The Covid-19 Inquiry has concluded that tens of thousands of care home residents died during the pandemic because the sector was “something of an afterthought”, with failures in protection and planning contributing to 43,000 deaths.
The sixth report from the inquiry found that not enough was done to protect the most vulnerable in care homes, which were put at risk to protect the NHS. Untested elderly people were discharged from hospitals into care homes that were not initially advised to keep these residents isolated.
The report refuted former health secretary Matt Hancock's claim to have thrown “a protective ring” around care homes, stating this “does not accurately reflect the lack of action taken to protect care homes across the UK in March and the first half of April 2020”.
Inquiry chair's damning verdict
Inquiry chair Baroness Heather Hallett said: “At the critical early stages of the pandemic, not enough was done to protect those living and working in care homes. The mantra at the time of 'protecting the NHS' sometimes came at the expense of the users and providers of care. The adult social care sector as a whole appeared to be something of an afterthought.”
She added: “The profound isolation and sense of abandonment felt by residents as a result of the visiting restrictions resulted in immense emotional harm. Most distressingly, some people were not permitted to be with their dying loved ones. Many remain wracked by a guilt that they do not deserve to carry.”
Visiting restrictions did not begin to ease until the summer of 2020, causing “profound and enduring effects” on residents who were left isolated, abandoned and alone for months.
Impact on care workers and carers
The report highlighted “wholly unacceptable” shortages of personal protective equipment, with carers forced to wear makeshift PPE such as waterproof ponchos from festivals, painters' overalls or homemade items using bin bags and bed sheets. It said “many put their own lives at risk”.
Baroness Hallett said the pandemic “exposed and exacerbated the underlying fragility of the adult social care workforce”, which entered the crisis with high staff vacancies and turnover, with workers on low pay and in poor conditions. Many care workers suffered burnout and quit the profession during and after the pandemic.
The report also highlighted the impact on the nation's 5.8 million unpaid carers who were “providing complex care for longer hours with little or no respite”.
Discharges and 'generational slaughter'
Some 25,000 residents were discharged into care homes between March 17 and April 15 2020, when “care homes received insufficient protection at the time they most needed it”. During hearings in 2025, a civil servant described the toll as a "generational slaughter within care homes".
The report said decision-makers faced an “unenviable choice” between keeping patients in hospital pending tests and risking bed shortages, or discharging potentially Covid-positive patients and risking introducing the virus to vulnerable residents. It said choosing the latter “created the perception that hospital capacity was of greater importance to the government than residential and domiciliary care capacity”.
Mr Hancock had told the inquiry it “was a question of what is the least worst solution to this terrible problem”. The probe noted he considered primary responsibility for pandemic planning for care homes lay with local councils rather than the government.
The High Court ruled in 2022 that government policies on discharging hospital patients into care homes at the start of the pandemic were "unlawful".
DNACPR orders and failure to prepare
The inquiry heard testimony from bereaved families who said they were not consulted before Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders were placed on loved ones. Baroness Hallett concluded some decisions were made inappropriately or without proper consultation, based on a person's age, health condition or learning disability. The report found no evidence of national policy encouraging blanket use of DNACPRs.
She recommends mandatory end-of-life care training for health and social care workers, who the report said often “lacked the skills to have these conversations thoughtfully and compassionately”.
The report also found that governments in the decade before Covid-19 failed to act on warnings that the social care sector was not prepared for a pandemic. The UK Influenza Pandemic Preparedness Strategy 2011 highlighted “particular challenges” for social care, and Exercise Cygnus in 2016 stressed the need for social care surge capacity, but these concerns were not addressed.
