It is being addressed Baz , nobody is shrugging their shoulders and saying, oh well, we tried. The stats I've seen are that some care providers think between 5% and 20% of staff have not been vaccinated (this was admittedly a couple of months back), either because they have a medical reason, or because they are refusing as you say (a number of reasons cited, not least of all cultural and believing some of the horseshit written about vaccine risks). When providers have tried to "enforce" for their employees as part of their terms and conditions, they have realised that employment law will not allow them to do this. Nobody really wants to be the first case to test this in the courts. Instead education, guidance and persuasion are being relied on for the large part, as well as adequate PPE, hygiene and social distancing/shielding measures to mitigate the risks as far as possible (which would still be the case vaccinated or not).
That said, we are still relying massively on people to exercise "common sense" (inside and outside the care setting) and it maybe a bit harsh, but I would not set much store by the common sense of an individual working in a care environment with the elderly and vulnerable, who still refuses a vaccine that might just save the lives of them and those they are in contact with.
The real problem for Care homes was allowing infected patients back into the care environment in the first place....and there are very few places the buck should be stopping for that tragedy.