NHS and the health board has not mentioned anything about additional payments so far as I am aware.”

Care Forum Wales, which supports care homes, nursing homes and social care providers across Wales, has already warned care homes are on the brink of collapse putting the whole sector under threat.

Chair Mario Kreft MBE said: “Across Wales, care providers are struggling to cope with the massive and unprecedented pressures and costs of fighting this disease and it is a postcode lottery depending on where you are in the country as to who gets the help they need.

“To break even a typical care home needs to be operating at 90 per cent or more yet some are running as low as 50 per cent- the sums just do not add up.

“While we welcome the recent upscale in testing, too many care providers remain on the brink of collapse with no end to their current financial problems in sight. It is absolutely critical the future of our care homes and domiciliary providers are protected now – otherwise we will have a much bigger catastrophe on our hands.

“Before all this began, we had a chronically underfunded system and this pandemic has exposed its fragility with shocking repercussions for care providers. Care homes provide care for the most vulnerable in society – now they too are vulnerable and in great need and desperately want support.”

Richard shares CFW’s concerns at the initial handling of the crisis, including the delay to lockdown care homes.

“One of the few good things that come out of all of this is that governments and the general public alike are finally beginning to realise where the front line really is,” he said.

“The workers in the NHS who are in the frontline are doing a magnificent job and we should be eternally grateful to them, but so are the many people in the front line in other care settings who are equally exposed to the danger often with less than adequate protection.”