‘People say, I didn’t know such homes existed’: a care home with courage

When Matt Hancock announced that care home residents could finally receive indoor visits from one friend or relative from 8 March, families across the UK breathed a huge sigh of relief.

The isolation of society’s oldest and most vulnerable people in their twilight years has been one of the cruellest side-effects of the pandemic, particularly as it didn’t seem to work, with almost 30,000 people dying with Covid in UK care homes by mid February.

But in one nursing home in Merseyside, residents have been able to enjoy visits for all but about eight weeks of the past year after the manager interpreted government guidance in a bolder way than most.

Jonathan Cunningham, a retired army major who served in Northern Ireland, Iraq and Bosnia, insists he has not broken any rules but simply applied “a little courage and innovation” in order to keep Birkdale Park nursing home in Southport open to visitors.

He has made sure residents can get out with their loved ones too, on an electric rickshaw he has fitted with a Perspex screen. Many love going for spins up and down Lord Street, Southport’s grand Victorian boulevard, enjoying the wind in their hair and even an occasional ice-cream.

Even last week during the third national lockdown, visitors arrived, taking lateral flow tests and sitting in their car while they waited for a result. Chris Chapman had come to see her mother, June Metcalfe, 92, for the first time since Christmas, and said it was wonderful to be allowed in and was bringing a jigsaw board to make puzzling easier.

Just two residents have tested positive for Covid last April. One made a good recovery, the other went to hospital and died with various other complications.

“It’s not just luck,” said Cunningham, smartly dressed in a jazzy waistcoat and perfectly shined shoes. “We must be doing something right.”

Contrary to popular belief, the government guidance never banned indoor visits, he said. There were always exceptions, for residents at the end of life, or for “welfare or mental health reasons, or in extremis”.

With most of his 35 residents suffering from dementia, he decided all had mental health needs which would be helped by visits from familiar faces. After going into lockdown last February, weeks before the whole nation was told to stay at home, Cunningham knew how detrimental it was to residents to not see any familiar faces.

“We had issues in terms of more challenging behaviour,” he said of the first weeks the home was locked down, when a total absence of PPE meant Cunningham improvised, buying 45 cagoules and 20 pairs of ski goggles to stand in for gowns and visors. “The nutritional intake went down, fluid intake went down. They just were not engaging. And it was deeply saddening to see that.”

After a few weeks of window visits, Cunningham decided to start letting visitors back inside, following strict health and safety protocols, with regular testing as soon as it was available. To refuse to do so would be to “discriminate” against people in their final days, he said.

“It breaks my heart, seeing how families have been separated over the last year, and people have died alone. Covid has brought immense tragedy and I didn’t want to add to that tragedy by further social and physical isolation of these beautiful people … These are the most precious days when, and particularly with dementia, in a matter of months, they might not recognise their daughter or their son. So if I can facilitate a visit, by working within the guidance – and I’ve got to stress that because I don’t want people thinking I’ve just gone rogue – then I will.”

Nursing home visitors tend to be older, with no children at home, and are often retired themselves and so pose minimal risk, said Cunningham. “By far the greatest risk is our staff coming in, and that has been proven by our own internal testing.”

Asked why other care home providers didn’t follow his lead, he said that many were part of large chains and were “governed by the group protocol and policies”. Whereas he has “a degree of probably freedom and flexibility that maybe other homes don’t enjoy. Only because it’s family run. And it’s on my head ultimately.”

Keeping his residents safe has been a great burden, he said. “But I also had 16 years of being in the forces, where you’ve got to look after soldiers’ lives and on your head be it. For me, the greatest tragedy was not taking action.”

The Care Quality Commission, which regulates care homes, said it had received no complaints about Birkdale Park. And as word spreads among the community, the waiting list for a room grows ever longer, said Cunningham. “People say, ‘can we move our mum to you? I didn’t realise that such homes existed.’”