How the care sector can take best advantage of business opportunities

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.

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Increase in deaths of people receiving care unrelated to COVID-19

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.

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COVID-19 and Scottish care homes

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.

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Domiciliary care and COVID-19

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.

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Further guidance issued by HM Coroner – COVID-19 deaths

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.

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Significant rise in figures for care home deaths as a result of COVID-19

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.

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Care providers: COVID-19 and PPE

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.

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Coronavirus Bill: health & care practitioners

The Coronavirus Bill announced yesterday will introduce a number of emergency measures to respond to the continuing spread of COVID-19 and the increasing pressures on the provisions of care and services.

The bill addresses a number of areas relevant to health and care practitioners, including the following:

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Guidance issued by public bodies for social care providers on Coronavirus

Guidance has been issued today to Social Care stakeholders regarding the Coronavirus/Covid19.

Many social care clients and residents will be elderly or medically vulnerable, thus deemed the most at risk from Coronavirus.

The CQC notes that it will seek to focus its activity on where there is the greatest risk to quality of care, as well as being flexible in terms of preparation and requirements for inspections.  In some cases inspections may be postponed at short notice.

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CQC report highlights failings in dental care across the care sector

The CQC has today released a review of oral health and dental care provided to those in care homes. The report concludes that this is poorly implemented in care homes.  The review is based on 100 visits to different care homes by dental inspectors and oral health specialists.

There are specific NICE (National Institute for Health and Care Excellence) guidelines to cover dental care for persons living in residential care but in the majority of cases these were not being followed.  Residents generally had their oral health assessed upon admission, but often care home staff were not aware of the NICE guidelines and had not had specific training on oral health.  More worryingly, over half of the care homes surveyed had no policy to promote oral health, and nearly three quarters of the care plans reviews did not cover oral health or only partly covered it.

The CQC comment in the foreword to the report highlights the fact that the elderly of today generally are more likely to retain their teeth than earlier generations.  Good oral care is essential for those in care homes to reduce pain and reduce the risk of malnutrition.  Oral care was also often not joined up meaning that when emergency dental treatment was required, the homes would call a GP, or 111, or send the person to A&E – thereby placing a strain on already overworked services.

The care sector should carefully consider this report with a view to future policies and management of residents’ oral health otherwise this may be an area that residents and families focus upon in terms of claiming for damages.

The CQC’s report can be found here:  https://www.cqc.org.uk/publications/major-report/smiling-matters-oral-health-care-care-homes


Written by Jennifer Johnston at BLM