Social Care and the Covid-19 Inquiry

27 April 2022

Very few people who worked in social care would recognise truth in the claim that a protective ring was placed around social care during the early days of the pandemic.

The claim became notorious both because of its widely-perceived inaccuracy and also because of Matt Hancocks’s denial in June 2021 of having made it early in the pandemic despite having first used those words on 15 May 2020.  In this case, it seems that the Secretary of State literally forgot social care.  However, for many working in the sector that reflected the general approach to social care throughout the pandemic, but especially in the early days.

The judgment of the independent think tank The Health Foundation was clear:

“Central government support for social care during the pandemic was often too little, too late, particularly during the first wave. The government’s claim of ‘a protective ring’ around care homes was not grounded in reality.

The social care system that entered the pandemic was underfunded, understaffed, and undervalued – scarred by decades of political neglect. These longstanding structural issues shaped the policy response to COVID-19 and effects of the pandemic on the system.”

The first urgent instruction I had in relation to Covid was on the evening of 27 March 2020 (a Friday night, the most common time for urgent instructions).  A care home contacted me to say that a resident had gone into hospital and she now required a PICC line, a need the care home was not able to meet.  The provider communicated that to the hospital before the Covid crisis.

However, on that Friday evening, the hospital contacted the home to say that they were going to discharge the resident back to the home.  She had Covid but the hospital assured the home that they only needed gloves and aprons to look after her despite the home manager knowing that the hospital was already using full protective clothing including masks, googles, full bodysuits and shoe covers.  The hospital threatened to report the home to the ‘authorities’ if they didn’t admit the resident, and to use (unspecified) emergency powers to require care home to admit her.

With my help, the care home resisted the pressure.  Other homes did not and Covid was brought into homes at a time when they were ill-equipped to deal with it.  I have also been involved in cases where there were outbreaks in care homes, often in the context of hospital discharges.  Rather than partner agencies supporting the homes, safeguarding investigations were launched.

Today, the High Court ruled that the guidance in relation to discharges from hospital to care homes in March and April 2020 was unlawful because it failed to take into account evidence that non-symptomatic patients could be contagious.  Accordingly, the guidance was irrational in failing to advise that where an asymptomatic patient (other than one who had tested negative) was admitted to a care home, he or she should, so far as practicable, be kept apart from other residents for 14 days.

The Inquiry’s draft terms of reference include:

  • “the management of the pandemic in care homes and other care settings, including infection prevention and control, the transfer of residents to or from homes, treatment and care of residents, restrictions on visiting, and changes to inspections;
  • the procurement and distribution of key equipment and supplies, including PPE and ventilators”.

It is vital that the voice of the social care sector is heard during the Inquiry. Representative bodies, care home groups, unions and those representing the interests of residents and relatives can, and should, seek core participant status to ensure that whilst social care was not always at the political centre stage during the pandemic, it will be during the Inquiry.

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