Care homes offered higher fees to take COVID-19 patients

Care homes in Cumbria are being offered £1,500 – that's double the local weekly fee - to take COVID-positive hospital patients, prompting a care operator to speak out against the move.

Care homes in the region have been sent a letter from Cumbria County Council and the clinical commissioning group asking them to take COVID-positive patients.

The county council offered the care homes higher payments to cover extra care costs. The offer was only open to homes that have been coronavirus-free for 28 days

'Slap in the face'

Care home operator Tony Carling based in Cumbria, has decided to refuse the council’s offer and will not take any COVID-positive patients.

“It really felt like quite a slap in the face after all the hard work we have done to keep our homes COVID-free up to this point", he told Radio 5.

“We rely very heavily on local authorities for our client base. The majority of our clients are placed and funded by the local authorities so it’s very difficult to turn down … you are under extreme financial pressure as to whether you will get any further business from that local authority if you don’t support their needs.”

He described his staff as “frightened” at the prospect that COVID-19 positive patients might be taken in by his home.

“I have empty beds in my care home but I am very lucky that I have owners who would rather keep those beds empty than take additional finance and take COVID positive residents into our home.”

Reports of other councils around the country looking to discharge COVID-positive hospital patients into care homes include a move by Middlesbrough Council. The council asked care homes to state by noon on 18 September whether or not they were ready to accept residents infected with COVID-19.

An email sent to care homes by Middlesbrough Council stated: ‘It is likely in the coming days and weeks that we will see residents leaving hospital that are COVID-19 positive. If any homes are not able to accept residents with a positive result and isolate appropriately, will you please let [us] know…by 12 noon 18/09/2020.’

A contract sent by Trafford Council in Greater Manchester outlines the discharge of patients from hospital to care homes and states that ‘some of these patients may have COVID-19, whether symptomatic or asymptomatic.’

A letter, leaked to Channel 4 News by Trafford Council, shows the contract care homes were asked to sign, agreeing to ‘rapid discharge’ procedures. The document states eligible care homes will receive COVID-positive patients within two hours of them being identified by the hospital as ready for discharge.

Trafford Council said in a statement the discharge of patients from hospital is a ‘carefully co-ordinated process in line with national government guidance’ and care homes can refuse to accept a patient ‘and no patient is transferred to a care home without discussion and agreement of the care home’.

Last April, hospitals were told to stop sending untested patients to care homes following COVID-19 outbreaks in care homes.

UK government guidance updated on September 16 reiterates that care homes in England should be prepared to accept coronavirus patients from hospitals. The guidance states that no care home should be forced to admit a resident if it is unable to cope with COVID-19.

Care homes 'well aware' of the consequences

In response to Cumbria County Council's offer involving COVID-positive patient discharges, Nadra Ahmed, chairwoman of the National Care Association told carehome.co.uk: "We have heard of a few areas where this is being considered but have not had sight of any letters etc.

"I think providers are well aware of the consequences of a poorly planned admission which has to be based on a full risk assessment from both the potential residents perspective and that of the residents and staff".

She urged care homes to "mitigate any risk in view of the insurance cover and the ability to isolate for the stated period and having available staff, PPE and testing ability in the best interest of those they care for".

Highlighting a lack of testing in care homes, she added: "It has been extremely disappointing as it is a major barrier for providers who are working exceptionally hard and diligently to keep their residents and staff safe from the virus. Testing and timely results are a key to social care provision in the battle for us against this virus".

'Plethora of issues'

Care Quality Commission figures show there were 14,264 deaths in care homes involving COVID-19 in England between 10 April and 18 September.

Commenting on challenges facing care homes including a rise in COVID-19 cases in September and decreasing occupancy levels, Martin Green, chief executive of Care England, which represents care home providers, submitted evidence to the HM Treasury’s latest Comprehensive Spending Review.

In a statement Care England said ‘With COVID-19 cases rising again, the submission makes the case for renewed support for the sector, to ensure that it is safeguarded from the COVID-19 pandemic'.

Issues highlighted include:

• COVID-19 related costs e.g. declining occupancy levels

• Long term funding gaps e.g. inadequate local authority fee rates

• Health related issues e.g. testing issues

• Workforce issues e.g. staff wellbeing and resilience

• Data infrastructure and funding in the adult social care sector.

Martin Green said: “During these unprecedented times, it is of paramount importance to keep on alerting the Government of the plethora of issues affecting the adult social care sector”.