The Cost of Covid on Care Homes
Care home fee increases have prompted backlashes by families and those who pay for care
Covid-19 has increased many costs for care homes, including increased costs for cleaning, PPE, testing and a fall in resident numbers
It is not surprising that the care homes have had to increase their prices, especially considering local authorities did not pay enough to cover care in pre-covid times
Anger about care home fees has been expressed recently by families of people who have to pay for care. Obviously, the people are already concerned about the massive problems created by visitor restrictions during the COVID-19 pandemic, and the widespread criticism of the industry in the press as people turn their anger on those who are trying to provide care. In some cases, prices have recently been increased. A frequently raise issue is whether care providers are ‘price gouging’, that is increasing the price beyond what is considered reasonable or fair.
Three main costs of running a care home
Research indicates that the three main costs of running a care home are staffing, other non-staffing costs, and the capital costs. Staffing costs are usually up to 60% of the cost. It is not just the wages, but National Insurance, holiday pay, sick pay and pension contributions. Also, training costs. Every new staff member should get some orientation, and there is statutory training for fire, safety etc. If staff turnover is high, these costs appear again and again with every new cohort of workers. The burden of time for advertising, interviewing and assessing the applicants can be significant.
The number of staff hours per are home room for catering, cleaning and laundry staff is normally about six hours per resident. During the pandemic it was clear that the requirements for all of these were increased. Meals on trays in rooms, more frequent daily cleaning, extra laundry…all of these increased the ancillary staffing costs. The common areas had to be cleaned, and the kitchens staffed, even when resident numbers sadly fell. Increased individual care of residents may have required increased care staff. Overtime and agency where it was needed and where it was available cost more than usual staffing rates per staff member, not just arithmetical increasing of staffing numbers.
The strain of Covid on Care Homes
In addition, many care homes were unable to fill beds after people died, because transfers from hospitals were limited to those certified Covid free, and many families were understandably reluctant to let anyone go to a care home if they could avoid it. Being at home on furlough, or even working from home, may have offered flexibility that allowed family carers to soldier on for longer than they would otherwise. So, the total amount of income for many care homes dropped at the same time that staff costs increased.
On top of this, structural building changes were required in many places, including creation of visiting pods in gardens or turning over a room to be the visiting area.
Time and money spent on testing
The testing processes to allow visiting when possible, meant that hundreds of staff, and resident tests were needed every week, and that all takes time. Some homes had staff who spend virtually all of their time administering tests including tests for visitors.
There are wide reports of insurance premiums going up as insurers feared that care homes would have to take the blame for the deaths from COVID-19 within their walls. Rents and mortgages for buildings still had to be paid and the additional costs of PPE etc that were supported in part by additional government funding did not cover the cost in many cases.
It was not business as usual
So, sadly, some services were not provided as usual. Outings were stopped and much of the in-house social activity that depended on visits from children, church groups, musicians, therapy dogs, artists and entertainers were paused. The homes would rather have been organising outings, than organising extra cleaning and quarantines. Outings cost less in cash terms. And they help combat loneliness and depression. But they had no choice but to spend this extra money sometimes on activities like surface cleaning that made little difference to this airborne virus.
PPE costs were only part of it, and anecdote suggest that rumours of its availability were exaggerated, and many homes had to pay inflated prices caused by price gouging suppliers, who were only taking advantage of the opportunity. Especially at the beginning, supplies were diverted to the NHS away from care homes in some places.
So, it would be astonishing if fees did not go up. Bearing in mind that the amounts paid by many local authorities do not match the actual cost of caring in normal times, this should be no surprise.
If you would like more information, you can buy my book Dementia, the One Stop Guide or Care Homes: When, Why and How to Choose a Care Home. I am available for consultancy for families or organisations. And if you have any further queries or questions, or suggestions for something you’d like to see me write on, please contact me via the Contact Page
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