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.    

Continue reading “Scottish care homes – COVID-19 and human rights”

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. 

Continue reading “Government publishes Adult Social Care Winter 2020/21 Plan”

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. 

Continue reading “Charity launches legal challenge to restrictions on care home visits”

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.   

Continue reading “Lack of PPE may have contributed towards COVID-19 death of a home care client”

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.

Continue reading ““We are facing a secondary pandemic of neurological disease.””

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

Expansion of COVID-19 testing in care settings

At the government’s daily COVID-19 briefing yesterday, the Health Secretary Matt Hancock announced a further expansion of its testing programme for COVID-19 in care settings.   Previously the focus had been on care homes providing care for over 65s and for those with dementia.  Testing will now be available for all residents and staff in England whether or not they have symptoms of COVID-19.  Testing will also be extended to under 65s and to encompass for example adults with a learning disability or with mental health problems.

Continue reading “Expansion of COVID-19 testing in care settings”