It is no secret that the spread of COVID-19 within the care sector has been the subject of significant media attention and cause for concern amongst those involved with care. But how hard can it be to answer the question: ‘How many deaths on care has there actually been?’ The answer is: it’s all in the detail. Continue reading “How many deaths in care have there actually been?”
“We are facing a secondary pandemic of neurological disease.”
Robert Stevens Associate Professor of Anaesthesiology and Critical Care Medicine at Johns Hopkins Medicine, US.
With medical science struggling to keep up with coronavirus and its consequences, it will be several years at least before more conclusive studies as to the long term impacts of the pandemic can be produced. The law lags even further behind.
Whilst COVID-19 has largely been considered to be a respiratory disease, more than 300 studies from around the world report a significant number of COVID-19 patients are displaying neurological abnormalities ranging from mild symptoms, such as headaches and loss of smell, to more severe variants commonly associated with mild to moderate brain injury.
The data obtained by the CQC and published in the third issue of their publication titled COVID-19 Insight reports a drop in the number of notifications received from providers in respect of Deprivation of Liberty (DoLS) applications from March – May 2020 suggesting on simple reading of the data that the answer to this question is “yes”.
There has been no shortage of commentary on the challenges facing care homes during the pandemic, from the number of infections and fatalities to the risk of further waves and lack of testing and PPE, along with the loss of income due to lower occupancy and reduced staff levels and reputational implications. There is speculation that some 25% of care homes may go out of business.
However, whilst these matters are real threats to businesses in the care sector, there are nevertheless some things that are well worth you considering as part of your plan for sustainable growth for a viable care business. The following are just some examples.
In the last few weeks, the COVID-19 related issues concerning care homes have become increasingly more apparent and a light has been shone on the pressures homes have faced. There has been suggestion that care providers have somewhat been missed by the Government, in respect of PPE, testing of staff and residents, or those returning from hospital. Sadly, since the beginning of April, the number of COVID-19 related deaths which took place in homes among residents overtook the number of care home resident deaths within hospitals. Many have suggested the main factor in respect of this has been the lack of testing of those with COVID-19 symptoms, when they have been returning to their care homes, having been receiving treatment externally.
On 6 May it was announced that five residents had died at a care home on the Scottish island of Skye at the centre of a COVID-19 (C-19) outbreak on the island. 57 residents and staff at this care home have tested positive for C-19. Ten deaths have also recently been reported at a care home in East Dunbartonshire.
Statistics from the National Records of Scotland show that by Sunday 3 May there had been 2,795 deaths in Scotland where C-19 is mentioned on a death certificate. More than four in ten of those deaths (42.8%) have been in care homes. The proportion of deaths in care homes has also been growing, accounting for almost 60% of C-19 deaths between 27 April and 3 May.
We have all seen the headlines reporting on the heavy toll that the COVID-19 pandemic is taking upon the care home sector, and figures published yesterday by the Office of National Statistics confirm that over one fifth of deaths in England and Wales in the period up to 24 April 2020 occurred in care homes
The latest ONS statistics do not include information on COVID-19 deaths from those who rely on domiciliary care, as they only confirm how many deaths occurred in hospitals, care homes, hospices and at home. So it’s difficult to know how domiciliary care is affected – but no doubt some of those deaths that took place in hospitals or at home will include domiciliary care service users.
The Chief Coroner for England and Wales issued further guidance on 28 April 2020 in the form of guidance sheet number 37 addressing COVID-19 deaths and possible exposure in the workplace. This will be of significance to those involved in inquests or investigations relating to COVID-19 deaths.
He confirms that the vast majority of deaths from COVID-19 arise from the natural progression of this naturally occurring disease and therefore will not be referred to the coroner. He reminds his coroners of the Ministry of Justice guidance on the Notification of Deaths Regulations 2019 which confirms that a death is to be typically considered unnatural if it has not resulted entirely from a naturally occurring disease process, importantly it goes on, where nothing else is implicated.
We have recently written several blogs regarding various COVID-19 related problems the care sector is facing. In particular the supply of PPE and the effect of COVID-19 generally on staffing levels and management of service users are critical issues.
The previous guidance from the Department of Health and Social Care failed to address adequately the issue of personal protective equipment (PPE) in care homes. With this said, on 15 April 2020 the Department of Health and Social Care published a new action plan for Adult Social Care, which aims to address the concerns, specifically in respect of PPE. This applies to both care homes and generally any setting where people receive adult social care.