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Care home COVID death toll far higher than CQC figures, report says  

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The number of COVID-19 deaths in care homes in England is likely to be far higher than figures published by the CQC, according to a report.  

The CQC published data last month on COVID-19 deaths in individual care homes. The regulator has recorded 39,017 death notifications involving COVID between 10 April 2020 and 31 March 2021.

Figures seen by The Telegraph based on correspondence between a care home manager and the CQC’s information access team show that around 4,000 care home residents may have died with COVID in the nine days before 10 April, however, when patients were being discharged from hospitals into care homes.

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The Telegraph said the extra deaths came after the CQC had “signed off” on government policy allowing the discharge of patients to care homes.

In response, the CQC said the guidance had been developed by the DHSC with input from NHS England and NHS Improvement, Public Health England and CQC.

The CQC added: “CQC’s objective in making amendments to the guidance was to ensure that care settings were involved in decisions about how to manage the care needs of their residents safely, while balancing this with the increased pressures on hospital capacity. In our view the original draft left providers with little power to challenge individual decisions if they felt their care setting was not adequately equipped to meet the needs of the person being admitted while keeping other residents safe.

“We felt it was imperative to be clear that providers should be involved in decision making for each placement and we ensured that the original guidance as drafted by DHSC was amended to achieve this before putting our name to it. We also highlighted a need to involve social care trade associations and linked bodies, to ensure they were sighted and their views reflected.”

The regulator highlighted that providers were able to refuse admission in the event that criteria allowing discharges was not in place, including information on COVID tests, the ability of the home to isolate people and having adequate PPE.

On recording COVID deaths prior to 10 April, the CQC said: “It is a legal requirement that care homes notify CQC of the death of a resident, including where a resident is transferred to hospital and sadly dies and the circumstances of that death.  During March 2020 CQC began receiving a significantly higher number of death notifications from providers, and from 23 March 2020, we shared this data on a daily basis with the Department of Health and Social Care.

“However, relatively few of these notifications referenced COVID-19 as cause of death, which did not match what we were hearing anecdotally from providers. As a result we redesigned our notification system to allow providers to indicate COVID-19 as the confirmed or suspected cause of death and to make it easier to record, collate and report on this data. We wrote to providers to make it clear that they should be notifying us of both confirmed and suspected COVID-19 deaths.”

The CQC said the “improved data collection” began on 10 April 2020 and was now published weekly by the ONS.

“When we began publishing this data, we also noted that there had been significant rise in deaths where suspected or confirmed COVID-19 was not indicated on the notification, and highlighted that further work would be needed to understand the rise in excess deaths,” the CQC added.

A Department of Health and Social Care spokesperson said: “Every death from coronavirus is a tragedy and our deepest sympathies are with everyone who has lost loved ones.

“Throughout the pandemic we have done all we can to protect vulnerable people in adult social care. We have provided billions of pounds to support the sector including on infection and prevention control measures, free PPE, priority vaccinations and additional testing. As a result, 93% of residents eligible staff in care home settings have had two vaccine doses.”

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The author Lee Peart

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