Care homes across England are tightening rules on visitors because of the uptick in coronavirus infections.
Thousands of families of residents face being turned away from seeing their loved ones, as care home operators attempt to stem the spread of Covid-19.
It’s a reminder of the distress experienced at the height of the pandemic, in March and April, when care home visits were completely banned.
Tens of thousands of elderly care home residents died from coronavirus after the life-threatening infection swept through the under-prepared sector.
Care UK and HC One, two of the largest national operators, have already closed dozens of homes to visitors, having re-opened them over the summer.
Covid-19 cases are rising in care homes, as well as the community. Official figures show they have tripled within the space of just one week, with 513 cases recorded in homes between August 31 and September 6.
The Labour party last night called on the government to set out a fresh strategy to protect care homes this winter, after its shambolic attempts earlier this year.
Care homes across England are tightening rules on visits due to an uptick in coronavirus infections (file image)
Thousands of families could be impacted by the closures of care homes in England in response to the surge in new coronavirus cases.
Care UK has closed 48 of its 124 care homes to visitors mostly ‘because of positive tests or because it is awaiting test results’, The Guardian reported.
HC One has closed some 133 of its 329 homes to visitors, and it is restricting visits in England’s hotspots, where the infection rate in the general population is high. HC One said it had recorded increasing numbers of infections among a small number of staff.
OUTBREAKS OF CORONAVIRUS-LIKE ILLNESS IN CARE HOMES AT A SIX-MONTH LOW
Outbreaks of coronavirus-like illnesses in care homes have dropped to a six month low, according to Public Health England.
Between August 24 and August 30 there were 58 outbreaks of coughs or ‘acute respiratory infections’ in England, said PHE, marking a 38 per cent fall on last week’s 94 cases.
But the number recorded is more than 90 per cent down on the levels seen at the height of the pandemic, which spiked to 1,010 a week at the start of April.
An outbreak constitutes two or more people having the same symptoms, such as coughing, wheezing or difficulty breathing.
Not all the outbreaks are confirmed coronavirus cases because the category includes other infections that can lead to coughing, such as influenza.
Any rises in infections in care homes are serious, because the elderly are most at risk of dying if they catch coronavirus, or a host of other infections.
The last time the number of outbreaks in care homes was this low was between March 9 and March 15, when they dropped to 41.
The UK launched its nationwide lockdown eight days later, by which point outbreaks had surged to 249.
The dropping number of outbreaks comes amid mounting concerns about the UK’s sudden rise in new coronavirus cases, and fears these could be passed into care homes.
The drop in care home outbreaks comes as coronavirus deaths hit a 24-week low at the end of August.
A total of 73 people died from Covid-19 in England and Wales in the week ending August 28, official statistics show. The dip marks a 24 per cent drop on the previous week’s 96 deaths, the first time they fell to single figures since the pandemic began.
It is also a nose-dive from the 8,000-plus deaths a week registered at the peak of the pandemic.
Many operators which had been planning to ease restrictions and allow more indoor visits this winter are now backtracking on their plans.
It includes the Orders of St John Care Trust, which looks after 3,000 residents in 84 homes in Wiltshire, Oxfordshire, Lincolnshire and Gloucestershire.
Dan Hayes, chief executive of the Orders of St John, said: ‘We are monitoring the uptick in infection and it is a possibility that in the near future visits may have to be restricted again, where necessary to protect our residents.’
Testing of his staff showed fewer than half a per cent were infected, but there has been a small increase recently.
He said: ‘Our focus had been on looking to expand visits, but we sadly have to consider the opposite if and when circumstances dictate we should.’
Care homes in England were given the go-ahead to reopen to visitors at the end of July, when cases of Covid-19 in the UK were at record lows. Wales allowed visits from late August, and Scotland and Northern Ireland from early July.
England’s care homes opened four months after visitor bans, which was feared to have alrady had a huge impact on elderly residents.
The lack of social contact caused dementia patients’ health to rapidly deteriorate as they felt confused, isolated and abandoned, the Alzheimer’s Society warned in June.
Decisions on reopening care homes to visitors were to be made locally by council directors of public health based on the risks, such as the Covid-19 infection rate in that area.
Visitors are required to wear a face mask and wash their hands thoroughly before and after putting it on.
But there are concerns these measures could be rolled back in the case of a second wave, after the health secretary said the government is prepared to ‘step up’ the restrictions as needed.
Some care homes had to shut to visitors in line with local lockdowns ordered by the Government. Parts of north-west England, West Midlands, West Yorkshire, Leicester, Scotland, Wales and Northern Ireland are currently under tighter Covid-19 rules.
The aim is to avoid families bringing the coronavirus into the home and reaching the most vulnerable people of society. The elderly are far more likely to die of the coronavirus if they catch it.
Already 15,000 people have died of confirmed or suspected Covid-19 in care home in England and Wales, figures collected by the Office for National Statistics show.
Figures show the number of cases in care homes is rising, although not to levels seen during the height of the pandemic.
In the week ending 6 September, 4.2 per cent of infections in England were in care homes – equivalent to 513 cases, Public Health England data shows.
Care homes have seen the highest number of Covid-like illnesses, according to Public Health England
LABOUR CALLS FOR ‘CLEAR WINTER PLAN’ FOR CARE HOMES
Labour has called on the government to set out a ‘clear winter plan’ to protect care homes.
Action must not be as ‘slow and chaotic’ as it was at the start of the Covid-19 outbreak, shadow minister for social care Liz Kendall has warned.
She has outlined her concerns in a letter to Health Secretary Matt Hancock, after the Department of Health and Social Care (DHSC) warned of the ‘first signs’ of a rise in confirmed Covid-19 cases.
In a letter to providers on Friday, Stuart Miller, director of adult social care delivery, said the care workforce is most affected, but ‘clearly’ there is a risk that the virus will spread to residents and in some cases already has.
Labour MP Ms Kendall said reports of rising infection rates in care homes are ‘a matter of serious concern’, while problems accessing tests are ‘especially worrying’.
She wrote: ‘With winter and the flu season fast approaching, it is vital that the Government now puts in place a clear winter plan to support social care.
‘The Government must learn the lessons from mistakes that have been made so far, and show users, families and staff that social care will be a top priority in the months ahead.’
She added: ‘Getting on top of challenges faced by social care ahead of winter is vital – we cannot afford for action to protect care homes and other services to be as slow and chaotic as it was at the start of this pandemic.’
Ms Kendall is calling for action in five areas to ensure past ‘mistakes’ are not repeated, including weekly, rapid testing of care staff across all care settings.
She added that it ‘beggars belief’ that Care Quality Commission inspectors are not tested before entering homes.
And ministers must ensure no-one with coronavirus is discharged from hospital into a care home – as was the case at the start of the pandemic, until mid-April.
Relatives of care home residents should be given access to regular testing and personal protective equipment (PPE) to help them safely visit and support their loved ones, but care staff must have access to enough PPE, Ms Kendall said.
The previous week the proportion was two per cent, equivalent to 159 cases.
The apparent increase in coronavirus spread in care homes prompted the Government to alert to care providers last Friday.
A letter urged care bosses to ‘take the necessary action to prevent and limit outbreaks’, pointing out that in the last three days there had been an increase in notifications of coronavirus cases in care homes.
At the moment it is the workforce that is most affected, but the letter says that ‘clearly’ there is a risk that the virus will spread to residents and in some cases already has.
The letter, which was written by Stuart Miller, director of adult social care delivery at the Department of Health and Social Care, said: ‘You will know already that we are experiencing a rise in confirmed Covid-19 cases, across the UK population.
‘I need to alert you to the first signs this rise is being reflected in care homes too.
‘Over the past three days, Public Health England (PHE) has reported an increase in notifications of Covid-19 cases in care homes.
‘Testing data has also shown an increase in the number of positive results.
‘Currently, the infections are mainly affecting the workforce but clearly there is a risk the virus will spread to care home residents, or to other parts of the care sector.
‘Unfortunately, in some care homes with recent outbreaks, this does appear to have occurred, with residents also becoming infected.’
The Sunday Times reported a Department of Health report marked ‘official sensitive’ and circulated on Friday said that the rate of coronavirus recorded through satellite tests – which are used in care homes – had quadrupled since the start of the month.
The newspaper also said that Health Secretary Matt Hancock was given an emergency update on Wednesday saying that outbreaks had been detected in 43 care homes.
Yesterday Labour called on the government to set out a ‘clear winter plan’ to protect care homes.
Action must not be as ‘slow and chaotic’ as it was at the start of the Covid-19 outbreak, shadow minister for social care Liz Kendall has warned.
She has outlined her concerns in a letter to Health Secretary Matt Hancock, after the Department of Health and Social Care (DHSC) warned of the ‘first signs’ of a rise in confirmed Covid-19 cases.
In a letter to providers on Friday, Stuart Miller, director of adult social care delivery, said the care workforce is most affected, but ‘clearly’ there is a risk that the virus will spread to residents and in some cases already has.
Labour MP Ms Kendall said reports of rising infection rates in care homes are ‘a matter of serious concern’, while problems accessing tests are ‘especially worrying’.
Unison said it feels like the government is ‘sleepwalking into another care home catastrophe’ amid testing concerns.
A Department of Health and Social Care spokeswoman said: ‘Throughout our coronavirus response we have been doing everything we can to ensure all staff and residents in care homes are protected. We are testing all residents and staff, have provided 208 million items of PPE and ring-fenced £600 million to prevent infections in care homes, with a further £3.7 billion available to councils to address pressures caused by the pandemic, including in adult social care.
‘The adult social care winter plan will be published shortly to ensure we have robust plans in place for the additional pressures we may face this winter, and to protect both the people who need care and the workforce that supports them.’
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.
