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Found 287 results
  1. Content Article
    Paul Brand investigates why 6,000 people have been given "notices to quit" by care homes across England, and why so many people are being kicked out of them.
  2. Content Article
    Visits from loved ones are vital to the health and wellbeing of people receiving care in care homes, hospitals and hospices. There have been concerns about visiting restrictions in health and care settings for several years, and the restrictions introduced in response to the COVID-19 pandemic exacerbated these concerns. While those restrictions were in place at the time to control the risk of transmission and keep people safe, it was detrimental for loved ones to have been kept apart or not to have had someone supporting them in hospital. Guidance is now clear that visiting should be encouraged and facilitated in all circumstances. This consultation seeks views on introducing secondary legislation to protect visiting as a fundamental standard across CQC-registered settings so that no one is denied reasonable access to visitors while they are resident in a care home, or a patient in hospital or a hospice. This includes accompanying people to hospital appointments (outpatients or diagnostic visits). Related reading on the hub: Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative
  3. Content Article
    Social care in England entered the pandemic in a fragile state. With much already written about the government’s response to the Covid-19 pandemic in the social care sector, this new report from the Nuffield Trust in collaboration with the Care Policy and Evaluation Centre analyses the structural and systemic factors that influenced that initial national response. Covid had far-reaching impacts on social care and exacerbated many longstanding issues. This work seeks to highlight progress and identify where action is needed to create a more resilient system.
  4. Content Article
    The Relatives and Residents Association (R&RA) is conducting a survey which aims to gather evidence on the impact of the Covid-19 pandemic on access to healthcare services for those living in care homes. R&RA is seeking responses from people who were living in care homes at any point during the pandemic, or from their relatives and friends. Our analysis of the responses will be shared with the UK Covid-19 Inquiry, including anonymised examples. The survey should take around 10-15 mins to complete.
  5. News Article
    People with dementia, particularly care home residents early in the pandemic, were “disproportionately” vulnerable to fatal Covid infections, according to a new report. The analysis, commissioned by the Scottish Government, also found that excess deaths involving dementia during 2020 were “almost wholly” attributable to Covid. Of the 2,154 deaths where both dementia and Covid were listed on the death certificate, 95 per cent had Covid as the main underlying cause. This contradicts previous suggestions that a rise in dementia deaths early in the pandemic may have been linked indirectly to the virus as a result of “lockdown distress” or an increased use of potentially harmful sedation in elderly people confused by restrictions. The report also found that 73% (1,577) of those who died with both Covid and dementia mentioned on their death certificates had passed away in care homes. Henry Simmons, chief executive of Alzheimer’s Scotland, said their loved ones had been “torn apart by grief and loss” and that the report “raises many more questions as to why so many people with dementia living in care homes quickly became victims of Covid-19”. Read full story Source: The Herald, 10 February 2022
  6. News Article
    The self-isolation period for positive cases is being cut and the limit on visitors lifted from next week. Residents who test positive will have to self-isolate for up to 10 days, with a minimum isolation period of five full days followed by two sequential negative lateral flow tests – as is already the case for the rest of the population. Isolation periods for those having care after an emergency hospital visit will also be reduced to a maximum of 10 days, while a requirement for residents to test or self-isolate after normal visits out will be removed. Care homes will have to follow outbreak management rules for 14 rather than 28 days, and by 16 February care workers will need to use lateral flow tests before work rather than taking a weekly PCR test. The limit on visitors to care homes will be lifted. Visitors should still obtain a negative lateral flow test result earlier in the day of their visit, and guidance on the use by visitors of PPE such as face masks remains unchanged. Read full story Source: The Guardian, 27 January 2022
  7. News Article
    Hundreds of care homes in England are providing substandard care to dementia patients, analysis by the Guardian has found. One in five homes specialising in dementia are rated “inadequate” or “requires improvement” by the Care Quality Commission (CQC), inspection reports show. Some pose such a serious risk to people with dementia – including filthy conditions, poor infection control and untrained staff – that inspectors have ordered them to be placed into special measures. Altogether, 1,636 care homes are failing patients in findings described by charities and campaigners as “appalling”. They said urgent action was needed to tackle the “unacceptable” state of dementia care across the country. Zoe Campbell, the director of operations at the Alzheimer’s Society, said: “It’s appalling to hear that one in five care homes specialising in dementia are delivering substandard care. Every person with dementia deserves to live in a safe, secure place and to be treated with compassion and respect.” Campbell said the revelations meant staff recruitment and dementia training must be prioritised in the government’s social care proposals. Read full story Source: The Guardian, 18 January 2022
  8. News Article
    Care operators are facing acute staffing shortages caused by Omicron with more than 90 declaring a “red” alert, which means staffing ratios have been breached. Over 11,000 care home workers are off for Covid reasons, according to internal health system staffing data seen by the Guardian. One of the UK’s largest private operators, Barchester, is dealing with outbreaks in 105 of its 250 homes. It said that rules meaning homes with Covid cannot accept hospital discharges will cause backlogs in the already struggling NHS. Across England, 9.4% of care home staff are off work, according to government live data, with close to 3% absent because of Covid. The figures, which may be an underestimate because of the festive break, are drawn from submissions by thousands of care providers. “The spread of Omicron across the country will bring more care homes into outbreak, put huge pressure on the already compromised staff group and mean those who need care do not get it,” said Vic Rayner, chief executive of the National Care Forum. Many care operators said delays in getting PCR test results back were a key frustration, meaning workers who may not be infected were isolating longer than necessary." Stephen Chandler, president of the Association of Directors of Social Services, said councils were braced for calls for help from care operators and said “the care that people experience will be affected”. Read full story Source: The Guardian, 5 January 2022
  9. News Article
    The pandemic has disproportionately affected people living in care homes, who accounted for an estimated 30% of all deaths from covid-19 across 25 countries despite making up only 1% of the world’s population, a report has estimated. The analysis was carried out by Collateral Global, a research group that says it is dedicated to reporting on the effects of governments’ mandatory COVID-19 mitigation measures. The report said the pandemic had exacerbated long running problems in the care sector, such as chronic underfunding, poor structural organisation, staff undertraining, underskilling, and underequipping, and a “lack of humanity in dealing with the most vulnerable members of society.” “Neglect, thirst, and hunger were—and possibly still are—the biggest killers,” the group said. They also said that care home residents faced barriers in access to emergency treatments during the pandemic. The study authors suggested that undiagnosed COVID-19, poor testing, and inadequate staffing and infection control were the likely factors contributing to the excess deaths in care homes. Martin Green, chief executive officer of Care England, said, “Adult social care and the NHS are two sides of the same coin and need to be treated as such. The government shouldn’t have placed such a myopic focus on the NHS without due consideration for social care too.” He said that he was “phenomenally” proud of the care workforce and wanted to ensure that they were recognised as professionals with proper career pathways and commensurate funding. Read full story (paywalled) Source: The BMJ, 22 December 2021
  10. News Article
    A watchdog found there were safety concerns at a south-east London care home weeks after a resident killed a woman in her bedroom, it has emerged. Alexander Rawson, 63, beat 93-year-old Eileen Dean to death at Fieldside Care Home in Catford on 3 January. Inspectors visited the care home on 26 January after the murder of the grandmother-of-five triggered alarm about patient safety. Inspectors concluded that the home failed to record dangers properly and residents "were not always safe". Mrs Dean suffered catastrophic injuries after she was attacked by Rawson with a walking stick, about two weeks after he had been moved into the home from a mental health unit. According to the Local Democracy Reporting Service, the report said: "People were not always safe. The provider had not ensured risks to people were always documented and mitigated. "Risk assessments and care plans contained conflicting information which could potentially lead to people being exposed to harm." Specific concerns were also raised to the watchdog about the home's "risk management processes." The 63-year-old was sentenced to indefinite detention in a secure psychiatric unit on Monday. Read full story Source: BBC News, 22 November 2021
  11. News Article
    A care home with some of the highest Covid death rates recorded in the pandemic is facing whistleblower claims over unsafe conditions. Golfhill Nursing Home, in Dennistoun in Glasgow's East End, Scotland, is run by Advinia Healthcare, which confirmed a "large scale" investigation was taking place. A report by the Crown Office, published in April, showed Golfhill care home recorded 11 deaths related to coronavirus, among the highest rates. The Care Inspectorate investigation is said to have followed "months of complaints" about sub-standard and unsafe conditions at the home, including residents being admitted to hospital suffering from dehydration. The problems are said to centre on the intermediate care unit, where elderly residents are transferred after being discharged from hospital, requiring a higher level of care and remaining there for around a month before being sent home or into long-term care. According to a source, the unit has been short staffed "almost on a daily basis" because employees were being transferred to other areas of the home. Read full story Source: The Scotsman, 17 December 2021
  12. News Article
    A resident at an inadequate care home died after their blood glucose increased to high levels and staff acted too slowly, a report found. Inspectors said The Berkshire Care Home in Wokingham breached guidelines in nine areas and must improve. They found residents were put at risk after medicines were not used properly and that records were not up to date. The Care Quality Commission (CQC) said an ambulance was only called for the person who died when they were found to be unresponsive. They later died in hospital. Its report said staff were "not sufficiently skilled" to safely care for people with diabetes. A resident was given paracetamol and co-dydramol eight times over three days, when they should not be used together because they both contain paracetamol, the report said. Another person was burned by a cup of tea and staff did not treat the injury properly, leading to the person developing an infection and later being admitted to hospital. Staff sometimes felt "rushed and under pressure", the report found. Read full story Source: BBC News, 18 December 2021
  13. News Article
    Social care services across England are “rapidly deteriorating”, with waiting lists soaring and councils struggling with care home closures, social services chiefs have warned. Long-term waiting lists have almost quadrupled and 1.5m hours of necessary home care were not delivered in the three months to November, amid a deepening staffing crisis going into winter. “Red lights are flashing right across our dashboard,” said Stephen Chandler, president of the Association of Directors of Adult Social Services (Adass), which ran a survey of 85 councils. “Older and disabled people are suffering.” A survey of care workers by the trade union Unison also found that staff shortages meant people were “dying without dignity” and in some cases there were not enough staff to sit with people in their final hours. A third of those surveyed said staffing levels were “dangerously low”. Read full story Source: The Guardian, 29 November 2021
  14. News Article
    Nursing shortages are allowing “profiteering” staffing agencies to triple their rates, care leaders have warned, raising the risk of vulnerable patients being forced to move care homes and increasing the burden on the NHS. The crisis is forcing some nursing homes to become standard residential care homes without support for people with chronic diseases. The shortage also makes it harder for NHS hospitals to discharge patients. Some hospitals have redeployed their own staff into nursing homes to free beds in hospitals. In other places, NHS trusts are competing for staff with care providers. Geoff Butcher, director of Blackadder Corporation, which runs six homes in the West Midlands, said that he paid nurses about £19.50 an hour, slightly higher than the NHS rate of £16.52. “Two of our nurses resigned recently and they’ve gone to an agency for £35 an hour,” he said. “And that agency then came to us and said we can have these staff back at £52 an hour. They want £95 an hour for those nurses on a bank holiday nightshift. It’s utterly unaffordable. “Because the NHS can’t recruit they are having to use these agencies as well. So the NHS is bidding against us, therefore they’re pushing the rates up, and the whole thing has gone into a completely crazy spiral. The agencies are just grossly profiteering out of it." Read full story Source: The Guardian, 14 November 2021
  15. News Article
    The government is being pressed to urgently pay care homes to take on thousands of patients from hospitals, many of which are on course to be overwhelmed by COVID-19 patients. Hospitals, particularly in London and the surrounding areas, are seeing very high and rapidly growing numbers of covid-19 admissions, and are running out of options to free up beds. Multiple senior NHS leaders said they need to discharge more patients to care homes, but that this had become increasingly difficult. Beds in many care homes are lying empty, but many care providers are refusing to accept residents where there is a risk of introducing covid-19 and fear of repeating the disaster of the spring in the sector. Part of the problem is some care providers which would otherwise become covid-designated homes say they are not insured for the risk of doing so. HSJ understands national officials in the NHS and government are now considering options to try to alleviate the problem, amid urgent requests from local NHS leaders, including paying for the additional insurance cost. However, sources said the Treasury had not yet been willing to foot the bill. Read full story Source: HSJ, 7 January 2021
  16. News Article
    Care homes will not receive the first batches of the Covid vaccine in Scotland because of problems transporting small doses around the country. The health secretary has said about 65,500 doses of the Pfizer vaccine will arrive in Scotland by next Tuesday. They will initially be stored in freezers in packs of 997 doses. The first people to receive the jab may have to travel to where the doses are being held. Health Secretary Jeane Freeman said that means care homes would have to wait until the issue of breaking down the vaccines packs into smaller doses is resolved. She told the BBC's Good Morning Scotland programme: "The doses come to us in packs of 997 and we need to know to what degree we can pack that down into smaller pack sizes. If we can't, then we absolutely need to bring those who need to be vaccinated to those freezers - to the centres - because there is a limit to how much you can transport the doses once you have defrosted them." "We don't want to waste any of this vaccine so it's not possible at this point to take it in smaller doses into, for example, care homes." Read full story Source: BBC News, 3 December 2020
  17. News Article
    Health inspectors in England have been moving between care homes with high levels of COVID-19 infection without being tested, raising fears they have put more residents at risk of catching the virus, leaks to the Guardian have revealed. In recent weeks all care home inspections carried out in the north of England have been of infected homes, including a facility where 38 of the 41 people receiving care and 30 staff – almost half of the workers – had tested positive, internal documents from the Care Quality Commission (CQC) show. Over the last two months inspectors have been checking infection control procedures and care standards in up to 600 care homes, many of which were dealing with outbreaks of COVID-19, but the Department of Health and Social Care (DHSC) has yet to provide testing. The CQC said on Friday it was expecting to start testing inspectors “in the coming weeks”. Weekly Covid deaths in care homes have been rising. In the week to 20 November, 398 people were notified to the CQC as having died from Covid, up from 138 a month earlier. The death toll remains lower than at the peak of the pandemic, when more than 2,500 people were dying a week in late April. The situation has sparked “very real anxieties about contracting the disease” and spreading it between infected homes, the leaked memos reveal. One inspector described work to his managers as like “going into the eye of the storm”. Read full story Source: The Guardian, 27 November 2020
  18. News Article
    Covid patients could be left to languish in hospital and block NHS beds amid delays in setting up “hot” care homes dedicated to receiving them, health chiefs have warned. A plan to reduce care home coronavirus outbreaks by setting up “hot homes” to receive infected people discharged from hospital is running late after dozens of councils missed a government deadline to nominate locations. By the end of October every area of England was supposed to have at least one facility approved for Covid-positive discharges, the government pledged last month. It was part of an attempt to prevent a repeat of the spring pandemic, which killed more than 18,000 residents after thousands of patients were discharged into care homes without tests. But as hospital admissions with Covid continue to rise, only 67 out of 151 local authorities have one set up, according to figures from the Care Quality Commission (CQC). NHS Providers, which represents NHS trusts, said the delays were adding to discharge problems, causing increasing patient stays and a growing number of “super-stranded” patients. “While the new discharge requirements are well-intentioned and aimed at protecting the most vulnerable in care homes, the challenge of implementing the changes has created blockages across mental health, acute and community beds,” said Miriam Deakin, the director of policy and strategy at NHS Providers. Read full story Source: The Guardian, 18 November 2020
  19. News Article
    Not a single resident has contracted the coronavirus at Goodwin House’s small residential facility in Northern Virginia, USA, where about 80 seniors live in homey apartments and keep their own sleeping and meal schedules. There’s been just one case at the Woodlands at John Knox Village in Broward County, Fla., where all 140 residents live in private rooms and are cared for by nurses who earn enough not to take a second job. These facilities, part of a national movement in the US to create less-institutionalised long-term care, stand out in a pandemic that has killed more than 61,000 nursing home residents in the US since March. At “Green House” homes, the best-known nontraditional model, residents are one-fifth as likely to get the coronavirus as those who live in typical nursing homes — and one-twentieth as likely to die of the disease it causes. The model has been praised by academics and doctors and seems far better suited than traditional facilities to stave off the spread of infection and the isolation that has devastated the elderly in recent months. But it remains on the fringes of a $137 billion industry. Read full story Source: The Washington Post, 3 November 2020
  20. News Article
    The government is facing criticism over its guidance on safe visits to care homes in England. Labour and a number of charities have described the suggestions, including floor-to-ceiling screens, designated visitor pods and window visits, as impractical. Alzheimer's Society has said it "completely misses the point". Justice Secretary Robert Buckland told BBC Radio 4's Today programme the guidance was "non-exhaustive". The updated government advice, which came into effect on Thursday, says care homes - especially those which have not allowed visits since March - "will be encouraged and supported to provide safe visiting opportunities". Labour's shadow care minister Liz Kendall said many care homes would not be able to comply with the government's requirements which meant "in reality thousands of families are likely to be banned from visiting their loved ones". She said instead of suggesting measures such as screens, the government should "designate a single family member as a key worker - making them a priority for weekly testing and proper PPE". Kate Lee, chief executive at Alzheimer's Society, said: "We're devastated by today's new care home visitor guidance - it completely misses the point: this attempt to protect people will kill them." She said the pandemic had left people with dementia isolated and thousands had died. The guidelines "completely ignore the vital role of family carers in providing the care for their loved ones with dementia that no one else can", she added. She said the "prison-style screens" proposed by the government with people speaking through phones were "frankly ridiculous when you consider someone with advanced dementia can often be bed-bound and struggling to speak". That view was echoed by Caroline Abrahams, charity director at Age UK, who said she was "acutely aware" that the methods being sanctioned were "unlikely to be useable by many older people with dementia, or indeed sensory loss". Read full story Source: BBC News, 5 November 2020
  21. News Article
    Trusts in more than half English local authorities still do not have an agreed safe place to discharge recovering covid patients to, despite the government asking councils to identify at least one such ‘designated setting’ by the end of October. The situation is leading to an increase in delayed discharges from hospital just as the service comes under increased pressure from the second covid wave and returning elective and emergency demand. In a letter last month, the government told local authorities to identify at least one “designated setting” – typically a care home – which hospitals could discharge covid positive patients to when they no longer need secondary care. The designated setting would also take discharged patients who had not received a negative covid test. The plan is designed to protect residents in other homes, after thousands of care home residents died due to outbreaks of the virus in the spring. But a well-placed source in the care sector told HSJ less than half of the 151 upper tier councils met the 31 October deadline, due to a range of reasons including insurance costs, fear of high mortality rates and reputational damage to the designated homes. It means that in many parts of the country, there are a lack of options when it comes to discharging patients, which is causing a rise in delayed discharges. Read full story (paywalled) Source: HSJ, 5 November 2020
  22. News Article
    A woman has been arrested after attempting to take her 97-year-old mother out of a care home for lockdown. Qualified nurse Ylenia Angeli, 73, wanted to care for her mother, who has dementia, at home. But when she told staff at the care home, they called the police who then briefly arrested Ms Angeli. The family have not been able to see their elderly relative for nine months, and decided to act ahead of the second national lockdown. Assistant Chief Constable Chris Noble, from Humberside Police, said: "These are incredibly difficult circumstances and we sympathise with all families who are in this position." "We responded to a report of an assault at the care home, who are legally responsible for the woman's care and were concerned for her wellbeing. We understand that this is an emotional and difficult situation for all those involved and will continue to provide whatever support we can to both parties." The incident came to light on the day the government announced new rules for families wishing to visit their loved ones in care homes. Under the guidance, issued hours before lockdown, families can meet relatives through a window or in a secure outdoor setting. Visits will need to be booked in advance, but the Department of Health and Social Care advice said care homes "will be encouraged and supported to provide safe visiting opportunities". All care home residents are allowed to receive visits from friends and family during the second national lockdown. Read full story Source: Sky News, 5 November 2020
  23. News Article
    A senior judge has said friends and family can legally visit their loved ones in care homes, in an apparent challenge to recent government policy that has in effect banned routine visits in areas of high COVID-19 infection. Mr Justice Hayden, vice-president of the court of protection which makes decisions for people who lack mental capacity, said courts are concerned about the impact on elderly people of lockdowns. He has circulated a memo that sets out his analysis that regulations do “permit contact with relatives” and friends and visits are “lawful”. He was responding to guidance from the Department of Health and Social Care (DHSC) last month telling thousands of care homes in England that visiting should be stopped in areas with tier 2 and tier 3 lock down restrictions, apart from in exceptional circumstances such as the end of life. It triggered blanket prohibitions by some councils and sparked anguish from relatives who warn a lack of contact is leading to misery and early death in some cases. Within a week, Gloucestershire county council told care homes in its area to stop visits until next spring. With the England-wide lockdown starting on Thursday, care home providers, families and groups including Age UK and Alzheimer’s Society, have called on ministers to this time make clearer provisions for visiting. Hayden said exceptions in the existing regulations mean contact with residents staying in care homes is lawful for close family members and friends. He said the court of protection was concerned about “the impact the present arrangements may have on elderly people living in care homes,” citing their suffering. Read full story Source: The Guardian, 2 November 2020
  24. News Article
    A total of 338 patients with a diagnosis of COVID-19 were discharged from Scottish hospitals into care homes in the three months from March this year, says a report from Public Health Scotland. The discharges were necessary to free up space in hospitals for COVID-19 patients but some care home owners have claimed that it introduced the virus into their premises, causing almost 2000 deaths across Scotland.2 Public Health Scotland says that most of the 3599 discharges that took place in the busiest month of March were among people who had never been tested. Of the 650 who were tested, 78 were positive, but the discharges still went ahead. Scotland has been found to have the highest rate of COVID-19 related deaths in care homes of any part of the UK. Read full story Source: BMJ, 29 October 2020
  25. News Article
    The government has been warned it is throwing “a lit match into a haystack” by discharging Covid-positive patients to care homes, with politicians demanding that the safety of residents and staff is guaranteed under the new policy. During the first wave of the pandemic, approximately 25,000 hospital patients were sent to care homes – many of whom were not tested – which helped spread the virus among residents. Around 16,000 care home deaths have been linked to COVID-19 since the start of the crisis. The strategy was one of the government’s “biggest and most devastating mistakes” of the crisis, says Amnesty International, and questions have been raised over the decision to introduce a similar policy as the UK’s second wave intensifies. As part of the 2020 adult social care winter plan, the government has called on local authorities and care providers to establish “stand-alone units” – so-called “hot homes” – that would be able to receive and treat Covid hospital patients while they recover from the disease. There is also an expectation that, due to housing pressures and a shortage of suitable facilities, some patients may be discharged to “zoned accommodation” within a home, before being allowed to return to normal living settings once they test negative for the virus. Councils have been told to start identifying and notifying the Care Quality Commission of appropriate accommodation, and to ensure high infection prevention standards are met. Under the requirements outlined by the government, discharged patients “must have a reported Covid test result". However, The Independent revealed on Monday that these rules have not been followed in some cases, with a recent British Red Cross survey finding that 26 per cent of respondents had not been tested before being discharged to a care home. There is also concern whether care homes possess enough adequate personal protective equipment to prevent outbreaks, with the CQC revealing last month that PPE was still not being worn in some sites. Read full story Source: The Independent, 27 0ctober 2020
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