CQC publishes data on COVID-19 deaths & persons with a learning disability

In the past few months, one of the dominant news stories has been that of the effect of the COVID-19 pandemic on the social care sector.  This has mostly focused upon the issues surrounding elderly care.

However, the Care Quality Commission (CQC) has this week published an analysis regarding deaths of persons with a learning disability and/or autism.  The analysis is based upon notifications from providers registered with the CQC where the death certificate indicates the deceased had a learning disability.  This shows in the period 10 April to 15 May there was a 134% increase in deaths in comparison to the same period in 2019.

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Protecting the vulnerable in the midst of COVID-19

Our recent blogs have consistently focused on this developing saga as COVID-19 continues and as we as a nation compare ourselves to our counterparts, we are increasingly coming up short.  There is a stark message coming through that our most vulnerable have been forgotten: the elderly in care homes, the detained in mental health units and those with learning disabilities.

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The CQC and care homes – the COVID-19 crisis

Despite early Government promises to the contrary, it always seemed obvious that the pandemic would hit care homes (residents, relatives and staff) with some force.  A letter dated 22 May 2020 from the Relatives and Residents’ Association (RRA) to the CQC makes very clear the views of the RRA, who accuse the CQC of failing to protect care homes.

The RRA letter describes the following failings on the part of the CQC, and demands action :-

  • Inadequate provision of data on care home deaths to the Government. Failing to do so resulted in the Government having inaccurate data and under-estimating the seriousness of the situation.
  • Showing a lack of urgency, and instead complacency. For example, the CQC did nothing to rebut the early statement from Public Health England that it was “very unlikely” that care homes would be affected by the pandemic.
  • Failing to represent the needs of care homes for PPE, testing and tracing.
  • Providing guidance for care homes (the “Emergency Framework) only on 1 May, over six weeks after lockdown was announced, and even then, providing no guidance for care homes on how to deal with anxious families.
  • Allowing standards to fall due to the decision to suspend inspections of care homes from 16 March 2020. (The CQC have said they would still arrange an inspection wherever they are aware of “significant risks” such as allegations of abuse, but otherwise, any monitoring is being carried out remotely.  We understand that approximately 2000 checks of care homes have not been carried out in the last two months that otherwise would have been.)

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COVID-19 – telemedicine in care homes

As part of the guidance from the British Geriatrics Society in relation to managing patients with or suspected to have COVID -19 in a care home setting, care home staff should be trained to check the temperature of residents displaying possible signs of COVID-19 using a tympanic thermometer. The guidance states that care home staff, where possible, should also be trained to measure other vital signs including blood pressure, heart rate, pulse oximetry and respiratory rate. This information can then be used by external healthcare practitioners such as GPs during virtual ward rounds and will help to triage and prioritise support of the care home residents and their care staff according to patient need.

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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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Using technology to tackle the issue of COVID-19 within care homes

Release of online portal

Within some of our more recent blog posts, we have commented upon the crisis of COVID-19 deaths within care homes, together with the growing concern that the official figures for the number of these deaths could be a lot higher than that reported.

In response to this crisis, on the 28 April, the Government announced that testing would be prioritised and expanded in the care sector, to include both symptomatic and asymptomatic care home staff and residents. As a result, all care home staff and residents are now eligible for testing with priority for those in homes that look after the over-65s. To aid this additional testing, an online portal has now been released within care homes, enabling care homes to arrange deliveries of COVID-19 tests.

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Do we care?

The COVID-19 pandemic has shone a light on the resourcing of care homes that is long overdue.

Following exchanges in the commons and a study by LSE it appears that 22,000 care home residents have died in England and Wales to date as a result of COVID-19 but statistics will no doubt continue to be debated with the lack of testing being a stumbling block for absolute clarity.

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COVID-19 recovery for the social care sector

Following the Prime Minister’s address on Sunday 10 May, detailed guidance has been published today on the Government’s Covid-19 recovery strategy, which includes a fresh emphasis on the importance and needs of the social care sector.

Particular emphasis is given to the NHS and capacity and how to protect care homes.  In particular, given the widely reported problems with the supply of PPE, the guidance sets out a specific strategy for PPE, including increased domestic manufacturing capability and more robust supply lines.

The Government also commits to bolstering and investing in the social care sector, recognising that an efficient social care sector will free up pressure on the NHS, as patients can be discharged from NHS care more efficiently to care and nursing homes.

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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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PPE for healthcare workers remains a troubling issue

As reported in our last blog, the Chief Coroner for England and Wales has recently provided updated guidance on inquests, commenting that in the contents of COVID-19, inquests are not a suitable forum to examine high level and government policy relating to the provision of personal protective equipment (PPE).

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