Special Investigation: As the coronavirus spreads across the UK, care homes have been left in crisis. Testing is at difficult to reach centres, deaths aren’t recorded in Government data and PPE causes financial strain.
THE CORONAVIRUS is spreading through care homes across the borough, warns the deputy leader of the Wokingham Liberal Democrats.
Last week, Clive Jones revealed to Wokingham.Today that an Earley care home has five cases of Covid-19, and one person there has died with the virus.
And Wokingham.Today understands that there have been other care home deaths within the borough.
Last week, the borough council confirmed there were multiple cases across care homes they work with.
Cllr Charles Margetts, executive member for health, wellbeing and adult services, said: “There were 16 confirmed Covid-19 cases in borough care homes, between 26 March and 6 April according to Public Health England.”
But these numbers do not include privately run homes — some of which are not testing residents for Covid-19.
And Public Health England does not reveal information about the number of Covid-19 deaths in care homes.
Cllr Jones added: “The national coronavirus figures don’t include care homes, and the Government is being very open about that. But one of the worrying things is that two weeks ago the Government insisted care homes take in people from hospital to free up beds.
“But people weren’t being tested and could have had coronavirus. And in a care home setting, they’re being placed with 10 or 20 vulnerable people, most of which could be over 80 years old.”
The National Care Association — who describe themselves as the voice of the independent care sector — confirmed that people entering care homes after being discharged from hospitals contributed to the rise in Covid-19 cases.
Speaking to Wokingham.Today, executive chairman, Nadra Ahmed said: “Covid-19 entered care homes, not really because of the lack of PPE, although it could be a contributing factor. “But it’s people coming into care homes who have Covid-19 — symptomatic or not — and transmitting the virus.
“People were being discharged from hospitals into care homes, and that has been a challenge.”
She also warned against estimating the number of deaths in social care settings.
“It’s dangerous to estimate the number of Covid-19 deaths in care homes,” she said. “Because testing hasn’t been happening and so they are just numbers.
“The Health Minister has now said they think 25% of all care homes across the UK have cases of Covid-19. So that also means 75% of them don’t.”
“In terms of the number of deaths, the figure is probably high. But care organisations are estimating anywhere between 4,000 and 7,500. We don’t have the exact figures.”
Latest data from the Office of National Statistics shows that up until Friday, April 10, 20% of Covid-19 deaths across the UK have occurred in the community, including in care homes.
In the South East, there have been 170 deaths in care homes, 24 of which were in Berkshire. But the figures are two weeks behind.
And the Local Government Association has called for quicker testing to provide transparency on the death statistics.
Cllr Ian Hudspeth, chairman of the LGA Community Wellbeing Board, said: “Council social care staff and care homes need… increased rapid and comprehensive testing.
“Data on all deaths from Covid-19 needs to be published promptly and accurately, so we can have full confidence and transparency in these figures as part of our plan to defeat this deadly virus.”
Covid-19 in The Berkshire Care Home
Wokingham resident, James Piggott contacted Wokingham.Today after his relative living in The Berkshire Care Home, was diagnosed with Covid-19.
“On Friday morning, they were sent to Royal Berkshire Hospital with a high fever and slight cough,” he said. “And on Saturday it was confirmed that they had contracted the coronavirus.”
Mr Piggott said he was concerned that staff at the Barkham Road care home were not wearing PPE for a number of weeks, and have only recently been wearing face masks.
This — he said — has led to an outbreak of the virus with multiple residents in hospital.
But Brighterkind, which manages The Berkshire Care Home, disputes there was ever a lack of PPE.
“I am unsure if any residents have died,” added Mr Piggott. “However the home manager was not transparent when I asked her if they had any cases — only to be very aware of one first hand.
“My friend rang the care home, and a staff member confirmed multiple cases over the phone,” he added.
A spokesperson from Brighterkind confirmed that, in common with other care homes, it had sadly seen some residents across its 21 sites die with symptoms of the coronavirus — but Wokingham.Today understands that none of the homes are testing residents for Covid-19.
They said: “With deep sadness, we can confirm that a number of residents who were displaying symptoms associated with coronavirus have passed away in our homes across the country.
“Our thoughts are with the families and friends of these residents and we are providing them with ongoing support at this difficult time.
“We are providing daily updates to care authorities on all confirmed and suspected cases of coronavirus among our residents and colleagues.”
On Monday, April 20 the Care Quality Commission (CQC) announced they have been contacting adult social care providers to book appointments for their staff to be tested for Covid-19.
But information about testing in homes has not yet been provided.
A spokesperson from the Four Seasons Healthcare group — who oversee multiple homes in Wokingham including The Berkshire Care Home — said: “We welcome the Government’s commitment to increasing testing capacity.
“Testing will enable a proportional response, as without a clear picture of who is infected and who is not, we are erring on the side of caution and practicing barrier nursing and isolation to protect our residents.
“Knowing who has had the virus will allow us to provide residents with a higher quality of life and make better decisions about individualised care.
“Giving our colleagues access to tests is just as important as testing our residents. It means that we can reduce absences caused by precautionary isolation and therefore reduce pressure on our teams. This is also a very anxious time for our colleagues, testing would ease this and make them feel more confident about the health of themselves and their families, as well as their ability to safely care for their residents.”
Sourcing PPE equipment
To begin with, PPE was prioritised for NHS staff working on Covid-19 wards in hospitals across the UK.
Now, it has become clear that sourcing PPE for healthcare sectors has put care homes in crisis.
However, Brighterkind said that their homes always have PPE supplies due to their infectious disease protocols. And that this stock was in place before the coronavirus pandemic.
Ms Ahmed explained the types of equipment care sectors were using before the virus.
“PPE was already in care homes,” she said. “As part of infectious disease control measures, homes already had aprons and gloves. But masks only really came into our vocabulary regarding PPE when the pandemic started.
“And as care providers began ordering masks, they were told they were being requisitioned for the NHS. And later there became issues sourcing gloves and aprons too.
“We are sourcing PPE, but the issue is how we source it.”
A spokesperson for Brighterkind added: “All of our homes have received deliveries of PPE with more on order and we are working closely with our suppliers to access further supplies to be distributed where needed, updating our teams daily on these efforts.
“Our strict protocols on infectious diseases are in place in all of our care homes, including social distancing and barrier nursing, and we are closely monitoring the health of the other residents and colleagues.
“We take our responsibility to provide a safe working environment for all our colleagues very seriously and we will continue to put all our resources and energy into supporting and protecting everyone in our homes.
“We would like to thank our colleagues, who are working tirelessly to support our residents under difficult circumstances and we will continue to put all our resources and energy into supporting and protecting everyone in our homes.”
Unclear guidance with PPE usage
But not all care homes are receiving clear guidance on PPE.
UNISON, the UK’s largest union, who represent 1.3 million workers has warned of national confusion over PPE use.
UNISON South East regional secretary, Steve Torrance said: “The ongoing lack of protective kit has left many terrified they’ll spread this deadly virus or become infected themselves.
“There’s still widespread confusion among workers and their employers over what equipment they should have.
“Some staff are being told off for wearing masks, while others can’t even get hold of hand sanitiser, according to reports still coming into UNISON’s PPE alert hotline.
“The government has got to get its act together if we are to prevent more lives being needlessly lost.”
Covid-19 testing to begin in care homes
On Wednesday, April 15 Matt Hancock stated that testing social care workers for Covid-19 had already begun, but would be rolled out nationwide.
He said: “As we continue to ramp up our testing programme, we will test all current care home residents with coronavirus symptoms and all new care home residents who are discharged from hospital into care.”
However, Mr Hancock failed to address concerns about sourcing PPE for care homes. Instead, he launched a “badge of honour for social care staff to proudly identify themselves publicly.”
The pin-badge labelled ‘CARE’ has provoked a mixed response. And employers of care workers were advised to buy badges for their staff, so they can have the same privileges as NHS workers during this time.
The badge is currently unavailable to buy but would cost £120 for the minimum order of 100 units.
The National Care Association criticised Matt Hancock for overlooking the social care sector.
Ms Ahmed said: “The NHS was prioritised over social care and maybe rightly so. But I think the Secretary of State for Health and Social Care forgot the second bit of his title.
“It was only when I started making appearances on prime-time TV and on Good Morning Britain that we entered the conversation. We had to drag ourselves into the game.”
Sourcing PPE creates cash-flow issues for councils
Last week, leader of the borough council, John Halsall confirmed that there have been a number of Covid-19 cases in care homes, but that all care homes and care providers are being fully supported by the borough council.
He added: “PPE supplies are currently adequate, and all social carers have equipment required.
Responding to Matt Hancock’s statement, Cllr Halsall said: “We need the Government to build on the announcement that social care staff and care home residents will be tested, by ensuring adequate, consistent and guaranteed supplies of PPE are made available to help those working on the frontline can be kept safe and well.
“We continue to raise with Government the issue of support to address cash flow issues and additional costs councils are facing.
“We continue to plan for the number of cases to rise within the Borough and we are expecting this to continue.”
Cllr Hudspeth, from the LGA has echoed Cllr Halsall in his call for better financial support for borough councils.
He said: “The current arrangements for accessing PPE by councils and care providers are not fit for purpose and are failing to provide what is needed on the frontline.
“It is vital that the arrangements set out in the plan are urgently translated to reality on the ground.
“There are many calls on the £1.6 billion provided by the Government to help councils with additional costs of supporting vulnerable people and delivering other services during the Covid-19 crisis.
“Councils will need access to additional resources to ensure they can continue to support care providers to deliver care and support to older and disabled people in the coming weeks.”
But Ms Ahmed of the National Care Association said local authorities should be doing more.
“We are now looking down the barrel of the gun at care provider failures where the provider was not supported by the local authority, so they are taking the financial strain,” she explained.
“Local authorities have already been given £1.6 billion, twice. And they have access to £800 million of grants too. How much more do they want?
“I understand the need to fund homelessness and domestic abuse support but it also needs to go to social care.
“Local authorities cannot ignore their duty of care to older people. They need to get their act together.”