By Philippa Shirtcliffe, QCS, Head of Care Quality (www.qcs.co.uk)
The results of a recent study by the University of Manchester make for hugely depressing reading, but are by no means surprising. They reveal that “10,000 more people may have died in care homes from Covid-19 than previously realised”. The academics, who conducted the research, cited a lack of PPE, poor testing regimes, and care home residents not receiving hospital treatment when they needed it – as “playing a part in the higher figures of deaths”.
But statistics don’t tell the whole story of what happened this spring in care homes in the UK. They say nothing about how this insidious disease seeped into homes leaving residents – both young and old – gasping for their last breaths. They say nothing about how they died in great pain without their loved ones by their side. Nor can facts and figures ever bring to light the pain, sadness and guilt of families, who through no fault of their own, were often unable to see their relatives before they died.
Restrictions around visiting continued until December, 2nd, when the government published new guidance, bowed to pressure from the public, and decreed that “visiting is a central part of care home life” and “must be supported and enabled”.
While the government is right to recognise that families have an inalienable right to see their loved ones, its guidance lacks clarity. Instead of publishing a set of clear protocols around visiting, it has thrown a ‘politically hot potato’ to the care sector. In doing so, it has placed a huge weight of responsibility on the shoulders of Registered Managers. The buck essentially stops with them to ensure that “proportionate steps” are taken to “manage risks”.
In creating a safe environment for visiting, the government has promised to distribute lateral flow tests to every care home in the land. The problem is that there are major questions marks surrounding the accuracy of these tests. While Oxford University and PHE say that lateral flow tests are accurate enough for community use , a study by the University of Liverpool has revealed that one test picks up infections just over half of the time. The researchers found it be particularly poor in identifying low levels of infection. As a result, Sheffield City Council has instructed care home providers not to use them.
In an article published on 11 December, an editorial published by the BMJ was critical of the government’s decision to champion lateral flow testing. It concluded that “whatever decision making process the UK government used, it ignored key evidence and dismissed expert international advice”.
It continued, “The result is a considerable burden on care home staff, universities, NHS staff, public health teams, and schools, with minimal additional safety compared with existing risk mitigation measures. Asymptomatic lateral flow testing is an unhelpful diversion from the important task of vaccination rollout.”
Instead of holding the government to account, many tabloids have short-sightedly labelled care providers as being overly officious and lacking compassion.
Nothing could be further from the truth. During this crisis, Registered Managers understand better than anybody that there is fine balance to be struck between protecting residents from the virus and making it possible to see their relatives. They are simply suspending visits because it is their duty to keep people safe. In not sharing the burden, the government has put Care Managers in an impossible predicament. Whatever action they take they are likely to face criticism.
The government needs to urgently step in. It can help alleviate pressure by commissioning more testing on the accuracy of lateral flows tests. There are several different companies offering the tests and it is clear that some are more accurate than others. If the lateral flow tests are not safe to use, then the government should distribute PCR testing kits to every care home. While they are not a hundred percent accurate and take much longer to reveal a result, I believe it is not a difficult test to manage and would give care home staff, service users, and families the reassurance they need to continue visiting.
Secondly, while the test and trace programme has made great strides during the autumn, it is still not as effective as it should be. With families currently only allowed to visit relatives in their tier, central and local government must work even more closely to develop and prioritise track and trace at a more local level. In Britain, this has proved much more difficult than it looks, but where it has been attempted, it has proved to be very successful in driving down local transmission.
Thirdly, many care homes have embraced technology during the Pandemic to good effect. While video conferencing tools have kept service users in touch with their relatives, tracking tools, can also add great value. Take QCS’s Visitor Tracking tool, for instance. It informs visitors, based on their recent movements, whether they can or cannot visit relatives. Not only does it show who has been in and out of care home in the last 21 days, it also checks when relatives last did lateral flow tests. The information can be uploaded in seconds at the click of a button, and while – on its own – it certainly cannot be regarded as a panacea – as one of a raft of measures it can help keep
the infection rate down. With infections rates likely to soar after the Christmas break, sup- port from the government in employing these ground-breaking measures, could be the difference in visits going ahead and not.
To find out more about QCS’s Visitor Tracking tool, please see link below:
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