Government and regulator silent on progress with ‘abhorrent’ COVID care home policy

The government and its regulator are refusing to say how many care homes are set to be approved to receive hospital patients who have tested positive for coronavirus.

A new government policy – described as “abhorrent” by disabled activists – will see patients in England who are set to be discharged from hospital into a care home after a positive COVID-19 test result admitted first to a “designated setting”.

They will have to be cared for in this designated setting – which must be approved by the Care Quality Commission (CQC) – until the end of their isolation period.

Although some of the designated settings will be “stand-alone units” where only service-users with coronavirus will be admitted, others will be care homes which have “separate zoned accommodation and staffing” for service-users with coronavirus and other parts occupied by residents who have not been infected.

The policy, drawn up by the Department of Health and Social Care (DHSC) and approved by CQC, has alarmed disabled activists because it risks repeating the outcome of the scandal that occurred early in the pandemic, when hospital patients were discharged into care homes without being tested for COVID-19.

That government failing was believed to have caused the loss of thousands of lives.

DHSC has told local authorities in England that it wants each of them to have access to “at least one CQC designated accommodation” by the end of this month (October).

Despite that request, neither CQC nor DHSC would give any information this week about the progress they had made in securing designated settings, and how many “zoned accommodation” settings have been submitted for approval.

A CQC spokesperson declined to say what proportion of accommodation suggested so far by councils for designated settings was in stand-alone units and what proportion was in zoned accommodation within care homes.

He also declined to say why the regulator did not ask DHSC to change the guidance to ensure that people who are COVID-positive are only discharged into services where all residents or patients have already tested positive.

Kate Terroni, CQC’s chief inspector of adult social care, said in a statement: “Care home providers should only admit a resident when they are confident they can meet their care needs, so where they are confident they’ve got good infection prevention control, they’ve got the right PPE [personal protective equipment], they’ve got the right workforce.

“We will absolutely support a provider to say they cannot admit someone if those ingredients aren’t in place.”

A DHSC spokesperson declined to say how many prospective designated settings had been sent to CQC for sign-off so far, and how many of them were care homes “with separate zoned accommodation and staffing” for service-users with coronavirus.

He also declined to say why DHSC does not ensure that all COVID-positive patients are discharged from hospital into well-resourced facilities that are only used for people already infected with the virus.

DHSC has said that no care home provider will be forced to admit an existing or new resident if they are unable to cope with the impact of the person’s COVID-19 illness safely, and that local authorities will be responsible for providing alternative accommodation.

In August, DHSC announced £588 million for the NHS to fund follow-on care and support for patients discharged from hospital.

This can be used to support designated settings to prepare for COVID-19 positive patients as they come out of hospital.

The DHSC spokesperson said in a statement: “Our absolute priority is to prevent infections in care homes while ensuring that everyone receives the right care, in the right place, at the right time.

“We are working with the Care Quality Commission and the NHS to ensure everyone discharged to a care home has an up-to-date COVID-19 test result and anyone positive is discharged to a care home CQC has assured is able to provide safe care.

“We are also working closely with the sector as we put these arrangements in place to ensure we deliver the right care for everyone.”

Meanwhile, a new report by British Red Cross and the statutory agency Healthwatch England found 30 per cent of those who were tested for COVID-19 while in hospital did not receive their test results before they left.

Most of them left to return to their own homes and many would have received domiciliary care from care workers who would have visited other service-users in other locations.

More than 500 patients and carers and care workers across England took part in the survey, which gathered people’s experiences between late March and late August.

It also found that 26 per cent of those respondents who were discharged to a care home from a hospital had not been tested first.

Healthwatch England said that all those respondents who were discharged to a care home without a test said this took place in March and April.

It is not able to say whether any of these cases took place after 15 April, when new government guidance made it compulsory for all patients being discharged from hospital into a care home to have a test first.

The report says it is “still not policy to test everyone who is discharged from hospital to another location (usually their own home), although some hospitals are doing this”.

It adds: “Improvements in testing capacity should have as an ambition immediate access to a COVID-19 test for anyone who wants one, with everyone being offered a test at the point of discharge.”

*For sources of information and support during the coronavirus crisis, visit the DNS advice and information page

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