Care homes in the spotlight: PPE lacking and death toll under-reported

Nearly four weeks after the UK entered into lockdown, care homes have finally hit the headlines, as issues such as the lack of personal protective equipment for staff and the substantial under-reporting of deaths among residents come to the fore. In Hastings grassroots suppliers are helping to fill the equipment gap, while East Sussex County Council is also taking action to improve the supply of PPE. Care sector sources are talking of fatalities in the thousands. Nick Terdre reports.

Concern about coronavirus in care homes might have hit the headlines earlier except that little systematic information has been available on the degree to which it has infiltrated the sector, and on the number of deaths of care home residents, which now appears to be several thousand.

In the care home environment, both carers and cared for are at risk. The availability of PPE, personal protective equipment, is as important for staff as for nurses and doctors in hospitals – they are often in close contact with residents who need help with dressing, bathing and going to the toilet. And while staff need protecting from residents who may have picked up the disease, residents are also vulnerable to catching the virus from staff who have been infected.

Regular testing is needed to identify as early as possible when either staff members or residents have the disease, but this has been lacking, with testing being limited to the first five residents of a home showing symptoms. Care home managers and representatives have regularly complained of a lack of PPE.

Grassroots groups have emerged to tackle the PPE gap. Hastings Makers for NHS & Keyworkers is responding to requests for PPE for care workers as well as healthcare staff, administrator Reece Dreavyn told HOT. Supplies, some for several dozen items, have been delivered to various homes, including Martha’s Trust and Laurels Care Home, as well as St Michael’s Hospice and home care agencies such as Apex Prime Care and Care at Home.

On both fronts the government has now said it will act to boost both the supply of PPE and the availability of testing. All residents displaying symptoms are to be tested, and patients discharged from hospital will also be tested prior to being admitted to a care home. Meanwhile the Care Quality Commission (CQC) will contact all 30,000 care providers to offer tests to care workers who need one.

Testing arrangements questioned

The commitment to provide testing for all care home residents displaying symptoms of Covid-19 was welcomed by John Guy, chair of trustees of Fairfield Residential Home in Oxford, but, he told the Today programme on Monday, when they made enquiries they were told this was just an action plan with no timeline associated with it. As they don’t know when they will be able to have their 10 residents with symptoms tested, they have to treat them as if they do have it, with barrier caring and using PPE, perhaps unnecessarily.

Although there is a testing centre in Oxford, Fairfield has been told by the CQC that their centre is in Twickenham, 60 miles away, Guy said. Care workers are not allowed to use public transport and many, being low-paid workers, do not have a car. One care worker had just gone off sick and was thought to be too ill to travel – and even if she could, who would look after her two children?

How many care home deaths?

Last Tuesday the Office for National Statistics (ONS) reported 217 deaths of care home residents up to 3 April, prompting criticism that the true death rate was much higher.

Based on returns on mortality rates from 47 affiliated care providers, the National Care Forum, which represents not-for-profit care providers, said on Saturday that more than 2,500 care home residents might have died of confirmed or suspected Covid-19 in the past week, nearly twice as many as in the previous week, and more than 4,000 in the period up to 13 April.

Executive director Vic Rayner told BBC Radio’s Broadcasting House on Sunday: “The statistics that we’re putting together, drawing from our members, and extrapolating that to a national picture, suggest that last week alone potentially up to 2,662 deaths occurred which hadn’t been reported. And if we look across the whole period to 6 March we think it’s closer to 4,000 deaths in care homes…

“The nationally reported figures announced at the podium every day [in the government’s daily briefing] are not including vast numbers of people within care homes…firstly because we haven’t had a comprehensive testing regime within the social care sector…and the second bit is that the official statistics that we have from the ONS have got a huge time lag.

“We need to put a ring of steel around care homes to give them the right protection and give those people who are living there, and the workforce, the right protection,” she said.

Broadcasting House also interviewed Anita Astall, who runs a care home in Nottinghamshire, who said more accurate figures should be available: “All care homes have to report their deaths to the Care Quality Commission and we’re now being asked by CQC to put whether the death is Covid related, whether it’s a positive case or it’s suspected. There should be accurate data.”

In her home 11 of 54 residents had died of the virus.

 

 

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