Coronavirus: Neglect of Social Care

[istherelight?]

So sorry to hear about your Mum, @Splashing About . My Mum died last month so I really feel for you.

A carer told me that a patient had been discharged from hospital into Mum's CH but was found to be displaying Covid-19 symptoms on arrival. The CH insisted that the NHS came out and tested the person. She tested negative. But she got sicker and had to be returned to hospital where she was tested again and found to be positive.

I would like to know just how many sick patients have been discharged into CHs and just who is ultimately responsible for deciding that it is OK to send symptomatic patients into the midst of some of the most vulnerable in society. I know the policy was to "Save the NHS" but it was a death sentence for so many.

Sorry about the rant. I just feel bitter about it all.

 

[Splashing About]

Yes the hospital discharged a Covid positive into mums home and didn’t inform the home...

Thank you everyone.
@canary I also liked the home’s homeliness feel and would choose this again. However....the powers that be need to stop assuming nursing homes and residential homes have the same ability to react to infection. They don’t.

 

[Pete1]

Oh no! My sincere condolences @Splashing About. I'm so sorry what happened to Mum - everyone who took part in the election should be. Your Mum has been let down very badly by this Government. I hope you are 'ok'?

 

[Splashing About]

I hope you are 'ok'?

I think I am ok and then I’m not. Early days and a number of emotions to deal with

 

[Palerider]

Basically most care homes are designed to feel like a home environment not a clinical space, it is often a converted house with all the issues of that around space and design. Cramped toilets etc

Variable provision of hand washing and other infection control measures. Infection control is not supported by a whole dept (as it is in hospital) and is mostly perfunctory as norovirus is their main challenge.

There is close personal care, lots of contact, shared space, shared facilities, and no standardised uniform, PPE or employment policies. (If you needed to pay the mortgage and wouldn’t get paid if you had to self isolate you’d be inclined to ignore any symptom.).

The building is hot and you are wearing PPE but don’t have the feel of a hospital to remind you to not fiddle with the mask, deaf patients struggle to hear you so you adjust frequently so they can hear.

In hospitals they have a highly paid team from multiple backgrounds who act as a committee, making decisions to develop strategy and ensure there are resources to support their recommendations. There is clinical governance, accountability etc. In my sisters care home there was an owner manager

There were more case of Covid in care homes than in our hospital at one point. There is poor access to testing. Early on I was phoned and asked to agree that my two relatives were not transferred to hospital. (Basically care homes were redesignated as hospices) Preserve hospitals.

Mum died this week in her home.

Just in from work and read your post. My sincere condolences @Splashing About and all of your points are well said.

 

[Lynmax]

My mum was discharged from hospital into a care home three weeks ago. Although the hospital found a placement, we were able to change it to one closer to us that has been recommended - although we has not been for a visit. Before admission mum had a test and had to be negative for the place to be offered. She was then supposed to be isolated in her room for two weeks but this proved impossible as she just kept walking out!

Interestingly, although mum will be self funding ( has a house, savings and a good pension) all her fees are being paid from a special Covid 19 fund until an assessment can be undertaken once visitors are allowed. Mum will not be required to pay anything back. The care Homecare receiving £1400 per week from the fund, actual fees are currently £950. The home initially proposed was much cheaper, fees currently under £700 but the fund manager approved the higher fees for the home we preferred

Cynically, I wonder if the higher rate is an incentive to get Homes to take people from hospital quickly.

 

[Palerider]

However....the powers that be need to stop assuming nursing homes and residential homes have the same ability to react to infection. They don’t.

This is something I raised in my own letter to our MP that has been passed on to the Dept of Health and Social Care -still no response

 

[Palerider]

So sorry to hear about your Mum, @Splashing About . My Mum died last month so I really feel for you.

A carer told me that a patient had been discharged from hospital into Mum's CH but was found to be displaying Covid-19 symptoms on arrival. The CH insisted that the NHS came out and tested the person. She tested negative. But she got sicker and had to be returned to hospital where she was tested again and found to be positive.

I would like to know just how many sick patients have been discharged into CHs and just who is ultimately responsible for deciding that it is OK to send symptomatic patients into the midst of some of the most vulnerable in society. I know the policy was to "Save the NHS" but it was a death sentence for so many.

Sorry about the rant. I just feel bitter about it all.

I don't think thats a rant. Its a perfectly reasonable question.

I think the focus was too much on the NHS and not keeping attention on other aspects of care services, such as care homes. No one doubts the NHS has to remain operational, but it seems too much emphasis was placed on that with no thought for considering social care in the mix.

The other thing is that these tests don't have 100% efficacy, which means they can return false negatives. Isolating someone in their room is supposed to cover for this eventuality as well as those who are positive -but is it realistic to isolate someone with dementia for two weeks in a small room, most likely not! Its a small miracle my mum has not gone down with Covid-19, having had 5 infected cases on her own wing.

How care homes operate is going to have to change as its now clear that mixing infected and non-infected residents is generally not a good idea. Care homes will have to look at cohorting residents in the future if they are going to make these places as safe as they can be. There is always a 'risk' but reducing that risk is the best option.

 

[Pete1]

I think I am ok and then I’m not. Early days and a number of emotions to deal with

Hi @Splashing About , I totally get that, such a difficult time to make arrangements with the restrictions too. I hope you have some support around you. Look after yourself.

 

[Palerider]

I'm not convincved the media have driven issue of PPE alone. I posted on this thread about how private care home companies manage their finances and one aspect of that with large care home provider companies (approx 20% of providers in the UK, with a large amount of residents on their books) simply cream off the profits or play with borrowing, and then hold their hands out for more taxpayer money.

On the Today program, Radio 4 yesterday morning as I was driving to work Jeremy Richardson, CEO of the second largest care home company in the UK was interviewed (the company has already been under financial scrutiny). He spoke honestly and seemed to be open. It was interesting to note how he calmly talked about the extra £3.86 billion made available to local authorities being swallowed up by their large overdrafts and not reaching care home providers -I nearly aspirated on my coffee!

He said that the government had been disingenuous at the beginning of the interview with not prioritising care homes at the start of the outbreak -yes I agree. He then went on to say that the deal with viruses every year such as influenza, norovirus and D&V but this virus is different (in a nut shell). He was asked if they had stock piled PPE for the eventually of an outbreak and said no, because this is 'different' (in a nut shell...again). Well it isn't different, the PPE used for influenza and norovirus is the same PPE being used in Covid-19. In fact prity much all the interventions being used are the same interventions that would be used in any outbreak. He did say that his own company did subsequently purchase adequate PPE.

If the care home sector is so poor, then re-nationalise it, but I doubt that it is, otherwise they wouldn't keep going. It completely mystifies me that these larger care home companies can ask for state funding when they are charging money to care (in some instances large fees), knowing they ultimately take on the responsibility as a care provider to make appropriate provision while shielding there own profits. I feel for the smaller care home providers, who really don't have the financial clout or voice that larger companies do.

Anyway for those who want to listen here is the link to the program aired yesterday, wind forward to about 33 mins:

BBC Radio 4 - Today, 16/05/2020

Including Sports Desk, Weather and Thought for the Day.

www.bbc.co.uk

 

[Sirena]

@Splashing About I just read your post, I am so sorry to hear about your mother. And I agree with everything you've said about the situation in CHs.

My mother's care home has remained Covid-free (we have a low number of infections in the area, so far). The staff told me it has been difficult to ensure a constantly supply of PPE, but so far they have managed to do so. They wear aprons and gloves for personal care but they don't routinely wear face masks because it causes difficulties with communication, particularly for those with hearing difficulties.

As others have commented, care homes are often converted from private houses, and my mother's is one of these - homely and comfortable. The toilets/bathrooms are generously sized and there are plenty of them, they always look spotlessly clean. The CH is independently owned (not a chain) and during the pandemic they have used only regular staff, no agency staff, to reduce the possibilities of infection being brought in. They locked down on 13 March and I cannot imagine them allowing visitors for some time to come.

Obviously social distancing is impossible. As for keeping a dementia patient in their room for 14 days - there is little chance of that unless they are actually immobile.

 

[pixie2]

There has been a bit of a brawl going on here in Australia about the issues of care homes going into lockdown and not allowing visitors in and our Prime Minister saying that the mental health of patients is really important and that care homes need to rethink their policies.

The care homes are saying of course that they need to protect their residents who are mostly frail and unwell from Covid 19 and the only way they can do this is to keep everyone except staff out. However, there have been incidents of deaths at care homes where a member of staff has brought the virus into the facility..

The Prime Minister is adamant that by using PPE and restricting visits to a maximum of two a day and family only that residents would benefit immensely by the contact with loved ones.

Bit of a Mexican standoff at the moment.

My mam died and am sure it was staff she got it from. I was robbed of months of hugs we could have shared

 

[Alzheimer's Society]

Thanks everyone. This thread is now closed as it has run its course. Cheers.