People from the residential and social care sector in Wales have spoken about the struggles they have faced amid the recent Covid wave.
According to a report by Care Forum Wales 75% of staff were off work in some homes due to having contracted coronavirus or were self-isolating.
As a last resort some homes were introducing 'fire-breaks' to temporarily restrict visiting as the highly infectious Omicron variant spread across Wales.
Read more: New rules on tests for people with Covid in Wales
Lynne Cullen, the manager of April Court Care Home in Swansea, which cares for around 60 elderly residents, said she and her staff faced particular difficulties towards the end of December.
"Over the Christmas period it definitely felt like a 'war footing'," she said.
"At its worst we had around 16 members of staff off sick due to being Covid-positive, a contact, or self-isolating. It was predominantly the care staff that were affected. We were left trying to provide the same standard of care that we were used to giving but with less staff.
"We have been in this situation a few times before – particularly between December 2020 and January 2021. We were badly hit and you're always remembering how dreadful it was, how it impacted our staff, our residents, and their families.
"This time round it all started when I woke up the morning of December 20 and got a text from one of my staff saying that they weren't feeling really well. At this point we knew about Omicron but it seemed a bit further away. No-one was really talking about it here in Wales and it wasn't in high numbers.
"Not to say we weren't prepared – we are always prepared – but it hit us quite suddenly with infections. It was here before we knew it on this occasion.
"For me personally my anxiety levels were off the scale. Every day you were facing more and more staff off work because of infections – you don't know if it was mild or not, if it was in the home and affecting the residents. It was quite a stressful environment during that time."
According to the chair of Care Forum Wales, Mario Kreft, the situation will only get worse before it gets better. With some care homes potentially being forced to declare an NHS-style "critical incident" Mr Kreft fears reinforcements might not be available due statutory organisations like local health boards and councils also being short of staff.
He said: "The scale of the challenge is one we have never faced before. It’s really, really tough out there.
"After two year of this the pressures have been building up and now we’re facing a completely different challenge because the Omicron strain of Covid is so prevalent and so transmissible.
"It’s quite possible that some care homes will have to call on the statutory services. There are plans in place and we have been working with Welsh Government and our colleagues in health boards and local government.
"We may have to declare what the NHS would call a 'critical incident' and in that case the only place you can go is the statutory agencies.
"The trouble is that we all know they are suffering like everybody else at the moment so whether there would be people available to alleviate the crisis I don’t know."
Such changes to care homes due to staff shortage could also have an impact on families visiting their loved ones, according to Mr Kreft.
"The last two years have been incredibly challenging and I think people need to understand that safe visiting currently also requires a staffing input which makes it even more difficult if you are short of staff and don’t have the capacity to ensure safe visiting," he explained.
"I don’t think there have been any situations where people haven’t been allowed to visit for people in very extreme circumstances.
"I think what we’ll see is fire-breaks or temporary pauses in terms of visiting individual care homes."
Both Ms Cullen and Mr Kreft praised care home staff for their continuous hard work throughout the pandemic.
"I think we feel slightly second-class in comparison to the NHS, especially at the very beginning of the pandemic," Ms Cullen said.
"It was all about protecting the NHS and not enough about the other people in care settings. It took some time and there has been some improvements – people are starting to realise we need support.
"The staff here have continuously worked hard and protected the residents as much as they can and it's nice to see that that now is being recognised.
"I think there's a responsibility on all of us to protect our care homes – get your vaccine, stay safe, and wear a mask. Only by doing so we can protect the most vulnerable in our society and bring this pandemic to an end."
Mr Kreft added: "The social care workforce has been heroic right through this pandemic. It’s taken a pandemic for people to realise how essential these workers are – just in the same way as the NHS and other services."
What did the councils in Wales have to say about local care home issues?
Following reports that teachers, other school and council staff were being asked to volunteer in the care sector amid staff shortages, WalesOnline asked the councils of Wales about the current local care home issues and how they were affecting them.
According to Cardiff Council the county was facing "challenges" due to staffing pressures across the care sector.
A spokesperson said: "Despite these very considerable challenges, our care home providers are currently managing to maintain safe staffing levels by existing staff working additional hours and the use of agency staff as needed. Cardiff Council is continuing to closely monitor the situation.
"The Council has a range of processes in place to support providers, so that they can maintain robust business continuity should staffing fall below current levels. This includes a collaborative and coordinated approach to identifying available agency staff, and an out of hours on call support system. The Council would look to deploy other staff into a care home in exceptional circumstances, should this be required."
The pandemic is having a significant impact on staffing levels across the care sector in Conwy, according to its council.
"Over Christmas and New Year, the sector has managed to continue to provide essential care with support from us, the Local Health Board and local Health Care and Nursing Agencies," a spokesperson said.
"We anticipate the next few weeks will be difficult and we will support the Care Home Managers to source agency staff and identify any other support that may be available to them."
Powys County Council does not manage care homes directly, and therefore, cannot say what are the levels of staff shortages within care homes.
However, they were able to say that care homes and domiciliary care providers "are experiencing staff absences and staffing shortages and that as of the 5th of January 2021 there are 10 older persons' care homes in Powys not open to admissions"
The county council has a number of services operating under business continuity, social care, housing, catering and cleaning and HR, to focus on business-critical activities and release staff from non-urgent work.
The council has also just established three Care Homes Emergency Response Teams of Council (north, mid and south) with staff who have volunteered to be deployed to help in a care home if needed.
In the event of needing to be deployed members will be temporarily released from their normal Council work duties to do this. The team members will only be deployed in a care home as a final measure once all other alternatives have been exhausted by the Council.
In response to the care homes staffing issues, Blaenau Gwent County Borough Council's spokesperson said: "Social care staff have gone above and beyond during this Pandemic to look after our most vulnerable people here in Blaenau Gwent.
"There is only one Local Authority maintained care home in the borough, the remainder are privately owned and managed. We do have some staff currently self-isolating from this care home, but we are managing this using existing staff members and some agency support."
A spokesperson for Pembroke County Council said: "At present there is no significant impact on our staffing levels that is disrupting the Authority’s services.
"When we have experienced challenges to staffing, in those circumstances (which have been limited) we have deployed staff from other services, for example catering and cleaning services."
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