“Catastrophic” care home deaths highlight need for urgent reforms

Mario Kreft MBE, chair of Care Forum Wales and owner of the Wrexham-based Pendine Park care organisation, spoke out in the wake of a damning report from the Senedd’s Health Committee which concluded care homes had been badly led down during the coronavirus crisis.

Among the issues flagged up were the bad decision-making around testing, PPE and discharging people from hospital into care homes without confirmation they were not infected.

Up until June 26, a total of 725 of the most vulnerable people had died with suspected or confirmed Covid-19 after it got inside Welsh care homes.

The report blasted the complete lack of clarity over testing with uncertainty over who was leading, managing and coordinating the work.

The dire shortage of PPE had caused huge problems in the early part of the pandemic and the fact that decisions took “too long” came at “great cost to the social care sector."

The committee concluded that a number of care homes faced closure because of acute funding problems and they said there was a pressing need for “systemic reform” to recognise the people working in social care.

According to Mr Kreft, social care was a “Cinderella service” that had always been pushed to the back of the queue when it should be “placed on a pedestal” alongside the NHS.

He said: “This report is essentially confirming what we knew already and what Care Forum Wales has been saying for months; that essentially care homes, their residents and staff inadvertently became collateral damage in a drive to protect the NHS from being overrun.

“Back in February Care Forum Wales launched a campaign to Shield Social Care and Save Lives.

“As part of the campaign, we were calling for an early lockdown of care homes, a rigorous testing regime, along with an adequate supply of PPE and proper financial support to safeguard care homes from a double whammy of soaring costs and falling occupancy levels.

“Unfortunately, Care Forum Wales and our sister organisations in the other UK nations were not part of the very early decision making process in formulating a strategy to tackle the pandemic.

“A survey conducted by Care Forum Wales showed that 42 per cent of

care homes felt they were being put under pressure to admit hospital patients who were Covid-19 positive or without being tested. Where this occurred, it turned safe havens into coronavirus warzones.

“All these themes are now being flagged up in the report from the health committee.

“Worryingly, the message we are getting from our members is that the testing regime is patchy at best and utterly shambolic at worst.

“Equally patchy and shambolic has been distribution by local councils of the £40 million of emergency funding announced by the Welsh Government.

“It was supposed to be the first tranche of funding to help the sector through the crisis but there is still no sign of the additional financial support that was promised.

“We now need to look at the recommendations in this important report learn lessons for the future, particularly in case there is a second wave of Covid-19.

“We need a national action plan that includes an immediate policy shift to put social care on a par with the NHS, creating a national service that is properly funded because it is, as the First Minister pointed out, the scaffold that supports the NHS.

“The sector is fragile as a result of the market being managed by local government for the past 25 years.

“The evidence is starkly illustrated in the league table of care home fees which highlights the unfair post code lottery which means providers in Cardiff get £12,000 a year more per resident than care homes in Powys for exactly the same service.

“Five of counties named and shamed in the bottom 10 worst payers are in North Wales.

“A glaring example of the way the sector has been mismanaged is the toolkit used by North Wales councils to calculate the fees which means that half the people on the front line are condemned to being paid the national living wage and no more.

“We need less talk and more action, with radical reform to ensure fairness and equality.

“I would concur with Sir Simon Stevens, head of the NHS in England, who said that this should be done within a year because this must be an absolute priority both in Wales and across the UK.

“The Welsh Government have designated social care as a sector of national strategic importance and a pillar of the foundation economy which can provide the jobs and income that can help regenerate Wales in the recession that’s looming.

“The shambolic way in which local government has been distribute the £40 million in emergency funding for care homes is the perfect illustration of why we need to take stock and create a new national plan within 12 months.

“Hopefully, one positive legacy of this pandemic will be that the value of the social care sector and the wonderful people who work in it is finally being recognised.

“What we have learned from this global pandemic is that we cannot continue to treat and manage the social care market as we have done for the past generation and expect a different outcome.

“We need a system that is fair and equitable instead of the post code lottery which means we have 29 variations on a theme – with 22 local authorities and seven health boards – when it comes to setting fees.

“The misplaced mindset in the UK has been focused on ensuring the NHS was not overrun without recognising the catastrophic damage and the high level of deaths in care homes.

“It ultimately created a vicious circle which actually also caused more damage to the NHS as well.

“We need strategic, radical reform so we can get this right once and for all.

“There are many deserving causes but there is nothing more deserving than social care which should be put on a pedestal along with the NHS because it is the scaffold that supports it.

“This is not a blame game. This is about setting a plan that will meet the needs of future generations by learning some important lessons from the mistakes made during the pandemic and the past generation, so that history does not repeat itself.”

A Welsh Government spokesman said: “We don’t accept the Committee’s finding that care home residents have been badly let down.

"Our approach has been routed in scientific evidence with the sole objective of saving lives, regardless of where people live.

“The Senedd’s health committee has focused on testing, which is just one part of our response. We have provided a wide range of support, including extra nursing staff where necessary and free PPE for care homes across Wales.

“Everyone working in social care has worked tirelessly to protect some of the most vulnerable people in Wales.

"We will continue to work with the sector to identify and provide any additional support it needs to respond to the virus.”

A Flintshire Council spokesperson said: "As a county council we have provided intensive support to local care homes throughout the pandemic. We speak to care homes and other care providers daily, and respond with the help they need.

"We have  provided staff to support care homes to help with staff shortages and have used our share of the  £40 million Hardship Fund of  Welsh Government to assist care home providers with a 10% uplift in care home fees, and with financial compensation for the costs of empty bed-spaces which homes have not been allowed to use due to the restrictions on home admissions. 

"We have provided and distributed Personal Protective Equipment (PPE) to the local care home and provider network and this has been well-received across the network. Our PPE store and distribution system is regarded as best practice nationally. 

"We agree with the Care Forum that social care funding in Wales and across the UK  needs to be greatly increased and be sustained into the future. Flintshire is a highly regarded provider of care services  and this is recognised by Care Inspectorate Wales.  We are also a direct provider of three homes, ones  that are highly regarded and much in demand."