The Department of Health and Social Care (DHSC) has this week written to English local authorities outlining plans to set up specific homes or units for people being discharged from hospital who are COVID-19 positive or are awaiting a test result. The DHSC has asked local authorities to identify suitable settings by the end of this week, with a view to having these facilities fully operational by the end of November.
This plan was hinted at in the Adult Social Care Plan that was published in September 2020, and follows existing requirements for all persons being discharged from hospital to a care home to have a COVID-19 test before discharge, and isolate for 14 days in any case upon admission or re-admission to a care home.
If this plan goes ahead, then it will have an obvious benefit in freeing up hospital beds and the strain on healthcare. These facilities will be required to be registered with the Care Quality Commission who will ensure that safe care can be provided and that appropriate infection control measures are taken. The DHSC’s letter envisages one or two facilities per council area.
However there are a host of potential problems relating to the operation of these facilities. For example, given the wide variety of adult social care users and their needs, it is likely to be difficult to adequately provide properly for them in such settings. A social care user with dementia may find it disruptive to have been in hospital, then discharged into a COVID-19 home and then moved on to their usual care home, if indeed it remains open.
It is also unclear whether social care users (or their families) will have any say in whether they are discharged into one of these homes. And this plan also depends on the availability and willingness of staff to work in these facilities, as well as having suitable PPE/training and funding. The DHSC’s plan also does not outline how such facilities are meant to be insured, and presumably a dedicated COVID-19 home would attract high premiums in respect of both PL and EL cover, although particularly for PL.
The DHSC’s letter also envisages that residents can be discharged to one of these facilities whilst awaiting the results of a COVID-19 test. So potentially a resident could be discharged whilst not suffering from COVID-19, but then contract this whilst in the COVID-19 facility.
Meanwhile the DHSC has also outlined this week plans for a pilot visitor scheme for care homes in England. This will involve designating family carers as “key workers” meaning that they can visit their relatives in care homes on a regular basis. Under the plans, one family member would be designated as a key family carer and therefore would need to undergo regular testing for COVID-19 and wear PPE. This news will no doubt be welcomed by families and residents, as there have been many recent press reports regarding the decline suffered by elderly care home residents due to lack of contact with loved ones. However it’s unclear who is responsible for the provision of PPE and training rests. If it is with the care provider and the visitor contracts COVID-19, could the care provider be responsible if they supplied insufficient training or PPE to the visitor? Care providers should also be mindful of the risks arising from visitors potentially bringing COVID-19 into the home.