Covid inquiry: care homes were ‘something of an afterthought’

To put it simply, the latest instalment of the covid inquiry shows care homes were massively thrown under the bus during the pandemic. 

Baroness Heather Hallett, who leads the Covid-19 inquiry, said it was a ‘significant omission’ that the government failed to advise care homes to isolate patients discharged from hospitals, contributing to the spread of the virus.

‘Care homes received insufficient protection at the time they most needed it,’ Hallett said. ‘These failures created environments in care settings in which the virus could spread like wildfire.

‘Most distressingly, some people were not permitted to be with their dying loved ones. Many remain racked by guilt that they do not deserve to carry.’

More than 43,000 people died from Covid-19 in UK care homes between March 2020 and July 2022. 

The inquiry, which has today published its sixth report, found 25,000 hospital patients were discharged into care homes across England during March and April 2020 to free up NHS beds, before mandatory testing was introduced on 15 April.

Former health secretary Matt Hancock accepted responsibility for the decision, describing it as the ‘least worst decision to a terrible problem’. However, Hallett rejected his claim he had thrown a ‘protective ring’ around care homes, calling it ‘unfounded’.

The report also criticised the lack of PPE for care workers, claiming it was ‘wholly unacceptable’. Some staff resorted to using ‘festival waterproof ponchos, painters’ overalls and gloves purchased from DIY shops’.

Hallett said: ‘The action taken by the UK government and devolved administrations to try and protect workers and users of adult social care came too late. My recommendations must be acted upon now before the next pandemic strikes.’ 

Responding to the findings, Health and Social Care Secretary Yvette Cooper said: ‘My thoughts are with all those who lost loved ones in the pandemic and especially those who endured the immense distress and harm of visiting restrictions in care homes, which meant they could not be with loved ones, even as they died.

‘We will provide a full response to the report’s recommendations in due course, but I agree with the chair when she says, adult social care has, for too long, been undervalued and under recognised.’

Since the news of the report broke, social care professionals have been sharing their thoughts, all of which can be read below. 

Professor Sam Baron, interim CEO of BASW 

We are deeply disappointed and perplexed that the report makes scant reference to the experiences of social workers during the pandemic and the impact that a profound lack of guidance, resources and support had on them specifically. 

Social workers went above and beyond throughout the Covid-19 pandemic to safeguard and advocate for individuals in communities across the UK at a desperately vulnerable and anxious time.

Given the bulk of evidence that we and our members submitted on this module, particular recognition of the challenges our profession faced, especially in relation to the serious risks to staff welfare and wellbeing, and of the critical role of Social Work in emergencies, should have at least been recognised.  

Eamonn O’Brien, chair of the Location Government Association 

The pandemic was an extraordinarily difficult time for people drawing on care and support, their families and those who care for them. Councils and their partners worked tirelessly to support vulnerable residents and communities in challenging circumstances. This report is an important opportunity to ensure lessons are learned.

We’re pleased to now be working closely with government on preparation, should there ever be a future pandemic. Councils, working closely with care providers, the NHS and local partners, have a central role in supporting and protecting vulnerable people.

Their experience and expertise must be at the heart of planning for any future pandemic, along with those with lived experience of care. It is essential that the sector is adequately funded and recognised as an equal partner to the NHS.

Dr Jane Townson OBE, chief executive of the Homecare Association 

Throughout the inquiry we heard heartbreaking testimonies from bereaved families and care professionals. We owe it to those we lost, and those who served to ensure we learn lessons and implement change in a way that is effective and enduring.

In our evidence we pointed to a hierarchy of invisibility, with people at home supported by both unpaid carers and professional careworkers considered only as an afterthought. This must change.

The adult social care sector entered the pandemic in a fragile state following decades of underfunding, poor commissioning and undervaluing of the workforce. The terms of reference of the UK Covid-19 public inquiry did not permit a focus on wider systemic issues. 

Caroline Abrahams CBE, charity director at Age UK 

Today’s report is, in its own way, quietly devastating. It describes what in truth we already knew: that when Covid-19 took off, people using social care and the staff and unpaid carers providing it were left totally exposed.

It makes clear that this was mainly due to a complete absence of pre-planning, leading to the system being overwhelmed when the virus struck. It is tremendously important that government heeds this lesson and that work begins now on actioning those of the inquiry’s recommendations which do not depend on fundamental social care reform, visiting guidance in care homes in the event of another pandemic being one of several examples. 

But fundamental social care reform is also required, and today’s report reinforces how important it is that we now actually see it. If a National Care Service had already been in place, underpinned by national standards and with clear accountability to government, the various disasters that befell social care during the pandemic would have been lessened and some might have been avoided altogether.

Paul Austin, director of Independent People Homecare Services

Today’s report by Baroness Hallett exposes how badly our most vulnerable citizens, their families and the people who cared for them were failed during the Covid-19 pandemic. One of its most disturbing findings is that people died with avoidable symptoms and distress.

An empty hospital bed is not a successful discharge if the person leaving it cannot be cared for safely. Families deserve to know how access to medical care and contact with loved ones will be protected next time.

Family contact is part of care, not an optional extra. Prolonged isolation can cause devastating harm, particularly for people with dementia, so we must consider how people can be cared for safely in their homes for as long as possible. Commissioners must recognise properly supported live-in care as an option in discharge and emergency planning.