Care homes in England ‘thrown to the wolves’ during pandemic

Care homes in England and their elderly residents were effectively “thrown to the wolves” during the coronavirus crisis, according to a scathing parliamentary report, which accused the government of a host of leadership, accountability and transparency failings.

Many of the problems were attributed to the lack of central control, with responsibility for adult social care spread between the Department of Health, local government and private and non-profit care providers, the public accounts committee found.

Almost 20,000 care home residents died with confirmed or suspected coronavirus between March 2 and June 12, according to official figures.

The cross-party committee of MPs said the crisis revealed the “tragic impact” of delays by successive governments to reform the social care sector, which has been treated as the NHS’s poor relation, and subject to years of underfunding.

This was “compounded by the government’s “inconsistent and at times negligent approach to giving the sector the support it needed”, they added.

Although the NHS declared the highest level of emergency for hospitals on January 30 and started to implement protective measures, it was not until April 15 that the government published an “action plan for adult social care,” the report said. 

By this time 25,000 patients had been discharged from hospitals to care homes without knowing whether they had the virus since the start of the pandemic. The report said the lack of testing was an “appalling error” even though “there was clear evidence of asymptomatic transmission of the virus” from the beginning of April. 

The number of first-time outbreaks in care homes in England peaked at 1,009 in early April and by mid-May about 5,900 homes, or 38 per cent of the total, had reported at least one outbreak, the report found.

The committee said the government had “squandered” the opportunity to build up supplies of personal protective equipment such as masks and gloves in January and February, and changed the guidance on PPE in care homes 40 times — “leading to confusion”.

The changes seemed to be based on what the system could cope with, rather than clinical advice and “what was right” and without taking into account the “reality on the ground,” the MPs found.

A “lack of transparency” around the availability and supply of PPE, and a tendency for government to “over-promise and under deliver”, exacerbated problems and raises questions about the government’s ability to ensure the country has a 90-day PPE stockpile.

The lack of transparency extended to the emergency Nightingale hospitals, which were built to cope with the pandemic and where the “use and cost are not yet known”, according to the report. 

Although private hospitals were paid to provide additional capacity during the crisis using open book accounting arrangements, the government told the committee it could “not even provide a rough estimate of costs until these had been audited”, which may take several weeks.

The committee has urged the government and the NHS to supply a breakdown on the total cost of private hospital contracts and how they were used by September 1. It also demanded to know how private and Nightingale hospitals “will be made best use of in the coming months”.

The committee expressed concern about “the scarcity of information on contracts and costs” and said the NHS when asked was “was unable, or unwilling, to provide any estimate of the cost of private sector capacity or the Nightingale hospitals”.

Meg Hillier MP, the Labour chair of the committee, said: “The failure to provide adequate PPE or testing to the millions of staff and volunteers who risked their lives to help us through the first peak of the crisis is a sad, low moment in our national response. Our care homes were effectively thrown to the wolves, and the virus has ravaged some of them.”

She also criticised the “bold and ambitious claims made by ministers about the roll out of test, track and trace that don’t match the reality” the lack of which meant that “vulnerable people surviving the first wave have been isolated for months”.

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