The continuing search for answers on COVID-19 and care homes north and south of the border

North of the border

As at 29 November 2020, there had been 2,315 COVID-19 (C-19) related deaths in Scottish care homes. On 27 May 2020, the First Minister of Scotland committed Scottish Government to holding a public inquiry into the handling of all aspects of the C-19 pandemic, including those relating to care homes, however calls are growing for a more immediate inquiry into the care home aspects.

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Study suggests excess death toll in care homes from Covid-19 has been hugely underestimated

An early draft of a study from the University of Manchester suggests there may have 10,000 more deaths of care homes residents than previously reported.  The study compares statistical data on deaths in care homes between January 2017 and February 2020 with data from April to August 2020. 

This study has not yet been peer reviewed, but notes that of the excess deaths, 65% were only directly attributed to Covid-19.  That leaves the remaining 35% (10,000 deaths) that were not officially attributed to Covid-19.  The question is what caused those excess 10,000 deaths. 

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Scottish care homes – COVID-19 and human rights

On 26 September 2020, the Herald newspaper reported that “moving elderly from Scots hospitals to homes during coronavirus pandemic may have been illegal.” The article focuses on the discharge from hospitals to care homes of “hundreds” of adults lacking in full legal capacity (ability to make relevant decisions). Edinburgh Napier University’s Centre for Mental Health and Capacity Law has expressed concern that since the start of the COVID-19 (C-19) pandemic, movement from hospitals to care homes of adults without capacity may have taken place without due legal process and in violation of the European Convention on Human Rights (ECHR) and the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD). ECHR rights said to be engaged include the right to personal liberty and security and the right to respect for private and family life. The CRPD aspect concerns equal rights for people with disabilities. Particular issues arising include the extent to which steps were taken to ascertain whether particular adults were capable of expressing a wish and whether family members and any legal guardian were consulted before people were moved.    

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Government publishes Adult Social Care Winter 2020/21 Plan

The government has now published its Winter Plan for Adult Social Care.  This detailed document sets out a plan for social care for adults of all ages for the coming months.  The Plan applies to England only.  It notes that COVID-19 will be circulating at the same time as normal winter flu and viruses, so there is likely to be additional pressure on the health and social care sector.  The Plan specifies the role central government will play as well as setting out its expectations for local authorities, NHS organisations and social care providers. 

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Charity launches legal challenge to restrictions on care home visits

A dementia charity is seeking a judicial review of visiting restrictions set out in the government guidance in care homes.  Visiting restrictions were put in place earlier this year at the start of the COVID-19 pandemic following official guidance to try and limit the spread of the virus amongst vulnerable residents.  However John’s Campaign, which fights for people with dementia to be supported by their family carers, says that in person visits by family members are crucial for these residents. 

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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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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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