The depth of suffering in care homes in England when Covid struck has been laid bare in a court case exposing “degrading” treatment with residents being “catastrophically disappointed”.
Standards of care at Temple Court nursing home in Kettering collapsed so much in April 2020, as ministers rushed to free up NHS capacity by discharging thousands of people, that residents were left lying in their own faeces, dehydrated, malnourished and with necrotic and infected wounds. , found the Commission on Quality of Care. Fifteen of its residents died with Covid in the first weeks of the pandemic.
The case heralds the UK’s Covid-19 public inquiry module next year which will put Matt Hancock’s claim to have thrown “a protective ring around social care” to the test.
The allegation resulted in a £120,000 fine handed down at Northampton Magistrates Court last week. The operator, Amicura, apologized but said she had been “acting in the national interest and supporting the NHS by accepting patients discharged from hospitals into nursing homes under government policy.”
The Northamptonshire home was one of hundreds across England under unprecedented pressure after Hancock, then health secretary, ordered a wave of nursing home discharges amid fears the coronavirus would overwhelm hospitals.
“They (staff) were overwhelmed, they were understaffed, and then with the influx of people, they couldn’t cope,” a relative told inspectors. One said that his loved one was always thirsty when he was visited and would “gulp” water when offered. When the community nurses were finally deployed, they found people in dirty bedding and made a large number of safeguarding referrals.
The high court already ruled that the government’s dumping policy was illegal and the failure to isolate people being discharged without being tested was “irrational” and “failed to take into account the risk of asymptomatic transmission for elderly and vulnerable residents.”
More than a quarter of all deaths among nursing home residents in March and April 2020 involved Covid-19: more than 12,500 people.
Temple Court’s population doubled in a few weeks as the operator, Amicura, took in 26 new residents, including 15 from the hospital, while senior staff were affected by the virus.
The CQC filed the indictment, which concluded last week, saying residents were “catastrophically let down by the care provider’s poor systems and processes.” The care company has also received an £80,000 costs order.
But Amicura said the shocks put “an incredible strain on our team, leaving many of them overwhelmed, exhausted and sick with the virus… This, coupled with the rapid rate of discharges from hospitals to homes, had an effect significant and detrimental… in the care provided.”
Before the pandemic struck, the CQC was already concerned about the quality of care at Temple Court, calling it “requires improvement”. Between late February and early April 2020, the nursing home accepted new residents without “adequately assessing the impact such an increase would have on the health and safety of all who live there,” the CQC said.
by the time the inspectors were at the beginning of May 2020said a family member, “it was chaos.”
The registered manager and senior care team had been away for about a month and the clinical lead was on extended leave. There were not enough staff with the necessary skills, and people suffering from blood clots, strokes, heart conditions and seizures were not receiving essential medicines. The treatment was described as “degrading.”
Ros Sanderson, CQC’s deputy director of compliance, said the provider “failed in its specific legal duty to protect residents from exposure to significant risk of harm.”
Amicura said: “We fully accept the court’s ruling and apologize unreservedly to all those affected by failures in our systems and processes in the early stages of the Covid-19 pandemic. Following these events, we immediately began to learn lessons about what went wrong and committed to making significant improvements across the company to ensure our residents are always safe, supported, and well-cared for.”
The case comes amid warnings that the care sector has not recovered from the pandemic, with around 165,000 staff positions still vacant, more than one in 10, despite the growing need for a population that gets old.
Earlier this month, a two-year study by health think tank Nuffield Trust and the London School of Economics concluded that the anguish in nursing homes at the start of the pandemic had been the result of “letting one of our most important public services languish in constant crisis for years.” He found that ministers had failed to appreciate the fragility of the sector by sending patients to poorly prepared nursing homes.
Skills for Care, a government-funded agency, has forecast that the UK may need an additional 480,000 social care workers by 2035 to keep up with demand. Meanwhile, 430,000 caregivers could be lost in the next 10 years if those over 55 decide to retire.
In one week this month, the CQC released 146 reports on residences it had previously assessed and downgraded the quality rating of one in five homes. In general, almost half of those evaluated in topics such as security, leadership and home care were “inadequate” or “requires improvement”. Less than 2% were “outstanding” and the rest were rated “good.”