Coronavirus: Neglect of Social Care

[Palerider]

Hopes raised for end to Covid-19 crisis in UK care homes as death rates fall

Article by Robert Booth in The Guardian yesterday, reveals that testing is still an issue in care homes with tests that have been carried out not reaching the labs to be processed in some instances.

I find it disdainful that there has been no real address from government on the management of care homes or any real plan so far, and that the only information available has been from the media. However there is a sign, perhaps a silent acknowledgement that care homes were never equipped to deal with a epidemic of this magnitude as Booth writes:

"...by the end of this week the NHS would also supply a named contact to help train care home staff – including in infection control – and that each home would be allocated a named clinician, a reflection of concern that care staff, who are not medically trained, have struggled to cope with the new virus... "​

 

[Louise7]

I find it disdainful that there has been no real address from government on the management of care homes or any real plan so far, and that the only information available has been from the media.

@Palerider The 'plan' is outlined in the document published yesterday, Section 5.2 - Protecting care homes:

https://www.gov.uk/government/publi...overy-strategy#fourteen-supporting-programmes

 

[Palerider]

@Palerider The 'plan' is outlined in the document published yesterday, Section 5.2 - Protecting care homes:

https://www.gov.uk/government/publi...overy-strategy#fourteen-supporting-programmes

Thanks @Louise7, was working yesterday so wasn't aware of its release

 

[northumbrian_k]

The Health and Social Care Secretary said on radio 4 this morning that deaths in care homes are falling quite sharply, transmission rates are coming down and 'only' about a quarter of all deaths so far have occurred in care homes, much lower than most international comparators. This sounds like good news.

 

[Louise7]

'only' about a quarter of all deaths so far have occurred in care homes, much lower than most international comparators.

Whilst it's good news that things are improving the problem with statistics is that they are open to interpretation. The international comparators tended to have much better testing programmes whereas the testing of care home residents here has only recently started, and maybe the fact that deaths are now falling quite sharply and transmission rates are coming down is because homes are now finally getting better supplies of PPE?

 

[DianeW]

My husband is a carer in a care home, it’s a small 15 bedded very homely place and thankfully they have been Covid free, but they are still accepting new residents (3 so far), and I feel worried for all at the home both staff and residents.

 

[Louise7]

My Mum's home have advised that they are now taking in new residents but have stated that no one will be admitted unless they have tested negative, and they will also be kept isolated for the first 14 days. It might be worth having a chat with the manager to discuss your concerns?

 

[Pete1]

However there is a sign, perhaps a silent acknowledgement that care homes were never equipped to deal with a epidemic of this magnitude

Hi @Palerider, sadly this was highlighted to the Government 2016 pandemic exercise Cygnus. The Government refused to release the report and played it down as not being relevant as it was a 'flu pandemic' which was not as virulent as Covid 19 pandemic - however, most of the issues identified have come to pass (not just around Social Care). The Guardian managed to obtain a copy of the report. This article presents the situation:

https://www.theguardian.com/world/2020/may/07/what-was-exercise-cygnus-and-what-did-it-find

 

[Palerider]

Hi @Palerider, sadly this was highlighted to the Government 2016 pandemic exercise Cygnus. The Government refused to release the report and played it down as not being relevant as it was a 'flu pandemic' which was not as virulent as Covid 19 pandemic - however, most of the issues identified have come to pass (not just around Social Care). The Guardian managed to obtain a copy of the report. This article presents the situation:

https://www.theguardian.com/world/2020/may/07/what-was-exercise-cygnus-and-what-did-it-find

Thanks @Pete1, I knew the report existed but didn't know The Guardian had a copy. I was a part of the 2009 swine flu outbreak in London and that did exhaust critical care beds in some parts of the South East. This report at least shows there was an attempt to address that.

I think it also shows just how complex the situation is with social care predominantly privatised and having a different agenda to public care agencies as well as maximising capacity in a pandemic scenario. A key word that strikes with me is 'capability' -this isn't just reflective of how the systems in place operate but is also about the people that manage them. The point of conducting an exercise like Cygnus is to test resilience and essentially the bottom line of public safety. A Public Inquiry is already being called for, I wonder if that will be delayed as well ?

 

[Palerider]

I do have better things to be doing today than reading and posting, but I feel so strongly I can't help myself!

So here is another thought provoking article by Tolly Poynbee in The Guardian yesterday:

Once again, care work has been exposed as the NHS's poor relation | Polly Toynbee

The ‘whatever it takes’ pandemic cash won’t last forever. A lasting solution must be found, says Guardian columnist Polly Toynbee

www.theguardian.com

I particuarly raised an eyebrow at this ? :

Care homes and community care workers were left defenceless. As one NHS leader told me: “If they’re lucky, homes will have one nurse who had a course in infection control 30 years ago.” ​

 

[jennifer1967]

it wasnt long ago when hospitals had problems looking after dementia patients who had other illness. they were experimenting with colours which are better for dementia sufferers. where i worked, 2yrs ago we were only sending those that had to go to hospital because they were kept in bed and not being walked so they lost the ability to walk or wash themselves because they werent encouraged. then the pandemic happened. i haver left to look after my husband, but it has always been a cinderella service looked down upon and ambulances when called actually take longer to get there unless really urgent because the residents are safe within a care setting. in my area they have closed most of the council run homes so nearly all are private

 

[Palerider]

Yesterday I visited mums CH and while I was chatting to mums nurse I asked how they all were -the staff. The care home is now Covid-19 free and all staff and residents have been tested. They had at one point 35 staff off sick due to Covid-19 symptoms, but the biggest issue has been that of PPE. They had to rely on donations of PPE from families of residents and outside organisations. That situation has now changed thankfully, but how could care homes be at the end of the qeue and why did it take so long? Interestingly there is a call for a Public Inquiry by The Doctors Association UK and the Good Law Project published in the BMJ yesterday on issues surrounding PPE -its worth a read as a serious challenge if they succeed.

Covid-19: Doctors make bid for public inquiry into lack of PPE for frontline workers

The Doctors Association UK and the Good Law Project have launched legal action to try to force the UK government to set up a public inquiry into the failure to procure and distribute enough personal protective equipment (PPE) for frontline health and social care workers in the covid-19 pandemic...

www.bmj.com

I personally hope that we don't get into a situation of political football as there are too many serious issues to become side tracked with just one. Lets hope lessons are learned and we can all move on to a better system of care.

 

[Splashing About]

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.

 

[canary]

Mum died this week in her home.

I am so sorry
(((((((((((((((((((((((((((((((((((((((hugs)))))))))))))))))))))))))))

 

[Grannie G]

Please accept my condolences @Splashing About

My husband was in a care home like the one you described, an old house modified to some extent but still resembling a home. There was a sitting room and a dining room , the television by the fireplace, carpets and curtains. It was shabby but clean and the bedroom was for sleeping unless individual residents were really poorly.

It would have been impossible to maintain any form of social distancing there. My husband always had his face in his hands when he slept in the chair regardless of what he may have touched.

It`s the biggest worry ever for those who have family in care homes.

 

[Cat27]

I’m so sorry @Splashing About. My thoughts are with you.

 

[canary]

My husband was in a care home like the one you described, an old house modified to some extent but still resembling a home. There was a sitting room and a dining room , the television by the fireplace, carpets and curtains. It was shabby but clean and the bedroom was for sleeping unless individual residents were really poorly.

Yes, mums care home was the same. That feel of it being a real home was one of the things that I really liked about it and Im sure made mum feel settled and happy. No good for social distancing, though.

 

[Sarasa]

Sorry to hear your news @Splashing About.
I hope there is a proper enquiry on what went wrong in care homes. Without getting too political I do think they were way down the list of things to worry about when this pandemic struck.

 

[Bikerbeth]

Thoughts with you @Splashing About at this time

 

[Agzy]

One thing is for certain @Pete1 @Louise7 -this now can't be ignored. On a more positive note, an optimistic article in the Health Service Journal (HSJ):

Will covid-19 close the integrated care gap or widen it?

It is time to rapidly shift our focus onto the primary, community and social care frontline to make our vision for integrated care a reality, writes Conor Burke

www.hsj.co.uk

Interesting article and must surely lead to a debate as to the role of so many independent care homes outside of the NHS structures and resposibilies.