'Perfect storm' of problems for social care in Norfolk

The social care sector in Norfolk and across the UK is in turmoil, with staff vacancies and high numbers of so-called 'bed blocking', where patients wait to be discharged from hospitals.

James Bullion, director of adult social care at Norfolk County Council, painted a bleak picture, particularly as the region heads into winter.

“We've clearly got some big staffing issues in the social care sector itself, which means that we're nervous about this winter and the demands that might come and whether the Covid numbers go back up again,” he said.

Throughout the pandemic bed blocking has become an increasing issue across the NHS and social care.

Mr Bullion said there were two issues - the number of patients and the length of time they stay, both of which have gone up throughout the pandemic.

At any one time, Mr Bullion said around 200 to 300 people are stuck in hospital waiting to go into care, double the number before the pandemic.

And while previously people had to wait three to seven days for a care spot to open up, patients could now wait up to three weeks.

“Part of the impact of the pandemic has been to worsen people's health, especially if you're older or frail," he said.

"We've had a 40pc increase in the past year of people approaching us post-hospital – from about 500 a month to about 800.

“Not all of them are in the hospital, in a bed waiting to be discharged, but many of them have had hospital treatment needing social care needs afterwards.”

Asked if he was concerned about social care, Mr Bullion admitted it was causing him "sleepless nights".

Oaklands Care Home in Scole, near Diss, has been rated as 'good' by the Care Quality Commission (Image: Getty Images/iStockphoto/Halfpoint)

“The fact that we’ve got people needing care that we can’t get them is a worry - there are people who aren’t in the right place where they can be cared for properly.

“The second worry is the system is so fragile because there are not enough care workers then it means you can have unexpected problems - if a staff member leaves or is off sick, and you’ve suddenly got new care need that you can’t easily meet.

"It’s a big concern for us and it’s obviously a bigger worry for people themselves.

“People don't want to be in hospital, they don't want to be in residential care, they want to be at home, with their family around them and with a carer that they know.”

Mr Bullion said several issues caused the bed blocking problems.

Partly, he said, it was down to demand outstripping supply, with there simply not being enough staff.

He said Norfolk has space for around 27,000 care jobs and around 10pc are vacant.

Alongside Covid causing staff shortages, mandatory vaccines and Brexit have compounded the issues.

As of Friday, around 5pc of social care staff were unvaccinated, with Mr Bullion hoping for a big surge in uptake. He said providers would need to recruit alternative staff.

While the Brexit effect was muddied with Covid, Mr Bullion said it could account for around 3pc to 4pc of the vacancies.

“It's another thing," he said. "You have Covid, you have mandatory vaccination, you add Brexit and then you add in worn out and tired staff – it's a bit of a perfect storm."

To address bed blocking, Mr Bullion said there needed to be two resolutions: the NHS expanding its community hospitals for temporary care and more workers coming into social care.

He said: “We’re working with employers to try and get more people to come and work, and I’m hoping that when furlough ends the economy starts picking up, people don’t rush into hospitality, that instead, people choose some of these jobs."

Particularly, Mr Bullion would like to see more men take a place in social care, an industry largely dominated by women, and for more support services at home with family and volunteer support.

We have contacted the Department for Health and Social Care for comment.

What is going on?

Barry Wilkinson started dog walking and gardening for his 91-year-old friend, Elizabeth*, about 10 years ago.

Over time he has taken on more responsibilities for his friend, helping care for her and becoming a co-executor of her estate.

Visiting her at a Norfolk hospital, Mr Wilkinson said he was staggered by the number of people stuck there.

"She's has had a sequence of admissions," he said. "This last admission she was declared medically fit but they didn't want to send her home and they couldn't find a bed to transfer her into.

"I think she was there for almost three weeks. "Staff confessed that there were more like her.

"You think, 'what the hell is going on?'"

*Names have been changed