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Did government guidance contribute to deaths in care homes?

View profile for Monica Kreel
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According to the Office for National Statistics (ONS), there were nearly 46,000 registered deaths of care home residents from 2 March 2020 to 1 May 2020. Out of these, over a quarter involved coronavirus. This staggering loss of life – over 12,500 care home deaths linked to coronavirus in just two months – requires searching questions and truthful answers.

On 19 March 2020, the government issued guidance for care homes that had wide ranging effects. The guidance stopped visitors to care homes, meaning that family members could no longer see their loved ones. Inspectors from the Care Quality Commission also stopped visiting around this time, although the guidance did not specifically mention CQC inspections. While the guidance said that medical staff were allowed to visit, our clients have told us that GPs were no longer visiting care homes and that GP appointments were happening over a video call, with care home staff holding their mobile phones to show the GP the resident’s swollen foot or skin rash or to listen to a cough.

The guidance of 19 March 2020 accepted that residents with symptoms of Covid-19 could not be placed in isolation wings within the care homes. But it said that an outbreak could be contained by ensuring that a resident with symptoms was kept in their room. The guidance did not say what would happen if a resident could not understand that they needed to be kept away from others and decided to wander around the care home. No Covid-19 tests were available for residents, even for those that had symptoms.

Although the guidance for care homes advised that Personal Protective Equipment (PPE) should be used when providing personal care to a person with symptoms of Covid-19 and sensibly advised that a carer should change their PPE each time they moved from one infected resident to the next, the Government expected each care home to buy their own PPE on the open market.

New guidance was issued by the Department of Health and Social Care (DHSC) on 2 April 2020. This guidance explained that “hospitals around the country need as many beds as possible to support and treat an increasing number of COVID-19 cases. This means the NHS will seek to discharge more patients into care homes”. The guidance had the chilling words: “Negative tests are not required prior to admissions into the care home.” It explained that even hospital patients who tested positive could be discharged into a care home and that the transmission of coronavirus could be contained by keeping the resident in their room for 14 days and by staff wearing PPE. The DHSC gave a list of PPE distributors, still expecting each privately run care home to buy their own PPE, except for 300 facemasks provided free to each care home. The guidance did not say 300 masks per day or per week so we can only assume that the guidance meant a one-off supply of 300 masks for each care home.

Many privately run care homes, which struggle to provide local authority care packages for the money paid to them by social services (often as low as £550 per week), also struggled to buy enough PPE for their staff. Low paid carers who had not been tested, continued to work because of the low rate of Statutory Sick Pay (SSP) or because they were not entitled to any SSP at all. Patients with Covid-19 were discharged from hospital into care homes. Care home residents with symptoms were not entitled to a test until 15 April. Care home staff could not get tested for Covid-19 until 23 April 2020.

Families, professional bodies and MPs are now calling for a public inquiry into the loss of life in care homes and nursing homes. Answers are needed about why this happened and whether government guidance contributed to the death toll.

As solicitors who support the rights of elderly and disabled people and their families, we recognise that there needs to be a detailed analysis of what went wrong. We also share the concerns of families about whether their loved ones in care homes are currently safe

If you have concerns about someone in a care home or nursing home and want advice from a solicitor our public law, community care or Court of Protection teams at TV Edwards may be able to assist you. Please contact us on 020 3440 8000 or a_courtofprotectionreferrals@tvedwards.com  to make an enquiry.