England's Covid care home deaths could be thousands higher than official figures, say providers

·4 min read
elderly woman - Realimage / Alamy Stock Photo
elderly woman - Realimage / Alamy Stock Photo

England’s Covid care home death toll is likely to be thousands higher than official figures show, amid claims the watchdog excluded key dates when patients were discharged from hospitals without tests.

The Care Quality Commission (CQC) declared there were 39,017 Covid-related deaths across care homes in England when it published official figures for the first time in July.

But care providers told The Telegraph the numbers were likely to be far higher, as only people who died with Covid between April 10 last year and March 31 this year were counted.

They claim that “thousands of elderly residents are likely to have died” in the days leading up to April 10 because just eight days earlier the CQC had signed off on a controversial government policy that allowed Covid-positive patients to be discharged from hospitals into care homes.

Last night, one manager said the regulator “failed every one of its own standards” and described the CQC signing off on the policy as “a death warrant”. They added: “They were neglecting what they were supposed to be doing for a living.”

Figures in the nine days before April 10 - nearly three weeks after Boris Johnson announced the first full lockdown - suggest around 4,000 people may have died with Covid.

The figure is calculated from correspondence between a care home manager and the CQC’s information access team, seen by The Telegraph.

It reveals almost 7,775 deaths occurred within this period in care homes - 4,190 deaths higher than the figure for the same period of time the year before. Prior to widespread testing, the number of excess deaths - or above average deaths - were used by epidemiologists to get an indication of the number of people who may have died with Covid.

Jeremy Hunt, the former health secretary and current chair of the health and social care select committee which is due to hear from the CQC after parliamentary recess, said: “One of the biggest tragedies last year was the discharging of untested patients into care homes.

“Both the NHS and its regulators need to explain why we were less stringent than countries like Germany that did not allow untested patients into care homes unless they were fully quarantined.”

Concerns were raised

One care home manager in the North of England wrote to the CQC after the data was published, raising concerns over the policy.

He told the regulator in emails that the CQC should have insisted “that untested patients NOT be discharged into care homes in the first week of April 2020” and questioned whether the disproportionate number of deaths was “the likely result” of this policy.

“No one seems to question or hold to account CQC leadership in signing off a document which likely resulted in the deaths of thousands of our elderly in care homes,” he wrote.

On April 2 2020, the CQC signed off on a policy drafted by the Department of Health and Social Care (DHSC), which said that patients who tested positive for Covid-19 could be discharged from hospitals into care homes “based on an understanding that certain elements were in place”. It also stated that testing was not required for asymptomatic patients returning to care homes.

The manager told The Telegraph: “The CQC’s remit is to protect patients and residents. It is not to get into bed with the Government to engineer bed vacancies.”

Prof Martin Green OBE, the CEO of Care England, said: “All eyes on the NHS may have led to blind spots which in turn resulted in many deaths.”

'Shameful episode'

Julia Jones, the co-founder of John’s Campaign, which advocates extended visiting rights for family carers of people with dementia, described the deaths in the first 10 days of April 2020 as “sickening”.

She added: “The CQC has failed abysmally to live up to its Fundamental Standard of Person-Centred Care, never more so than in this shameful episode.”

Kate Terroni, the chief inspector of adult social care at the CQC, said that on April 2 DHSC issued the guidance - with input from NHS England and NHS Improvement, Public Health England and the CQC.

She said care providers “would be able to refuse an admission” if certain criteria were not in place, including the results of Covid tests, the date and onset of symptoms, adequate PPE for staff and the ability to isolate symptomatic people.

The CQC said that during March 2020, care homes were informing the regulator of “a significantly higher number of death notifications”.

However, relatively few of these notifications referenced Covid-19 as cause of death, which did not match what the providers were saying.

As a result, the CQC said it redesigned its notification system to allow providers to indicate Covid-19 as the confirmed or suspected cause of death and “to make it easier to record, collate and report on this data”, and that this “improved data collection began on April 10, 2020”.

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