Highlighting lack of PPE and testing 'unintentionally created perception care homes are no go zones'

A boss of a care home group which owns care homes and extra care housing in Kent fears the care sector’s decision to openly highlight the lack of PPE and testing “may have unintentionally created a perception that care homes are no go zones”.

Care homes have been on the frontline during the pandemic with the elderly being the most at risk. Yet some have been struggling to procure PPE and testing to keep staff and residents safe and felt the care sector was forgotten about, with attention focussed on the NHS.

Care providers such as HC-One and MHA have been very open about the amount of deaths and infections in their homes and they as well as other providers such as Wellburn Care Homes have been vocal in calling for more testing of both staff and residents in care homes as well as more PPE and extra funding from the government.

Between 10 April and 5 June, the Care Quality Commission has revealed there were 11,614 death notifications involving COVID-19 in care homes in England.

The Care Inspectorate Wales recorded 486 deaths involving COVID-19 in care homes between 17 March and 5 June and the National Records of Scotland data shows 1,818 people have died in Scottish care homes up till 31 May.

This lobbying by care homes has succeeded in bringing the issue into the spotlight however it has been a double edged sword, as although it has pushed the government into providing crucial financial help and extra guidance, it has also led to care homes being seen as “no go zones”, according to Leon Steer, chief executive of Rapport Housing and Care,

MHA’s chief executive, Sam Monaghan, told BBC Newsnight at the beginning of June: “It is not difficult to imagine that a lot of people may not have ended up dying if we’d had earlier testing and we’d been therefore better able to manage infection control in our homes.

“We lobbied right from the outset that routine testing was going to be absolutely vital in terms of us managing and doing effective infection control in our homes.”

While Rachel Beckett, chairman of Wellburn Care Homes warned in April that care homes are at “breaking point” saying care home providers had found themselves at the “eye of a storm”, with the last month having been a “monumental challenge” and with the worst still to come.

Have we 'unintentionally thrown the baby out with the bathwater'?

Leon Steer asks: “Is there a danger, however, that in our attempt to ensure vulnerable people receive the support they need during this pandemic and in the future, we could have unintentionally ‘thrown the baby out with the bathwater’?

“Most of the people I have spoken to outside of our sector now see care homes as no go zones. Not surprisingly, therefore, we, along with most providers, have seen enquiries and admissions, along with income, drop dramatically.”

Mr Steer is concerned that the media attention on care homes has led people to assume “that care homes have experienced a considerable lack of Government support in multiple areas”. However he adds: “Despite the immense injustices care homes have experienced during this pandemic, approximately two-thirds have reported no cases of coronavirus and, because of the exceptional skill and resilience of care staff, some of the frailest members of society who contracted the virus have also recovered.

“I am mindful that because of the lack of testing, there is every likelihood that there have been more cases. However, would that have shown that the majority of care home residents and staff have had the virus or the minority?

“Certainly, from the early test results we are seeing for our residents and staff (who are now all being tested in our homes) I suspect it will be the minority, essentially, because of the valiant efforts of our staff who have willingly worn uncomfortable PPE and religiously followed infection control procedures.”

Has the care sector 'over emphasised inadequate support over herculean achievements of staff'?

He questions whether “their reward however is going to be an uphill struggle because we have unintentionally destroyed confidence in the sector? Without any doubt we should be raising awareness of the injustices the sector has suffered, but have we been proportionate with our views? Have we over emphasised the inadequate support we have received compared with the herculean achievements of our staff, who have been continuing to keep care homes essentially a safe place to live?

“Have our views represented the majority of care homes or the minority?” wonders Mr Steer, who points out that at one of his homes, neither residents or staff have contracted the virus.

He believes another misconception that is contributing to the drop in admissions is that families are not permitted to have any contact with a resident.

However he says: “At present visitors are unable to enter a care home. Contact is being maintained, however, through video technology as well as viewing family members through an external window and talking on a telephone. These arrangements are unquestionably not the same as personal contact. However, they explode the myth that you are not permitted to have any contact at all.”

Mr Steer highlights that even before the pandemic, the care home market was “very fragile”, adding data produced by Company Watch in 2019 shows that the percentage of care home companies with a one in four chance of going into insolvency or in need of major restructuring in the next three years had increased from 24 per cent in March 2014 to 30 per cent in September 2019.

Care homes suffered reputational problems after Winterbourne View

“One of the fundamental pillars that supports all companies is business confidence. This was severely damaged in the care sector following the horrific discoveries at Winterbourne View in June 2011 by the BBC Panorama programme. I believe all of us who are striving to provide outstanding care fully support the prosecutions and other enforcement actions that were taken subsequently. The extensive reporting of this, however, cast a massive shadow over the sector, severely damaging business confidence. While some other homes were subsequently discovered to be inadequate, the vast majority of homes were not. All of us, however, paid an enormous reputational and commercial penalty as a result of this.”

“Urgent efforts need to be made to ensure that people outside of the sector fully understand that care homes essentially continue to provide safe care. Whist it would be reckless in the extreme to suggest that there is no likelihood of a resident catching coronavirus, the reality is, approximately two-thirds of homes have not had any cases and family members can stay in contact with their loved ones following admission.

“Regrettably, however, by raising awareness of the current difficulties in an attempt to improve the sector, we may have unintentionally created a perception that care homes are no go zones. This has resulted in admissions plummeting to unsustainable levels and, as a consequence, the number of care home closures will increase at a time when demand will begin to outstrip supply.”

Mr Steer concludes: “Now is the time to reassure people that our care homes are a safe and caring environment for their loved ones. The sector looks after 410,000 residents compared to 141,000 beds in NHS hospitals. We deserve more plaudits for the enormous contribution we make to society.”