The Care Quality Commission (CQC) has published the results of CQC’s coronavirus (COVID-19) inpatient survey.
The report: ‘How care homes managed infection prevention and control during the coronavirus pandemic 2020’ details what the Care Quality Commission have witnessed in care homes and hears from care providers on what has worked and what has proved a challenge.
During August 2020, the CQC carried out a special programme of infection Prevention Control (IPC) inspections in 301 care homes selected as potential examples of where IPC was being done well. The CQC have also reviewed IPC in 139 ‘risked-based’ inspections between 1 August and 4 September, which were carried out in response to concerns about safety and quality. During these inspections, the CQC reviewed how well staff and people living in care homes were protected by IPC measures, looking at assurance overall and across ‘eight ticks
The report revealed that most people were positive about the care and treatment they received in hospital during the first wave of the pandemic
But those diagnosed with coronavirus had poorer experiences than those without the virus – particularly in relation to:
- discharge from hospital and
- knowing what would happen next with their care.
The results also reveal some concerns that certain groups found some aspects of their hospital stay more difficult, such as:
- people with dementia or Alzheimer’s
- those with a mental health condition.
The survey captured the views of more than 10,000 adults who were discharged from hospital during April and May 2020. We carried it out to gather feedback to help services and local systems plan for and improve future coronavirus care.
The sample of patients surveyed included people admitted with confirmed or suspected coronavirus. It also included those admitted for unrelated reasons.
The survey asked people to give their opinions on the care they received, including:
- quality of information and interaction with staff
- how well they were able to communicate with family and friends
- the cleanliness of the hospital environment
- their discharge arrangements.
The results reveal some notable trends, including:
Feeling safe from risk
Most patients (83%) said they felt safe from the risk of catching coronavirus in hospital:
- those diagnosed while in hospital felt least safe (68%)
- compared with those who did not receive a coronavirus diagnosis (84%).
Confidence and trust in staff
Over 8 in ten people surveyed (83%) said they ‘always’ had confidence and trust in the staff treating them:
- 77% said they were involved ‘a great deal’ or ‘a fair amount’ in the decisions made about their treatment
- 70% felt they ‘always’ received enough emotional support from staff during their stay.
Patients with a coronavirus diagnosis reported poorer experiences than people who did not have the virus. Particularly in relation to discharge and accessing support after leaving hospital.
Around a third of people with coronavirus (32%) did not know what would happen next with their care when leaving hospital. This compared with 18% of people without coronavirus.
Three in 10 (29%) diagnosed with coronavirus felt help from health and social care services would have been ‘useful’ after leaving hospital but did not get any.
The majority of respondents (80%) said that their room or ward was ‘very clean’.
Most also recalled seeing a range of infection control measures. This included staff wearing personal protective equipment (PPE), handwashing, and cleaning of surfaces.
But fewer people saw social distancing measures such as markers on the floor or signage.
Keeping in touch with family and friends
Seventy-five per cent of people said they were ‘often’ able to keep in touch with their family and friends during the pandemic. But, 13% said they did not receive the help they needed to do so.
Older patients, patients with a sensory impairment and people with a learning disability, a mental health condition or neurological condition were less likely to feel they were able to keep in touch with family and friends.
Communicating with staff
Certain groups of patients found communicating with staff who were wearing PPE especially difficult. Those aged 85 and over were less likely to always understand what they were being told. As were:
- patients with Autism, dementia or Alzheimer’s disease
- patients who were deaf or hard of hearing
- patients with Learning Disabilities.
Kate Terroni, Chief Inspector of Adult Social Care said, ‘We’re committed to ensuring safe, effective, compassionate and high-quality care and are working with the Department of Health and Social Care and others to support the care system through winter.
‘As this report shows most care providers that we have inspected have shown they are responding to the challenges of infection prevention control well, under these extraordinary circumstances. We have seen some providers using innovative and exciting practices to keep people safe. They have been supported by staff who have gone the extra mile to keep the people in their care healthy, stimulated, and as independent as possible, while keeping family members and carers informed and engaged.
‘By continuing to monitor and inspect these care locations we have and will continue to take action to protect people, share best practice and support providers to protect against the spread of COVID in care homes.
Professor Ted Baker, Chief Inspector of Hospitals, said:
“The positive experience reported by many people surveyed reflects the tremendous efforts of hospital staff at a time of unprecedented pressure.
“As winter approaches and the ongoing challenge of coronavirus remains, it is crucial that we use the results to identify any action that can be taken to help maintain safety, drive improvements in care, and tackle inequalities going forward.
“Disappointingly, the results show that for some people the process of leaving hospital and accessing support after was not good enough, particularly for those in hospital with coronavirus. This mirrors the findings of a recent report by Healthwatch England and The British Red Cross.
“Previous CQC inpatient surveys have repeatedly shown discharge and access to onward services as an area where greater improvement is needed. The increased pressures that responding to the pandemic has placed on health and social care has brought the issue into sharp focus.
“More needs to be done to ensure people are fully supported when leaving hospital and when they return home with a clear join up between hospital, community and primary care. This can only be achieved if all parts of the health and care system come together and local leaders support services to work collaboratively to build capacity to respond to the needs of their area.”