Professor Amanda Phelan:

The elephant in the room is that it is difficult to recruit people for various areas and, in rural areas, it is especially difficult in respect of home care. While a person might have been approved for a care package, he or she may have to wait simply because there are no staff working there. Furthermore, there is a higher level of attrition in places such as nursing homes that are heavily reliant on, say, Filipino or Indian nurses and which recruit in that way. If we are looking at care provision, we have to take a step back and ask ourselves how we can make it attractive for people and ensure they will be paid properly for the care they deliver.

One impact of the pandemic, I presume, is that the numbers of CAO places for nursing and midwifery dropped this year. I think that is because people are continually hearing about how difficult it is to work in the healthcare system at the moment and during the pandemic, and people have caught Covid up to four times. They want to continue but it is a very difficult situation. We need to look at the conditions of providing care that are adequate and will provide sufficient care for covering safeguarding. Methods of care are also implicated in safeguarding. If there is neglect in a nursing home, for example, or if there is simply missed care, whereby the pressure on the staff is so great that they cannot complete routine tasks whether in part or in full, that can lead to issues such as pressure ulcers.

When we talk about long-term care, therefore, we are looking at that from the home environment, the whole spectrum, and how can we put in measures that will have the right professional at the right time in the right place for the right individual.