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Found 111 results
  1. News Article
    Sweeping bans on visiting at thousands of care homes risk residents dying prematurely this winter as they give up hope in the absence of loved ones, experts in elderly care have warned. More than 2,700 care homes in England are either already shut or will be told to do so imminently by local public health officials, according to a Guardian analysis of new government rules announced to protect the most vulnerable from COVID-19. Care groups are calling for the government to make limited visiting possible, including by designating selected family members as key workers. Since Friday any care homes in local authority areas named by Public Health England for wider anti-Covid interventions must immediately move to stop visiting, except in exceptional circumstances such as end of life. It also halts visits to windows and gardens and follows seven months of restrictions in many care homes that closed their doors to routine visits in March. The blanket bans will result in the “raw reality of residents going downhill fast, giving up hope and ultimately dying sooner than would otherwise be the case”, warned the charity Age UK and the National Care Forum (NCF), which represents charitable care providers. Read full story Source: The Guardian, 23 September 2020
  2. News Article
    Health inspectors have uncovered multiple problems with infection control and the use of personal protective equipment (PPE) in care homes in England ahead of a second spike in COVID-19, which is starting to be detected in care facilities across the country. The Care Quality Commission (CQC) found homes where PPE was not being worn and that had out-of-date infection prevention policies and were failing to take steps to protect black and minority ethnic residents and staff who have been identified as potentially more vulnerable to the virus. The checks took place last month in 59 English care homes and were triggered by concerns about safety and quality or complaints by residents, staff and relatives. The checks precede a government announcement within days of a winter infection control fund that is expected to broadly match the £600m already committed this year. The fund will pay additional staff costs stemming from using fewer highly mobile temporary workers, who have been shown to spread the virus. However, the CQC inspections found PPE being worn inconsistently by staff members, limited supplies of masks in some places, and a failure to store PPE safely away from infection risk. “We found examples of infection prevention and control policies that were out of date,” the inspectors said. “Some had been updated early on in the Covid-19 outbreak but had not been amended since and so contained out-of-date information. This posed a risk to the staff and people who live in the care home. Others had not been updated since 2019. One care home had completed a [contingency] plan, but it only covered the hot weather and did not include preparations for autumn and winter.” Read full story Source: The Guardian, 16 September 2020
  3. News Article
    The government has written to care home providers in England to warn them of a rise in new coronavirus infections within the sector. A letter from the Department of Health urged care bosses to take "necessary action to prevent and limit outbreaks". Cases were mainly among staff but risked spreading to residents, it said. It comes as a further 3,330 positive cases were recorded in the UK - the third consecutive day in which cases have been over 3,000. It brings the total number of confirmed cases to 368,504. Friday's letter from the Department of Health and Social Care said testing data had revealed an increase in the number of positive results in care homes and called on the care sector to work with the government. "You will know already that we are experiencing a rise in confirmed Covid-19 cases across the UK population," wrote Stuart Miller, director of adult social care delivery. "I need to alert you to the first signs this rise is being reflected in care homes too." "I am writing at the earliest opportunity, so we can work in partnership to prevent further spread of the disease. The rapid flow of data and information, to and from care providers, is vital to this effort." Mr Miller said the infections had been detected chiefly among staff but had been transmitted to residents in some cases. He went on to stress "the importance of regular testing and consistent use of PPE". Read full story Source: BBC News, 14 September 2020
  4. News Article
    The human rights watchdog for England and Wales has backed a grieving daughter’s court action against the health secretary, Matt Hancock, over his handling of the coronavirus pandemic in care homes. Cathy Gardner, who lost her father, Michael Gibson, to COVID-19 in a care home that accepted hospital discharges, is seeking a judicial review of policies that she alleges “failed to take into account the vulnerability of care home residents and staff to infection and death, the inadequacy of testing and PPE availability”. The government denies acting illegally over care homes in England, where more than 15,000 people have died with confirmed or suspected COVID-19. But the Equalities and Human Rights Commission said the case “raises potentially important issues of public interest and concern as to the way in which the rights of care home residents have been and will be protected during the current coronavirus pandemic”. “The bereaved families group isn’t backing down in its call for a public inquiry and I am not backing down in my call for a judicial review into policies I believe led to deaths in care homes,” Gardner said. ”I am delighted the EHRC have written to the court. This is a Human Rights Act case.” Read full story Source: The Guardian, 3 September 2020
  5. News Article
    A dementia charity is seeking a judicial review of the government guidance on care home visits. John's Campaign says many care homes in England are still refusing regular face-to-face visits, often essential for people with severe dementia. Dr Angela McIntyre, a retired doctor backing the campaign, has not seen her 92-year-old mother since March. A Department of Health spokesman said: "We know limiting visits in care homes has been difficult for many families." He added: "Our first priority is to prevent infections in care homes, and this means that visiting policy should still be restricted with alternatives sought wherever possible. "Visiting policies should be tailored by the individual care home and take into account local risks in their area." But John's Campaign believes the guidance does not take into account how important visits from family members are for dementia patients and believes it could be in breach of the law. Read full story Source: BBC Health, 3 September 2020
  6. Content Article
    Today HSIB has published a new national intelligence report, Personal protective equipment (PPE): care workers delivering homecare during the COVID-19 response.[1] This looks at inconsistencies in the guidance on PPE requirements for care workers visiting ‘clinically extremely vulnerable’ individuals at home. The report is in response to a member of the public raising concerns when visiting a patient at home in the ‘clinically extremely vulnerable’ category. They noted that while they were visited by district nurses in PPE, their care workers did not wear this, advising that this was not required. The patient later died, and their death was confirmed as COVID-19 related. HSIB found that during April the guidance made available by Public Health England for care staff in this regard was inconsistent. While the primary guidance did not refer to the need to wear PPE when visiting ‘clinically extremely vulnerable’ individuals, other guidance issued in the same month did set out these additional safety provisions. As a result of this, multiple versions of the guidance were available to care workers, who would not be aware of the PPE requirements if they referred to the earlier version of this. Speed of the response HSIB state that they brought this to the attention of Public Health England on the 28 April 2020. They subsequently replaced the primary guidance with a link to a version with the additional PPE provisions on the 13 May. Given the importance of clarity on infection control and PPE, it is very concerning that the conflicting guidance remained live on the gov.uk website for a further two weeks after the issue was identified. A wider system issue The report acknowledges the complexity of providing and keeping up to date such a wide range of guidance, particularly in a crisis scenario, noting that this creates “a risk that patient safety issues may be missed”.[2] When considering the learning potential of this case, HSIB suggest that “there is an opportunity to introduce a document management system for guidelines to ensure that the latest information is available”.[3] While this specific issue is now resolved, it is disappointing that there is no wider recommendation relating to the systems risks above identified by HSIB. Patient Safety Learning believes that there should be an additional recommendation on this that clearly identifies the relevant healthcare bodies responsible for looking into this. There are also questions about how updated guidance is published and shared. Commenting on this in The Independent, Jane Townson, Chief Executive of the UK Homecare Association, mentioned problems with guidance being updated late at night with little notice.[4] She also stated that “there was a very high risk that care providers were not alerted to the changes unless they belonged to a membership association”.[5] Who can lead this change? While we have noted Public Health England's specific role in this case, formulating this type of guidance can involve a number of bodies across the UK, such as: Department of Health and Social Care NHS England and NHS Improvement Public Health England Public Health Wales Public Health Agency Northern Ireland Health Protection Scotland When system-wide patient safety issues arise all these organisations have a role to play. We know that when it comes to implementing changes the system is “confused and complex, with no clear understanding of how it is organised and who is responsible for what”.[6] Patient Safety learning believes it is vital that there is a clear approach to addressing such underlying safety issues. We need to ensure that learning and recommendations for change are prioritised and implemented widely across the health and social care system. References Healthcare Safety Investigation Branch, National Intelligence Report: Personal protective equipment (PPE): care workers delivering homecare during the COVID-19 response, August 2020. Ibid. Ibid. The Independent, Coronavirus: ‘Confusing’ advice from Public Health England put patients at risk, watchdog says, 26 August 2020. Ibid. Care Quality Commission, Opening the door to change: NHS safety culture and the need for transformation, 2018.
  7. News Article
    Nursing homes were put under “constant” pressure to accept patients with coronavirus while being regularly refused treatment from hospitals and GPs for residents who became ill at the height of the Covid crisis, a landmark study has found. The Queen’s Nursing Institute said homes were told hospitals had blanket “no admissions” policies during April and May while GPs and local managers imposed unlawful do not resuscitate orders on residents. The findings have emerged in a survey by the QNI, the world’s oldest nursing charity, which surveyed 163 care home nurses and managers working across the country. Carried out between May and June this year, the study establishes an evidence base of the impact on the sector from coronavirus, in addition to the official figures showing care home death rates. One nurse said they were under “constant pressure to admit people who were Covid positive” while another said: “The acute sector pushed us to take untested admissions. The two weeks of daily deaths during an outbreak were possibly the two worst weeks of my 35-year nursing career.” Read full story Source: The Independent, 22 August 2020
  8. Content Article
    Key findings The survey responses confirm that for the majority of respondents, the pandemic has been a very challenging experience. They indicated that their work and wellbeing has been worse or much worse than at normal times, during the survey period. Having to accept patients from hospitals with unknown COVID-19 status, being told about plans not to resuscitate residents without consulting families, residents or care home staff, lack of guidance on issues like personal protection and issues of poor access to pay if they became ill were some of the major issues the care home workforce faced during March and April 2020. While two thirds of respondents said they ‘always’ had access to appropriate personal protective equipment (PPE) and most others said that it was usually available, a small minority were not provided with PPE and had to improvise, by obtaining it themselves or by making it. The need for appropriate PPE in care homes is of critical importance in staff and resident safety: 21% of respondents said that their home accepted people discharged from hospital who had tested positive for COVID-19. The majority of survey respondents found it easy to access hospital care for their residents when this was required; however, a substantial minority found this difficult or very difficult. Additionally, a substantial number found it difficult to access District Nursing and GP services, which are universal parts of the National Health Service. In addition, many indicated that they were not able to access essential training from other health professionals at this time. Some respondents refocused work to consider how they could improve on their approach to end of life care. Worryingly, some who responded raised serious ethical and professional concerns, for example GPs, Clinical Commissioning Groups and hospital trusts making resuscitation decisions without first speaking to residents, families and care home staff or trying to enact ‘blanket’ ‘do not resuscitate’ decisions for whole groups of people.
  9. News Article
    COVID-19 death tolls at individual care homes are being kept secret by regulators in part to protect providers’ commercial interests before a possible second coronavirus surge, the Guardian can reveal. England’s Care Quality Commission (CQC) and the Care Inspectorate in Scotland are refusing to make public which homes or providers recorded the most fatalities amid fears it could undermine the UK’s care system, which relies on private operators. In response to freedom of information requests, the regulators said they were worried that the supply of beds and standards of care could be threatened if customers left badly affected operators. The CQC and Care Inspectorate share home-by-home data with their respective governments – but both refused to make it public. Residents’ families attacked the policy, with one bereaved daughter describing it as “ridiculous” and another relative saying deaths data could indicate a home’s preparedness for future outbreaks. “Commercial interest when people’s lives are at stake shouldn’t even be a factor,” said Shirin Koohyar, who lost her father in April after he tested positive for Covid at a west London care home. “The patient is the important one here, not the corporation.” Read full story Source: The Guardian, 27 August 2020
  10. News Article
    A home care worker who did not wear protective equipment may have infected a client with a fatal case of coronavirus during weeks of contradictory government guidance on whether the kit was needed or not, an official investigation has found. The government’s confusion about how much protection care workers visiting homes needed is detailed in a report into the death of an unnamed person by the Healthcare Safety Investigation Branch (HSIB), which conducts independent investigations of patient safety concerns in NHS-funded care in England. It was responding to a complaint raised by a member of the public in April. The report shows that Public Health England published two contradictory documents that month. One advised care workers making home visits to wear PPE and the other did not mention the need. The contradiction was not cleared up for six weeks. The government’s guidance had been a shambles that had placed workers and their vulnerable clients at risk, the policy director at the United Kingdom Homecare Association, Colin Angel, said on Wednesday. The association also accused the government of sidelining its expertise and publishing new guidance with little notice, sometimes late on Friday nights, meaning that it was not always noticed by the people it was intended for.
  11. Content Article
    In April HSIB identified an emerging safety risk of confusion over guidance on PPE requirements after a case was referred to them by a member of the public. Care workers had visited the home of a ‘clinically extremely vulnerable’ patient and did not wear PPE. The patient later died and the death was confirmed as COVID-19 related. The report emphasises that the patient was not showing symptoms of the virus when the care visits took place. The guidance available at the time found that Public Health England’s (PHE) primary COVID-19 guidance for home care provision, published on 6 April, did not reference the PPE needed when caring for those within the most vulnerable groups. On 2 April, separate Official UK Guidance on PPE had been published for those working in outpatient, community and social care settings but was not linked to the PHE primary guidance and not easily accessible. Public Health England then issued newer guidance on 27 April (how to work safely in domiciliary care in England) which did include PPE provisions for the ‘clinically extremely vulnerable’ group. However, the original (6 April) guidance was still live and available and did not reference the new update. After HSIB highlighted the case and the associated safety concerns to Public Health England, they withdrew the link to the primary guidance and provided a link to the newer guidance. Medical Director, Dr Kevin Stewart said: “Guidance that protects frontline workers and vulnerable patients needs to be as clear and accessible as possible and this is even more important in times of crisis. However, there are multiple guidelines for different care sectors and it is easy to see where confusion can occur as new updates overlap with older versions. Our report recognises the challenges in implementing national guidance and that further work is needed to understand the most effective systems that would enable better version control. Whilst our analysis focused on PPE guidance for carers working in homes, the risk to patient safety because of poorly communicated guidance is applicable across all healthcare settings. Our aim is to identify specific safety risks for COVID-19 and share that insight as widely as possible to aid the decision-making process and ensure consistent care for all.”
  12. News Article
    Policymakers’ failure to tackle chronically underfunded social care has resulted in a “lost decade” and a system now at breaking point, according to a new report. A team led by Jon Glasby, a professor of health and social care at the University of Birmingham, says that without swift government intervention including urgent funding changes England’s adult social care system could quickly become unsustainable. Adult social care includes residential care homes and help with eating, washing, dressing and shopping. The paper says the impact has been particularly felt in services for older people. Those for working-age people have been less affected. It suggests that despite the legitimate needs of other groups “it is hard to interpret this other than as the product of ageist attitudes and assumptions about the role and needs of older people”. Read full story Source: The Guardian, 9 August 2020
  13. Content Article
    Key points: The coronavirus (COVID-19) pandemic has had a profound impact on people receiving and providing social care in England. Since March, there have been more than 30,500 deaths among care home residents than we would normally expect, and a further 4,500 excess deaths among people receiving care in their own homes (domiciliary care). There has been a greater proportional increase in deaths among domiciliary care users than in care homes (225% compared to 208%). And while deaths in care homes have now returned to average levels for this time of year, the latest data (up until 19 June) shows that there have continued to be excess deaths reported among domiciliary care users.Social care workers are among the occupational groups at highest risk of COVID-19 mortality, with care home workers and home carers accounting for the highest proportion (76%) of COVID-19 deaths within this group. During March and April, there was a substantial reduction in hospital admissions among care home residents. Elective admissions reduced to 58% of the 5-year historical average and emergency admissions to 85% of the 5-year historical average. By reducing admissions, care home and NHS teams may have reduced the risk of transmission, but there may have also been an increase in unmet health needs. During March and April, discharges from hospitals to residential care homes were 75% of the historical average, while discharges from hospitals to nursing homes increased to 120% of the historical average. These difficult decisions to discharge patients were made in an urgent and uncertain context but may have played a role in transferring risk to a poorly supported social care system.
  14. News Article
    New analysis by the Health Foundation reveals the devastating impact the pandemic has had on social care in England. The independent charity says the findings provide further evidence that the government acted too slowly and did not do enough to support social care users and staff, and that protecting social care has been given far lower priority than the NHS. The Health Foundation finds that policy action on social care has focused primarily on care homes and that this has risked leaving out other vulnerable groups of users and services, including those receiving care in their own homes (domiciliary care). It also notes that the shortcomings of the government’s response have been made worse by longstanding political neglect and chronic underfunding of the social care system. Since March there have been more than 30,500 excess deaths* among care home residents in England and 4,500 excess deaths among people receiving domiciliary care. While high numbers of excess deaths of people living in care homes have been well reported, the analysis shows there has been a greater proportional increase in deaths among domiciliary care users than in care homes (225% compared to 208%). And while deaths in care homes have now returned to average levels for this time of year, the latest data (up until 19 June) shows that there have continued to be excess deaths reported among domiciliary care users. The Health Foundation says that decades of inaction by successive governments have meant that the social care system entered the pandemic underfunded, understaffed, and at risk of collapse. Read full article here.
  15. News Article
    Relatives of care home residents with dementia should be treated as key workers, leading charities say. In a letter to the health secretary, they write that the care given by family members is "essential" to residents' mental and physical health. They argue the current limits on visitors have had "damaging consequences" and they want visits to resume safely, with relatives given the same access to care homes and coronavirus testing as staff. Signed by the bosses of leading charities including Dementia UK and the Alzheimer's Society, the letter calls on the government to "urgently" address what it calls the "hidden catastrophe" happening in care homes. The charities say that this "enforced separation" has caused a "deterioration" in residents' mental and physical health, particularly for those living with dementia - who make up more than 70% of the population of care homes. Read full story Source: BBC News, 9 July 2020
  16. News Article
    Staff working in care homes are to be tested every week starting on Monday, with residents tested every month, the government has said. The expansion of testing comes as a whistleblower at one of the testing laboratories revealed dozens of shifts had been cancelled throughout May and June because of a lack of test samples. Ministers hope that the expansion of testing will help to prevent the spread of infection to vulnerable residents. Read full story Source: The Independent, 3 July 2020
  17. News Article
    A dramatic collapse in standards at a care home where a dozen people died from COVID-19 has been revealed by inspectors who discovered hungry and thirsty residents living with infected wounds in filthy conditions. Infection control was inadequate, residents with dementia were left only partially dressed and one family complained of finding their loved one smeared in dried faeces at Temple Court care home in Kettering, which is operated by Amicura, a branch of Minster Care which runs more than 70 homes in the UK. Amicura said the home had been “completely overwhelmed” by COVID-19 infections which it said arrived with 15 patients discharged from hospitals in the second half of March. They were overrun,” one relative told the inspectors. “They were short-staffed and then with the influx of people, they couldn’t cope.” Residents’ wounds had become necrotic and infected, requiring hospital treatment and several people had experienced falls, some of which resulted in injuries needing hospital treatment, the inspectors found. The conditions discovered by the Care Quality Commission on 12-13 May were so poor that surviving residents were moved out immediately. The CQC report into the service, published on Friday, found multiple breaches of the health and social care act. Northamptonshire police have launched an investigation to identify whether any offences may have been committed. Read full story Source: The Guardian, 26 June 2020
  18. News Article
    Discharging patients into care homes in England in early April, when the number of coronavirus cases was rapidly increasing, was neither reckless nor wrong, the Department of Health and Social Care’s (DHSC) most senior civil servant has claimed. Faced with aggressive questioning from MPs on the powerful public accounts committee on Monday, Sir Chris Wormald, permanent secretary at the DHSC, said the guidance for discharge was correct based on the information available at the time. Conservative MP Sir Geoffrey Clifton-Brown said to Wormald: “You were discharging them from hospital into care homes when care homes were already in dire trouble, some of the most vulnerable people in society, the testing wasn’t available, PPE [personal protective equipment] wasn’t available, the training wasn’t available. Wasn’t this a pretty reckless policy by the government?” Wormald replied: “We don’t believe that. Now, as Prof [Stephen] Powis [national medical director of NHS England] described, at this point Covid was not considered to be widespread in the community.” A clearly frustrated Clifton-Brown interrupted him saying there were already 1,000 care homes with coronavirus cases at the beginning of April. He also questioned why detailed advice in relation to coronavirus for the social care sector had not been issued until 15 April, almost a month after the equivalent information was provided to the NHS. Read full story Source: The Guardian, 23 June 2020
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