Joint statement by CQC & MHS published

In the face of recent criticism of its response to COVID-19, the CQC has issued a joint statement with the Deputy Chief Inspector for Mental Health Services (MHS) setting out their ongoing approach to the pandemic.

The full statement can be read here.

From 6 October, the CQC and MHS will commence a roll out of a new ‘transitional regulatory approach’ (TRA). The first areas to experience this will be adult social care and dental services.

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Lack of PPE may have contributed towards COVID-19 death of a home care client

There has been significant focus in the media in the last few months on the effect of COVID-19 on the care sector and in particular the lack of PPE available, especially at the outset of the COVID-19 pandemic.   

A recent report by the Healthcare Safety Investigation Branch (HSIB) has highlighted confusing governmental guidance on whether home care carers should wear PPE or not.  The HSIB investigates patient safety in NHS funded care.  The HSIB report notes that the primary guidance produced by Public Health England on 6 April 2020 did not mention the need to wear PPE when caring for an “extremely clinically vulnerable” client.  Further guidance produced after the report did mention the need to wear PPE but the primary domiciliary care guidance was not updated until 13 May 2020 to confirm that PPE should be worn when visiting extremely clinically vulnerable clients.   

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COVID-19 – Clinical negligence protocol

A new protocol for the handling of clinical negligence claims during the COVID-19 crisis was agreed on 14 August 2020 between NHS Resolution (NHSR), the Society of Clinical Injury Lawyers (SCIL) and Action Against Medical Accidents (AvMA).  The Protocol has been modelled on a best practice approach to litigation agreed between APIL and FOIL.

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How many deaths in care have there actually been?

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.”

“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.

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Has COVID-19 resulted in the unauthorised Deprivation of Liberty in care settings?

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”.

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Covid-19 – ‘Bubbling’ care homes

Care homes have undoubtedly been significantly affected by Covid-19 and the manner in which cases have both spread and been controlled has been criticised across national media outlets. The Office for National Statistics, reported on 3 July that for deaths registered up to 9 May 2020, 12,536 involved Covid-19. The number may of course be significantly higher as testing has not been undertaken in every death.

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathsinvolvingcovid19inthecaresectorenglandandwales/deathsoccurringupto1may2020andregisteredupto9may2020provisional#deaths-involving-covid-19-among-care-home-residents

A recent study by NHS Lothian and Edinburgh University , looking at care-home outbreaks in a large Scottish health board has been undertaken. The study considered 189 care homes in the Lothian area where more than 400 people died from Corona.

The study identified that 37% of care homes considered within the sample group had experienced an outbreak of Covid-19 and significantly the larger the care home, the larger the associated outbreaks. NHS Lothian and Edinburgh University found the likelihood of the infection spreading increased three fold with every increase of around 20 beds. Homes with less than 20 residents had a 5% chance of outbreak, compared with a figure between 83% and 100% for homes with 60 to 80 residents.

The concerns with how the virus was controlled in care homes is still relevant considering the potential for a second wave. Lessons can and should be learned to prevent such significant numbers of deaths occurring again and actions taken to lessen the impact of a second wave. The study found that many of the deaths were due to outbreaks in only a few locations. This essentially means there is a wide pool of care homes that Covid-19 has not broken into, and thus a wide pool of potentially vulnerable residents that will need further protection ahead of any second wave.

The possibility of creating ‘bubbles’ within care homes has been suggested. These ‘bubbles’ in a care home setting could be created from sectioning larger Homes into smaller units.  Residents would be assigned to a small sub-unit and particular staff would also be assigned to those units. This way interactions between residents, staff, and the general footfall through the home could be limited, reducing the potential spread. Staff could be assigned to certain areas, and more scheduling of bubbled staff could be introduced for the running of the care home, such as cooking, cleaning and maintenance.

This in theory sounds like a possible way to reduce the outbreaks within care homes, however this will of course take considerable planning, resources, and staffing which will in turn increase the funding required to support the care homes.  Consideration will need to be given to individual set ups of care homes, and the possibility to  create small units within them, especially for homes with residents who may be prone to wandering, such as those suffering with dementia.

Pressure will likely continue to mount on the government, requiring clearer advice, and forward planning for a potential second wave and to ensure steps are in place to prevent the impact of any second wave.


Written by Holly Paterson at BLM

holly.paterson@blmlaw.com

COVID-19 and Scottish care homes: an update

On Monday 13 July 2020 Scottish Government reported that no COVID-19 (C-19) deaths had been registered in Scotland on any of the five preceding days. However – on the same day – Scottish Government also reported that public health teams were investigating after seven new cases of coronavirus – picked up by routine testing – had been traced to a single care home in the greater Glasgow area. All seven people who tested positive were asymptomatic at the point of testing.

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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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