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.
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.
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.
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.