Leah Cooke, QCS, Content Operations, discusses how care homes should be prepare for the CQC’s release of data on the number of COVID-19 deaths in care homes in England on Wednesday.
Later this week, the Care Quality Commission (CQC) will publish data relating to the number of COVID-19 deaths in care homes in England. The statistics, which will be released on Wednesday, will cover COVID-deaths between 10, April 2020 and 31, March 2021. The announcement, which was made in June, comes at a time when COVID-19 infections are on the rise.
Daily UK infections have surged to around 50,000 a day currently and experts say that now the lockdown has been lifted, cases could rise further.
So, why in the middle of a pandemic, has the CQC decided to release such highly-sensitive data?
Firstly, the CQC has been under great pressure from the media and various campaign groups to release the data. The BBC made an FOI Request to the Care Quality Commission, which was rejected, while COVID-19 Bereaved Families for Justice, a 4,000-strong campaign group, has been pushing for the figures to be made public for some time now.
The release of data
Secondly, the CQC promised to put the information in the public domain as soon as it was able “to do so accurately and safely”. It’s important to point out that when the CQC announced that it would be releasing figures last month, COVID infections were much lower.
The stark reality, however, that we have all come to realise is that the R-Number – which is a barometer of infection – can rise very quickly. This is exactly what has happened and with the sudden surge in new cases, some are questioning whether the CQC should delay publishing the figures until infections have stabilised.
It’s important to stress that those who subscribe to this view do so – not because they want to stall or prevent the statistics from being published – but because the UK may be on the verge of a COVID-19 third wave. That said, I have great sympathy for those who have lost loved ones to COVID in care homes. They need answers. They need closure. And as the CQC rightly say, “every single number represents an individual life lost to COVID-19”and it has “a responsibility to represent these figures – and these lives as accurately as possible”.
But, returning to my first point, we must bear in mind that even with a high percentage of adults vaccinated, taming the Delta variant, which may be 50% more infectious than its Alpha counterpart, will be a monumental challenge. Health and care services will find themselves under great pressure this winter and the care sector is likely to see more deaths too.
Mental health and emotional wellbeing
In this highly pressured environment, some in the social sector may feel that releasing notifications of COVID-19 deaths could heap even more pressure on the shoulders of front-line workers. Take registered managers, for instance. They will need to firstly check that the figures correspond to the statistics that they have sent the CQC. If they do not, they will need to contact the CQC before they circulate the figures to the wider public later this week.
Secondly, when the figures are in the public domain, some care homes, where COVID-19 deaths are high, will inevitably receive information requests from loved ones, who may have lost a relative to COVID-19 at the care home. They may also face increased scrutiny from the media.
In the crucible of a pandemic, this extra burden could have an adverse effect on mental health and emotional well-being. Take frontline workers, for example, who despite demonstrating superhuman levels of compassion and care for those they were looking after, could only watch as COVID-19 claimed the lives of service users – and in some cases – fellow staff.
Many, despite adhering to all the guidance, have been profoundly affected by what they have experienced. They have seen things no one should see and many have worked with counsellors and colleagues to try to make sense of their experiences. Some might question whether it is right or fair to ask them to revisit the mental wounds that they have been left with, so soon in the healing process.
More questions than answers
Thirdly, while the CQC statistics, will certainly invite more questions, care homes may not be able to provide the answers that bereaved families so desperately seek. Many people will want to know how COVID-19 found its way into the care home in the first place. The problem is that the COVID-19 virus is as invisible as it is insidious. For providers, who have put in place extremely rigorous and robust IPC measures throughout the pandemic, it may not be immediately obvious as to how the infection came into the home.
Take the example of Scotland, where figures were released in late May by the Care Inspectorate. The statistical bulletin and the trends that have been revealed have raised more questions than answers.
Why were older people living in care homes most affected, for instance? Why did care homes situated in the most populated areas have a higher rate of COVID related deaths than homes in rural locales? And why was there “no clear relationship” between care quality and the COVID-related deaths?[i] While these findings provide food for thought for governments, for scientists and for journalists, they are unlikely to give families and staff who have lost colleagues any comfort or closure.
So, ahead of statistics being published, how should care homes in England mentally prepare their staff – and at the same time, how can they best help families searching for the answers they require to find inner peace?
In terms of promoting wellbeing, outstanding Registered Managers are highly visible and approachable. They realise the importance of maintaining an open line of communication with all their staff and they have a knack of honing in on the minor nuances in behaviour that might alert them to the fact that they are stressed and anxious. QCS, the leading provider of content, polices and standards for the social care sector, and the company that I work for, has published several policies on staff wellbeing and stress management as well as a number of best practice blogs – all written by experts in their field.
In regard to bereaved families, some may contact care homes by email, some by phone and other may want a face-to-face meeting. Whichever form of communication they choose, it’s important that care services are well prepared.
Registered Managers should be open and transparent with families. If requested to, they should be able to discuss tailored IPC policies and procedures and the results of bespoke audits, all of which can be crafted using the QCS platform.
What shone through in Scotland though was that the majority of families weren’t looking to apportion blame. Instead, they wanted to know their loved one was happy living in the care home, or in the case of a care worker, enjoyed working there.
On this note, my colleague Senga Currie, who is QCS’s Head of Development for Scotland, told me a heart-warming story, which showed a care home and its staff at its best. Sadly, during the pandemic she told me that a care home she knew had lost one its staff members to COVID-19.
The Registered Manager decided to hold a memorial service at the home and invited the deceased care worker’s family members. Not only did they witness the high esteem in which their loved one was held, they saw how invaluable they were to the service and that alone gave the family the closure they needed.
Handling the media
Finally, what about the ‘Good’ and ‘Outstanding’ care homes which, through no fault of their own, sustained a high number of COVID-related deaths during the pandemic? Unfortunately, as a result, some of these services may attract increased media attention.
This may mean that some Registered Managers may find themselves handling media enquiries relating to the CQC data. Frontline-staff too, who might not have any media training, may also be required to field calls from the press. To help both managers and staff handle the media, QCS has produced a helpful guide about how they can deal with a media enquiry call, which subscribers can access via the QCS platform.
But let me end this piece not by focusing on the effect that negative newspaper column inches generated by the statistics might have on the sector. Instead, we should think about each and every one of those who passed away during the pandemic, and also the heroic efforts of carers who died while caring for them. When the CQC releases the figures, it is remembering the lives lived behind the statistics that really matter.
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[i] Care Inspectorate, Covid-19 related deaths in care homes, 2020/21, Care homes for adults and older people in Scotland, a statistical bulletin publication date: 26, May, 2021