Reading Council refuses government request to admit COVID-19 patients to its care homes

Reading Borough Council has refused to comply with the government’s request to identify care homes with high infection control procedures which can care for COVID-19 patients after they have been discharged from hospital.

The Department of Health and Social Care (DHSC) sent a letter to all local authorities in England telling local authorities they need to ‘identify designated accommodation’ and then notify the Care Quality Commission (CQC) of the details of these facilities.

The deadline for every local authority to have access to at least one CQC designated accommodation is by the end of October.

In a letter to DHSC director Tom Surrey, Reading Council expressed its “disappointment” at the request to local councils to find places for COVID-19 patients, pending the completion of social isolation or a negative test.

'It is not acceptable to ask care homes' to take 'potentially infectious' patients

The letter, signed by Seona Douglas, Reading Borough Council’s executive director for Social Care & Health, alongside other adult social care directors, states: "In Berkshire West we consider that it is not acceptable to ask care homes to take new admission patients who are tested positive for COVID-19 and are potentially infectious.

"This is based on our experiences earlier in the pandemic, which have left many care settings very worn down with the impact that this has had for the residents and their families, some suffering significantly. Many of our care homes would struggle to convert their premises to accommodate safely such patients without this affecting others, despite the measures many have put in place to manage the risks.”

The letter goes on to say: “The ‘Home First’ principle is embedded in our system as the most appropriate way to encourage independence and well-being for our residents, hence we wish to consider alternatives to those proposed in your letters in order to manage COVID-19 positive discharges.”

The council’s ‘Home First’ policy enables patients to return home with a tailored package of ‘wrap around’ support and reablement.

The DHSC letter to all local authorities in England states ‘Anyone with a COVID-19 positive test result being discharged into or back into a registered care home setting must be discharged into an appropriate designated setting and cared for there for the remainder of the required isolation period.’

Designated care homes will be 'standalone units' or have 'separate zoned accommodation'

The care homes being chosen by the CQC will have high infection control standards and will provide care for older people or people with learning disabilities or those with physical disabilities. They will be expected to be 'standalone units' or care homes with 'separate zoned accommodation and staffing'.

However Councillor Jason Brock, Reading Borough council leader, said: “We are very clear that designating care homes for COVID positive patients, pending the completion of social isolation or a negative COVID-19 test, is neither the safest option, nor provides the best outcome for patients themselves.

“Alongside our NHS colleagues, care homes in Reading and everywhere have been at the forefront of the struggle against COVID. And while many homes are struggling financially, asking them to now take in COVID patients, and everything that entails in terms of planning, logistics and resources, is a huge additional task at a time of enormous pressure. That is particularly the case where a safer and more effective solution exists in the form of an appropriate package of care being provided at home.”

Care homes already facing 'extremely difficult period'

Tony Jones, Reading’s lead councillor for adult social care, added: “Care homes and their staff across Reading have responded magnificently over recent months. They themselves know they face another extremely difficult period ahead, without them now being asked to take on another huge burden. This is a requirement which does not take into consideration the day to day running of a care setting, whether that be ensuring the right staff resources are in place, or indeed the funding. There is of course also the inevitable impact on residents already staying at their home, and their families.

“For many years the Council in Reading has successfully championed home care for people discharged from hospital as the best solution which provides the best possible outcomes for patients. We firmly believe that is the safest and most effective way forward in Reading, and we have said that to Government.

“We are also extremely surprised that while it is councils who are being asked to provide care homes places for COVID patients, the funding for this work is instead allocated to health partners."

Like 'throwing a lit match onto a haystack'

Amnesty International has denounced the plans, with its director Kate Allen, saying “The discharge of COVID-19 patients into care homes full of vulnerable residents is widely regarded as one of the biggest and most devastating mistakes of the Government’s handling of the pandemic. Yet the same deadly policy is being pursued despite the knowledge of how disastrous it was.

“It is like throwing a lit match into a haystack."

Care home providers and care leaders have also said they are “highly concerned” about the scheme and are calling for more clarity.

Professor Martin Green, chief executive of Care England, said: "In order to participate in the designated care settings scheme it is vital that providers have a much greater degree of detail, for example, information on leaving the facility, care functions on offer, refusal of visits, role of the regulator and of course funding considerations.

"How this scheme will be viable for providers and how it will impact upon their workforce needs to be scoped out in more detail in order for it to be successful.

"Given the incredible role that the adult social care workforce has played during this dreadful pandemic, we need to be mindful that they must not be overloaded."

Before anyone is discharged from hospital with a positive COVID result into one of the designated homes, the DHSC said councils needed to 'ensure that there is repeat testing, PPE, arrangements for staff isolation or non-movement, protection from viral overload, sickness pay and clinical treatment and oversight'.

A DHSC spokesperson said: “We are working with the CQC and the NHS to ensure that everyone discharged to a care home has an up-to-date COVID test result, with anyone who is COVID-positive being discharged to a care home that the CQC has assured is able to provide care and support for people who are COVID-19 positive."

The costs of the designated care homes are expected to be met through the £588 million discharge funding.