Covid Inquiry Criticizes UK Care Home Response
A new report details critical failings in protecting vulnerable individuals during the pandemic, including insufficient PPE and delayed action.
The sixth report from the Covid inquiry has delivered a scathing assessment of the United Kingdom's efforts to safeguard individuals in care settings during the pandemic, citing a catalogue of failures that led to devastating consequences. The report highlights that approximately 500,000 people resided in care homes at the pandemic's outset, with an additional million receiving care in their own homes.
No 'Protective Ring'
Despite assurances from then-health secretary Matt Hancock that a "protective ring" had been placed around care homes, the inquiry found this was not the reality. The report characterizes the care sector as an "afterthought," noting a severe lack of personal protective equipment (PPE). Staff were forced to resort to makeshift solutions like bin bags and ponchos. Furthermore, the inquiry criticized the practice of transferring hospital patients, potentially infected with Covid-19, into care homes to free up hospital beds. While understandable given hospital capacity pressures, this move occurred without adequate testing and isolation protocols, a significant oversight identified by the report.
Underlying Weaknesses Exacerbated Crisis
The pandemic exposed and worsened pre-existing vulnerabilities within the social care sector. High rates of staff vacancies and turnover created a fragile workforce, diminishing its capacity to cope with the crisis. The reliance on agency staff, who often worked across multiple homes, increased infection transmission risks. Financial strains on care providers, exacerbated by a drop in service users and a lack of financial support for staff on zero-hours contracts, further hampered the response. The fragmented nature of the system, with numerous providers overseen by local authorities, meant the sector was less directly connected to government than the National Health Service.
Visiting Restrictions Caused Harm
Precautionary measures to restrict visiting, intended for infection control, were found to have gone too far. While initial bans were deemed rational, the inquiry noted that the balance between benefits and harms shifted over time. Visits are crucial for residents' personal care and mental well-being. By September 2020, evidence suggested visitors posed a marginal risk, with staff identified as the primary entry point for infections. Despite guidance from the four UK nations to relax restrictions, many care homes maintained strict limitations, leading to a significant decline in residents' health and well-being.
Concerns Over Do Not Resuscitate Orders
The report also raised concerns about the use of blanket "do not resuscitate" (DNACPR) orders for care home residents. While CPR decisions should be made on an individual basis, the inquiry heard evidence of GPs imposing blanket orders. Records indicated a sharp increase in DNACPRs during the first nine months of the pandemic, mirroring findings from an earlier Care Quality Commission investigation into inappropriate orders.
Impact on Care Staff
The mental health and well-being of care staff were profoundly affected. Some staff moved into care homes to protect residents, while others faced immense strain from caring for multiple residents nearing the end of life. One care home reported losing half its residents within three weeks. Staff recounted deep distress, including having to facilitate final goodbyes between residents and families via video calls and crying alongside residents during these emotional moments.