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Rapid discharge to care homes during COVID-19 had ‘tragic consequences’

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The rapid discharge of patients from hospitals to care homes during the height of the coronavirus crisis, had tragic consequences, ADASS has said.

In its Coronavirus Survey, ADASS said an absence of testing for people leaving hospital during the period of Rapid Discharge could have accelerated the spread of coronavirus in care settings.

More than half of directors (54%) said people were not tested on discharge when 25,000 people were admitted to care homes from hospitals between 17 March and 15 April.

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Around a quarter (23%) thought that more than half of care home COVID-19 infections were due to rapid hospital discharge with a quarter (27%) of respondents reporting that people were discharged to providers with insufficient PPE and only a quarter (24%) saying people were moved to settings where they could isolate safely.

ADASS President, James Bullion, said: “We are not saying there was a wilful intention to take infection to care homes. We are saying that because of the policy it was a significant cause and had tragic consequences.”

The lack of PPE planning was also laid bare in a report by the NAO which revealed that the only central stockpile at the beginning of the outbreak was designed for a flu pandemic.

The NAO said gowns and visors had not be included in the stockpile despite this being advised by an independent committee in 2019.

Additionally, the NAO said the central procurement route set up to supply PPE during the outbreak met only a “small proportion” of social care provider needs.

In further findings, ADASS said a quarter of directors had concerns about the financial stability of most of their residential and nursing providers since the COVID-19 outbreak with 7% concerned about all of their providers.

When asked by CHP what was being done to avoid a care home bed capacity crisis as a result of closures, James said there was a local level intervention system in place with around a third of councils holding conversations with providers. James said ADASS was also calling on the government to acknowledge that there may be “an industry level intervention” required to look at industry restructuring in the event of declining occupancy.

Commenting on the NAO report, Professor Martin Green, CEO, Care England, said: “This report makes it crystal clear for all to see just how under resourced care homes were before the pandemic hit.  We should be congratulating adult social care staff for going above and beyond their duties in order to provide care for their residents especially against a backdrop of insufficient funding, lack of PPE and an inadequate testing regime.”

Meg Hillier MP, Chair of the Committee of Public Accounts, added: “Shockingly, the government squandered the last opportunity to add to the central PPE stockpile, even after the NHS had gone to the highest level of alert.

“Care homes were at the back of the queue for both PPE and testing so only got a small fraction of what they needed from central government. Residents and staff were an afterthought yet again: out of sight and out of mind, with devastating consequences.”

A Department of Health and Social Care spokesperson said: “This is an unprecedented global pandemic and we have taken the right decisions at the right time based on the latest scientific and medical advice.

“Our plan throughout has been to save lives, protect our NHS and flatten the curve. We have been working tirelessly with the care sector throughout to reduce transmission and save lives and a result 60% of care homes have had no outbreak at all, according to the latest PHE statistics.

“Since the launch of whole care home testing, the government has provided over 1 million test kits to almost 9,000 care homes and on Monday we announced that every care home in England will now be offered a coronavirus test for all residents and staff, even if they have no symptoms.

“We have delivered over 1.7 billion pieces of PPE and we continue to ensure supplies reach the frontline. The modelled PPE requirements presented in this report are theoretical worst case estimates – it is misleading to compare them to figures on centrally procured PPE which do not account for equipment supplied through other routes or existing local stocks.”

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The author Lee Peart

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