Quarter of home care workers in Wales sought mental health help during pandemic, study finds

The impact of the COVID-19 pandemic on the health of domiciliary care workers in Wales has been revealed in the initial findings of a study led by Cardiff University.

The research, unveiled in an interim policy report out today, found a quarter (28%) sought medical help or received treatment related to mental ill health in the first 12 months of the pandemic in Wales from 1 March 2020.

The findings suggest 12% of care workers tested positive for COVID-19. Low rates during the first wave up to August 2020 then rose sharply in the second from 1 September 2020, the study found.

The researchers analysed routine health data of 15,727 care workers and also interviewed 24 to build a picture of how Wales’s domiciliary care workforce fared during last year.

“Our findings reveal the significant personal burden placed on care workers during the pandemic,” said Professor Mike Robling, Director of Population Health Trials at Cardiff University’s Centre for Trials Research and principal investigator on the study.

“There are multiple factors at play – disrupted workforce organisation, staff availability, isolated working practices and uncertainties over work environments. It has been humbling to hear how care workers have adapted and risen to the challenge of supporting their clients during the pandemic.

“Our initial recommendations focus on how we can provide better care for our carers. Strategies to support individuals and teams are vital to address the emotional burden of pandemic working for carers and ensure continuity of care to clients. My concern is that this burden may be even greater and last longer than we have so far been able to demonstrate with the data we have.”

One carer said the pandemic had been the “biggest challenge” the care sector had faced.

“PPE shortages, staff shortages, caring for individuals who have contracted the virus while also trying to keep yourself safe – it’s been a struggle,” said Sarah Edmunds, service manager for Radis Community Care in Newport.

“The mental health of staff was extremely under-estimated. Staff have worked long, hard hours in full PPE, the only fresh air they got was when they managed to find a few minutes to step outside and take their PPE off.

“Staff were getting ill with minor ailments; however, these were knocking them off their feet for lengthy periods of time, they just weren’t recovering as fast as they used to, probably due to the exhaustion the previous year had caused to them and their physical selves.

“Mentioning future possible lockdowns and restrictions has a massive negative effect on staff, just the thought of having to do all of it again is heartbreaking, but if it comes, we will be there, standing strong as a team as we always have.”

The policy report said mental health problems were recorded by diagnoses, medication or contacts and suggested “a high level of need during the pandemic”. However, it is not yet known if this represents an increase on pre-pandemic levels.

Interviews with care staff raised issues over the availability of PPE and testing, while strategies such as bonus payments, risk assessments and staff training were “sub-optimally deployed and insufficiently tailored” to the needs of carers, the report said.

Carers said they remained motivated to support their clients but reported additional burdens, such as others also visiting or working in the client’s home, a pressure to work when not fully well, access to adequate childcare and fears for themselves, their family and their clients related to COVID-19.

“While many people have been able to work from home during the pandemic, home care workers have been on the front line, providing help and support to some of the most vulnerable people in our society,” said Professor Robling.

“It is vital the issues raised are addressed at both an organisational and policy level to keep care workers safe and well, so they are able to continue helping those most in need.”

The study, led by Cardiff University, in partnership with Public Health Wales and Swansea University and supported by Social Care Wales, is funded by UK Research and Innovation.

The Centre for Trials Research at Cardiff University is core funded by Welsh Government through Health and Care Research Wales and Cancer Research UK.