The care home manager who first highlighted the COVID-19 pandemic crisis in care homes doesn’t believe “lessons for the future will be drawn to ensure similar situations are tackled effectively,” following the conclusion of the COVID-19 Inquiry public hearings in April.
Her concerns are mirrored by the Greater Manchester Hazards Centre and the Hazards Campaign that both advocate for improved workplace health, safety and welfare and which are calling on the Government to respond with ‘enforceable legal standards – not just guidance, not recommendations, but law.’
Across the adult social care sector there were 46,632 deaths registered as involving COVID-19 between March 2020 and January 2022.
Sharon Reed’s experiences as care home manager during COVID-19
Sharon Reed has managed Weymouth’s Danmor Lodge private care home for up to 25 residents of 65 years or over, who are looked after by 40 staff, for 13 years, during which time it has won a number of high standard awards.
After earlier working as a junior school head teacher in Lebanon, she swapped age groups because she felt she could make a positive impact on the final part of people’s lives and which “everyone deserves.”
In May 2020, she told the Big Issue North magazine of her frustrations at being unable to access the government testing systems for COVID-19 that was spreading rapidly across the care sector. By 1 May 2020, 8,312 COVID-19 deaths – around a quarter of the overall total – had been recorded in care homes and that figure was 50% higher when the figures included care home residents who had died elsewhere, mainly in hospitals.
Reed told the magazine of staff, terrified at catching the virus, who chose to self-isolate whilst others who did so after contracting COVID-19 returned to work too quickly and were subsequently off again with exhaustion.
She estimated that around 60 per cent contracted Covid-19, while the figure among residents, one of whom died of the virus, was higher.
Testing hardly done, nobody knew anything
Reed needed to test staff and residents in order to prevent the spread of the disease, the emergence of which in mid-November 2019 in China had not led to Public Health England (PHE) alerting care homes or hospitals to its possible devastating impact on the most vulnerable in society. Government ministers too acted slowly.
“We learnt about what was coming through media reports,” contends Reed. “And when it did break we still received no official information.” She rang PHE and the local Clinical Commissioning Group but nobody knew anything.
She faced a struggle to access government testing systems. In the early stages of the outbreak when she asked for “a testing kit it contained just five swabs.” The two she returned were positive but when she sought to use the remaining three she was told not to send them as a second courier was not available.
Hospital patients were discharged to care homes without prior testing
All this at a time when the government was sending hospital patients to care homes even though they had not been tested for the virus.
“I said at the time that Health Secretary Matt Hancock and Helen Whateley should have thrown a ring of steel around care homes and explained our role. They did not do either,” said Reed.
“I don’t think they made it their business to actually understand what we do. Five years on since COVID arrived, Hancock told the Inquiry in July last year that there should be a legal requirement to always have a stock of Personal Protective Equipment. (PPE) Every care home has PPE as they have all sorts of other viruses that they manage throughout the year. Flu is one, another is the norovirus.”
Reed also watched with bemusement Hancock’s suggestion that care homes should construct an isolation wing. “That would be very costly, especially at a time when most homes have very small profit margins.
“It’s perfectly possible to isolate people in their bedroom. That’s what we did with some success after the initial period when we struggled to bring things under control.”
Government did not speak up for care home staff
What she regards as the failure of the government to speak up on behalf of care home staff also led to them being mistakenly attacked in social media for blocking residents with COVID from going to hospital or being pressured into completing do-not-resuscitate forms. “In fact, many complete these before entering a care home.”
So contends that “care staff who gave their all to care for residents felt completely abandoned.” As such when vaccination was made mandatory in July 2021, many felt this was the final straw and a number of highly experienced, often overworked staff who had witnessed the inconsistencies of government policies left the sector for good.
Staff feared the effects of the vaccines, and some quit their job rather than having to have a vaccination they were not sure about.
According to Reed they have not returned and this has led to care homes facing a staff shortage that has only narrowly been overcome by actively recruiting staff from overseas.
Reed spends a great deal of time training, talking and counselling staff, whose well-being is constantly being challenged by the issues and situations they are dealing with including the final moments of the life of a person they have got to know well. “We aim to develop a family atmosphere and so it can be painful for a staff member to see a resident die.”
Sharon was very unimpressed by Hancock’s inquiry evidence, She also fears that the arrival, which seems almost certain, of such a common deadly virus in the future will lead to far more people dying than should be the case.
There was no “protective ring” for care homes
Reed says:
He [Hancock] actually told the inquiry that if we had another pandemic it would be worse. Tens of thousands who live and work in care homes would die.
He admitted his statement that he was placing a protective ring around care homes was just rhetoric. It was brazen. They made it up as they went along. That is still so. At one point we were told not to let anyone visit and now we are told we can’t stop people visiting. But each situation should be assessed separately.
Clearly, they did not act quickly enough. And if that happens again when a deadly virus takes shape then the results will be similar but in addition the private care sector would collapse, thus leading to an ongoing national tragedy in which many older people, many with multiple medical conditions, will be left destitute.
Systematic failures
According to the Hazards Campaign the UK Covid-19 Inquiry Module 3 report has ‘confirmed five systematic failures in infection control that left healthcare workers exposed to preventable harm.’ Sadly, many healthcare workers who raised the alarm at the time were not present to give evidence as they are long since dead. The campaign wrote to the Health and Safety Executive, which for years has had its enforcement responsibilities and staff numbers cut, in March 2020 urging for the rigorous enforcement of workplace health and safety law.
The SafeAir4All petition co-ordinated by Hazards was submitted to Downing Street last year calling for statutory air quality across all health and social care settings has yet to draw a response.
A spokesperson for Hazards said it is ”seeking for the recognition that COVID-19 is airborne leading to the Infection, Protection and Control (IPC) guidance measures being updated accordingly. There should be legally binding ventilation and clean air standards in all healthcare and care settings.”
There should also be mandatory fit-tested FFP2 or 3 as the baseline for health care workers treating patients with infectious respiratory conditions. Front-line workers, trade unionists and independent scientists should be transparently embodied in the development of all IPC guidance.
“Workers’ organisations identified the failures in real time. The science was available. The warnings were given, What was absent was the political will to act. The Inquiry now has the opportunity – and the responsibility – to make that inaction impossible in the future.”
Action is needed but will lessons be learnt?
Reed supports these aims. She doesn’t want to see similar COVID-19 style horrors being forced on care staff or anyone else in the future. She believes that rigorous action is needed but admits nervousness as
Having watched the inquiry I have little confidence that lessons for the future will be drawn. Problems will remain.
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