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Elderly Covid-19 hospital patients to be sent back to care homes

Second Covid-19 care home crisis fears as bosses are told they will have to accept infected hospital patients once again and place them in secure quarantine facilities

  • Sparked fear Government has not learnt from its catastrophic errors in first wave
  • Health bosses are looking for 500 homes with high infection control standards
  • They will use them to send elderly Covid-19 patients to isolate and recover 

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.

The sensational decision has sparked widespread fears the Government has not learnt from its catastrophic errors during the first wave of the pandemic that led to the virus killing tens of thousands of elderly residents. 

Department of Health bosses have written to care providers asking them to identify a group of designated facilities able to look after Covid-19-positive patients.

The letter says the homes would need to be inspected by the Care Quality Commission (CQC) to ensure they meet the regulator’s infection control standards.

Councils will be required to provide alternative accommodation for the resident to isolate in if a care home does not have appropriate facilities. 

Care bosses have accused the Government of playing with fire by purposefully allowing the virus back within touching distance of the exact people who should be shielded from it. 

Care homes 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 it led to more than 20,000 care home residents being killed by the virus, according to estimates from the Office for National Statistics.  

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)

Sam Monaghan, the chief executive of MHA, which runs a string of care homes in London, told BBC Radio 4’s Today programme: ‘This is something that came out yesterday and we would be highly concerned – as we were at the outbreak of Covid – in terms of people who had tested positive coming into closed communities where the risk of spread is considerable.

‘You are also asking staff to place themselves in the way of potentially contracting the virus as well.’

Care homes residents are 13 times more likely to die from coronavirus than elderly people in the community, a study suggests.

Canadian experts analysed Covid-19 deaths in more than 600 care homes in Ontario and compared them to victims of a similar age from the province.

They found care home residents were at a 13.1-fold greater risk of succumbing to the coronavirus than people of the same age who lived at home.

Elderly people normally end up in homes when they are too frail to live on their own or are suffering with health troubles — both of which drive up the risk of infection leading to severe illness.

The researchers behind the study pointed to overcrowding, staffing shortages and a lack of PPE and tests as being the main factors behind why the death risk is so much higher.

They say untested staff bringing the disease into the homes was another ‘strong’ driver behind the fatalities.  

The research, by academics from the University of Toronto, looked at the crises in 627 care homes in Ontario up until the first week of April.

Of the 627 care facilities, 272 (43 per cent) reported Covid-19 infections in residents or staff. 

By this time, 83 care home residents had passed away from the virus out of a total of 79,498 (0.11 per cent).

The researchers compared this to the number of deaths involving people over the age of 69 in Ontario who didn’t live in homes.

By April 10, there had been 229 victims out of 1,731,315 individuals in that age group in the province (0.013 per cent). 

The researchers said this amounted to a 13-fold greater risk of Covid-19 death for care homes residents — even though the raw data showed the difference was eight times greater. 

The study also found the risk of dying from Covid-19 was seven times greater for care home residents compared to over-80s in the community. 

People in that age group, regardless of where they live, are at a huge risk of dying from coronavirus, which explains why the difference is lower.

Most humans only live until they are in their eighties because the immune system, as well as vital organs, degrade over time.

They are also more prone to having deadly underlying health conditions – such as dementia and heart disease.

A vicious disease like Covid-19 is often too taxing on the body for people in this age group.  

And, when comparing care home deaths to over-60s in the community – the risk of coronavirus to care home residents was 23.1 times greater. 

Councils have been asked to identify accommodation that could meet current and future winter demand and notify the CQC of these premises, ‘ideally’ by Friday or as soon as possible.

According to the letter, the CQC is ready to approve 500 settings by the end of November, and will prioritise areas with the highest level of restrictions. But care providers said the scheme was ‘severely lacking’ in operational detail.

Vic Rayner, executive director at the National Care Forum, said: ‘Key questions around who will operate these services, how they will be staffed, what choice will patients have in relation to their discharge and critically how care for the multiplicity of needs will be managed in one setting appear to be still not settled.

‘Within 48 hours local authorities are being asked to identify these schemes – and then a rapid run around of designation will ensue.

‘The pressure on providers, authorities, regulators and people who are being discharged from hospital will be huge.’

The DHSC letter 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 £588 million 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.

Mike Padgham, chairman of the Independent Care Group (ICG), said he would like to see the Government show more leadership so councils and providers are not left to ‘shoulder all the pressure on their own’.

He said: ‘First and foremost, it should certainly not be the case that homes are forced to accept Covid-19 hospital discharges, as may have happened last time.

‘They should not be put in such a position that they are forced to accept Covid-19 discharges as a means of survival.

‘The Government must provide financial support to homes so that survival and filling empty beds is not the sole reason homes decide to accept discharges. It has to be an issue that each home can decide upon, based on their own circumstances.’

Ian Hudspeth, chairman of the Local Government Association’s community wellbeing board, said it is ‘absolutely essential that lessons are learnt from the first wave, to avoid a repeat of what happened previously’.

He continued: ‘Care providers remain under intense strain. For many, those experiences are now compounded by problems with the testing regime and uncertainties around funding, along with caution about taking on anything new or with greater risk.

‘Councils and care providers will work closely together to identify the most appropriate care homes, with the priority being that any measures must be designed to keep everybody, including both those who work in and receive care services, safe and to avoid the spread of infection.’

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. 

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