Government was “negligent” over care homes, report finds

A report by the Public Accounts Committee has delivered a scathing assessment of the government’s record on care homes, claiming it failed to provide enough support for adult social care during the coronavirus crisis.

 According to the Committee’s findings: “Years of inattention, funding cuts and delayed reforms have been compounded by the Government’s slow, inconsistent and, at times, negligent approach to giving the sector the support it needed during the pandemic.” By contrast, MPs said the NHS had managed to cope well with the crisis.

Many of the failures, which have been highlighted by Reaction’s coverage of the disaster taking place in social care, were flagged by the Committee.

In particular, the discharge of 25,000 patients into care homes without testing for Covid-19 was condemned as “an appalling error”, as well as “reckless and negligent”. The report also criticised the lack of testing of residents and staff in care homes. While it notes that lack of availability was a key reason behind the limited testing, it argues that testing capacity should have been ramped up far earlier, from January 30 when a Level 4 National Incident was declared.

Government failure to provide care home staff with adequate PPE was also singled out for criticism. Not only was PPE in short supply – there had also been a lack of transparency about its availability with “a tendency for the Government to over-promise and under deliver.”

Further confusion was caused by the fact that PPE guidance was changed no less than 40 times, sometimes “without regard to the reality on the ground.” The Department of Health and Social Care was found responsible for “squandering the opportunity to build up PPE supplies” in January and February.

The chaotic mismanagement was in part due to the fact that throughout the pandemic no single organisation was responsible for overseeing and supporting adult social care. This task was made even more difficult by the extremely fragmented nature of the sector. As the report observed, repeated governments have put off the difficult challenge of reforming social care.

Indeed, the Committee observed that social care was often treated as “the NHS’s poor relation”. The report pointed out that the pandemic has made this long-running prioritisation of the NHS over social care only more apparent.

The report raised concern about whether social care staff, who worked long hours with little support during the outbreak, could reasonably be expected to meet the challenge of a potential second wave. Robert Kilgour, Executive Chairman of Renaissance Care Homes, said that in the aftermath of the crisis the mental health of social care staff was “a big concern”.

He added: “In the crisis adrenaline kept people going – now problems are appearing as things start to relax.”

Fortunately, some aspects had improved according to Kilgour – particularly when it came to availability of PPE and testing. He also said care homes now had “more confidence in the knowledge of what to do”.

Renaissance’s care homes for their part had put in place “strong safeguards” to stop coronavirus being spread within them by discharged patients or visitors.

Still, Kilgour noted that key issues which were “above [his] paygrade” still had to be resolved.

The Committee made a number of recommendations aimed at improving the social care sector’s ability to cope with a potential second wave and improve standards in general. These include appointing named individuals in charge of different aspects of the UK’s pandemic response, establishing procedures to ensure patients discharged from hospitals into social care don’t spread coronavirus, ensuring that the UK has adequate supplies of testing and PPE to cope with a second peak, and increasing support for care home staff.

In the longer term, the Committee is also demanding that the DHSC lay out plans for comprehensive reform of adult social care to ensure parity with the NHS.

These recommendations have been received positively by many in the sector. Professor Martin Green, the Chief Executive of Care England, England’s largest social care representative body, praised the report’s “forensic” analysis, and urged the government “to implement the recommendations in order that the nation is better prepared for future spikes”.

Green said he hoped the recommendations would lay the groundwork for “services centred around individuals and free of much of the excessive bureaucracy and neglect within government that has characterised the attitude to this sector for too long.”

Kilgour said he believed there was currently “a unique opportunity” to push through reforms.

The question now is whether the government will be bold enough to overhaul this sector, whose inadequacies have been so tragically highlighted by the pandemic. Or perhaps, like its predecessors, it will shrink at the challenge of taking on such a vast and knotty problem.