Government plans to send elderly Covid-19 hospital patients back into care homes will be like ‘throwing a lit match into a haystack’, a leading human rights group has warned.
More than 20,000 care home residents died from Covid-19 during the first wave of the pandemic. Experts say the decision to discharge thousands of untested hospital patients into care homes at the peak of the spring crisis was partly to blame.
Last week it was revealed health bosses are pursuing the same catastrophic policy again, in an attempt to free up NHS beds to protect the health service from being overwhelmed this winter.
The Department of Health reassured that homes selected to house infected patients would be carefully inspected so the facilities would not turn into breeding grounds for the virus.
But leaked documents sent by local councils to care homes — seen by the human rights group Amnesty International — offer no assurances that facilities will be properly Covid-secure.
The application forms, sent to providers up and down the country this week, asks how many free beds their facilities have and how many Covid-19 patients they can take. They also ask if care homes have adequate staffing numbers to be able to designate a team to caring for Covid-19 patients to reduce the risk of infections spreading.
Amnesty said it was concerned care homes, which have taken a financial hit by the pandemic and have fewer residents than normal, may feel obliged to accept hospital patients to stay afloat, even ‘without having the means to do so safely’.
Care homes are once again being asked to take in elderly hospital patients infected with coronavirus to protect the NHS from being overwhelmed in winter (file)
Amnesty said the treatment of care homes during the spring was ‘a violation of residents’ human rights’ and to repeat the same mistake again would be ‘irresponsible and unacceptable’.
It accused ministers of playing with fire by purposefully allowing the virus back within touching distance of the exact people who should be shielded from it.
Kate Allen, Amnesty’s director, said: ‘The discharge of Covid-19 patients into care homes full of vulnerable residents is widely regarded as one of the biggest and most devastating mistakes of the Government’s handling of the pandemic.
‘Yet the same deadly policy from earlier in the pandemic is being pursued, despite the knowledge of how disastrous it was and how many lives were lost as a consequence.
‘It is like throwing a lit match into a haystack. There is no doubt that the first mass discharge of patients without testing was a violation of residents’ human rights and could have caused avoidable deaths.’
15 died in care home used as a ‘dumping ground’ for Covid patients
The devastation in care homes during the first wave was felt by the families of residents at Temple Court – a site that was eventually ordered to close.
The virus ripped through the privately run home in Kettering, Northamptonshire, leading to the deaths of 15 residents in six weeks.
It was allegedly used as a ‘dumping ground’ for suspected recovering Covid patients.
The deaths came after untested patients were sent home from local hospitals in an effort to free up beds.
Of the 15 coronavirus-related deaths from the first admission on March 19 – when the home was said to be Covid-free – to May 1, four residents had coronavirus recorded on their death certificates.
At least another seven are suspected to have died with the virus.
The facility had 30 beds, meaning Covid is suspected to have played a part in the deaths of half its residents.
As the outbreak spread, all 12 full-time staff went off sick with symptoms of Covid-19, leaving the home reliant on agency staff. Care standards are then said to have declined with the change of staff.
One of those who died after the outbreak was widower Mikhail Waskiw, 91, who came to Britain as a Ukrainian war refugee in the 1940s.
Mikhail Waskiw, 91, who came to Britain as a war refugee in the 1940s
Mr Waskiw, who died in April, was admitted to the home for three weeks of respite care at the end of February following a hip operation.
His son Raymond, 62, said residents at the home were ‘like lambs to the slaughter’. He said: ‘My father was more or less pushed there by social services. Before we could get him out, the lockdown happened. He had been in reasonably good health apart from his hip operation, but he spent his last three weeks unable to see visitors. It is a scandal that potential Covid-19 patients were just sent into care homes. They, and the residents already there like my father, were like lambs to the slaughter.’
Northamptonshire Police launched an investigation into the home in June after it was ordered to close. It was rated ‘inadequate’ by the Care Quality Commission watchdog in the same month.
Department of Health bosses last week wrote to local council asking them to identify a group of designated facilities to house infected patients in.
Ministers are aiming to create 500 facilities by the end of November and insist the move is aimed at preventing a second crisis in care homes.
The Government has assured the public that selected homes will be inspected by the Care Quality Commission (CQC) – a Government-run agency – to ensure they meet infection control standards.
But Amnesty said it was worried that homes which accept infected patients will not have been assessed by an independent body.
This, the group says, would ‘guarantee homes have the necessary infrastructure, staff, equipment, training, and systems in place to ensure effective protection from the virus for residents and staff, and adequate care for incoming infected patients’.
The group said it had written to the CQC to get assurances about how it will ensure care homes are Covid-secure, but had received no response.
Ms Allen added: ‘As the country heads towards another peak of cases, it is incredibly worrying that care homes are being asked to take in Covid-19 patients without adequate support, effectively putting the lives of their residents and staff at risk. This is irresponsible and unacceptable.
‘If the Government is serious about protecting people through winter it must urgently require an independent mechanism to assess care homes’ capacity to accept Covid-19 patients safely.
‘We must see a full independent public inquiry with an immediate initial phase so that lessons can be learnt and informed decisions can be made before any more lives are lost.’
Kate Terroni, chief inspector of adult social care at the CQC, said: ‘Care home providers should only admit a resident when they are confident they can meet their care needs, so where they are confident they’ve got good infection prevention control, they’ve got the right PPE, they’ve got the right workforce.
‘We will absolutely support a provider to say they cannot admit someone if those ingredients aren’t in place.’
The DHSC letter to care providers last month said it is hoped that every local authority will have access to at least one CQC designated site by the end of October.
The cost of these designated facilities is expected to be funded through the £588million discharge funding.
The letter, from the DHSC’s director for Adult Social Care Quality, Tom Surrey, reads: ‘Emphasis should be on commissioning standalone units or settings with separate zoned accommodation and staffing.’
The designated scheme does not apply to residents who contract Covid-19 in their care home, people using emergency departments who are not admitted, or people supported to live in their own home, it adds.
Local authorities have also been asked to ensure there is repeat testing, sufficient personal protective equipment (PPE), arrangements for staff isolation or non-movement, protection from viral overload, sickness pay and clinical treatment.
Care homes — still suffering from a lack of tests and PPE to contain coronavirus and protect staff — were thrown to the wolves in the spring when thousands of hospital patients were discharged into them without being tested for the virus.
The move was designed to free up beds for an incoming surge of Covid-19 sufferers and protect the NHS from being overwhelmed. But the decision was partly to blame for more than 20,000 care home residents being killed by the virus, according to estimates from the Office for National Statistics.
Another problem during the first wave was that workers — particularly agency staff — were able to go freely between care homes and unknowingly spread the disease.
But instead of clamping down on either issue, ministers instead banned care home visits across the UK at the height of the pandemic. Elderly residents went months without seeing their loved ones in the flesh.
Chris Whitty, England’s Chief Medical Officer, admitted over the summer that ministers and experts didn’t consider care home residents were being put at risk of Covid-19 because of agency staff working across multiple homes.
Part-time carers and bank staff who were infected but showed no symptoms were able to move freely between care homes at the start of the crisis without being tested.
Staff on zero hours contracts also went to work despite feeling ill because they were not guaranteed sick pay, which helped the disease to race through the sector and kill more than 20,000 vulnerable residents.
WHAT WENT WRONG FOR CARE HOMES? A TIMELINE OF FAILINGS
FEBRUARY – SAGE scientists warned Government ‘very early on’ about the risk to care homes
Britain’s chief scientific adviser, Sir Patrick Vallance, revealed in April that he and other senior scientists warned politicians ‘very early on’ about the risk COVID-19 posed to care homes.
He said: ‘So very early on we looked at a number of topics, we looked at nosocomial infection very early on, that’s the spread in hospitals, and we flagged that as something that the NHS needed to think about.
‘We flagged the fact that we thought care homes would be an important area to look at, and we flagged things like vaccine development and so on. So we try to take a longer term view of things as well as dealing with the urgent and immediate areas.’
The SAGE committee met for the first time on January 22, suggesting ‘very early on’ in its discussions was likely the end of January or the beginning of February.
MARCH – Hospital patients discharged to homes without tests
In March and April at least 25,000 people were discharged from NHS hospitals into care homes without getting tested for coronavirus, a report by the National Audit Office found.
This move came at the peak of the outbreak and has been blamed for ‘seeding’ Covid-19 outbreaks in the homes which later became impossible to control.
NHS England issued an order to its hospitals to free up as many beds as they could, and later sent out joint guidance with the Department of Health saying that patients did not need to be tested beforehand.
Chair of the public accounts committee and a Labour MP in London, Meg Hillier, said: ‘Residents and staff were an afterthought yet again: out of sight and out of mind, with devastating consequences.’
MARCH – Public Health England advice still did not raise alarm about care home risk and allowed visits
An early key error in the handling of the crisis, social care consultant Melanie Henwood told the Mail on Sunday, was advice issued by Public Health England (PHE) on February 25 that it remained ‘very unlikely’ people in care homes would become infected as there was ‘currently no transmission of Covid-19 in the UK’.
Yet a fortnight earlier the UK Government’s Scientific Pandemic Influenza Modelling committee had concluded: ‘It is a realistic probability that there is already sustained transmission in the UK, or that it will become established in the coming weeks.’
On March 13, PHE advice for care homes changed ‘asking no one to visit who has suspected Covid-19 or is generally unwell’ – but visits were still allowed.
Three days later, Mr Johnson said: ‘Absolutely, we don’t want to see people unnecessarily visiting care homes.’
MARCH/APRIL – Testing not readily available to care home residents
In March and April coronavirus swab tests – to see who currently has the disease – were rationed and not available to all care home residents suspected of having Covid-19.
Government policy dictated that a sample of residents would be tested if one showed symptoms, then an outbreak would be declared and anyone else with symptoms presumed to be infected without a test.
The Department of Health has been in control of who gets Covid-19 tests and when, based on UK testing capacity.
MARCH/APRIL – Bosses warned homes didn’t have enough PPE
Care home bosses were furious in March and April – now known to have been the peak of the UK’s epidemic – that their staff didn’t have enough access to personal protective equipment such as gloves, masks and aprons.
A letter sent from the Association of Directors of Adult Social Services (Adass) to the Department of Health saw the care chiefs accuse a senior figure at the Department of overseeing a ‘shambolic response’.
Adass said it was facing ‘confusion’ and additional work as a result of mixed messaging put out by the Government.
It said the situation around PPE, which was by then mandatory for all healthcare workers, was ‘shambolic’ and that deliveries had been ‘paltry’ or ‘haphazard’.
A shortage of PPE has been a consistent issue from staff in care homes since the pandemic began, and the union Unison revealed at the beginning of May that it had already received 3,600 reports about inadequate access to PPE from workers in the sector.
APRIL – Care home deaths left out of official fatality count
The Department of Health refused to include people who had died outside of hospitals in its official daily death count until April 29, three weeks after deaths had peaked in the UK.
It started to include the ‘all settings’ measure from that date and added on 3,811 previously uncounted Covid-19 deaths on the first day.