The UK Covid-19 Inquiry has concluded that the care sector was treated as "an afterthought" during the pandemic, leading to thousands of deaths as the virus was allowed to "spread like wildfire".
Inquiry chairwoman Baroness Heather Hallett stated that claims made by then-health secretary Matt Hancock in May 2020 regarding a "protective ring" around care homes were "unfounded", remarking that "quite the opposite was true".
Insufficient Protection for Vulnerable Residents
The inquiry revealed that vulnerable residents were left with "insufficient protection" after hospital patients were routinely discharged into care homes without being tested for the virus. The mantra of protecting the NHS "sometimes came at the expense of the users and providers of care", the report found, with care homes "becoming prisons" for some amid visiting bans and many residents feeling "abandoned".
Baroness Hallett said the pandemic had "a devastating impact" on carers and those they cared for, and said efforts to protect these groups "came too late", with failures a direct consequence of "an absence of proper pandemic planning for the adult social care sector". Her report said the "failures" set out in her findings "created environments in care settings in which the virus could spread like wildfire".
More Than 43,000 Care Home Deaths
There were more than 43,000 recorded care home deaths involving Covid-19 between March 2020 and July 2022, the report said. Inquiry hearings last year heard a civil servant describe the toll as a "generational slaughter within care homes".
At a Downing Street press conference on May 15, 2020, Mr Hancock – who resigned from government in 2021 after admitting to breaking social distancing guidance by having an affair with a colleague – said: "Right from the start, we've tried to throw a protective ring around our care homes." Bereaved families have previously called the phrase a "sickening lie" and a "joke".
Report Findings and Recommendations
In a video statement following the publication of her report into the adult social care sector on Tuesday, Lady Hallett said: "At the critical early stages of the pandemic, not enough was done to protect those living and working in care homes. The claim that a so-called 'protective ring' had been thrown around care homes – 'right from the start' – was unfounded. Quite the opposite was true. During the crucial weeks of March and early April 2020, the overriding focus of the UK government and devolved administrations was on protecting hospitals."
Her report stated: "The UK government and devolved administrations knew, prior to the Covid-19 pandemic, of the extreme vulnerability of care home residents to respiratory viruses. Despite this, care homes received insufficient protection at the time they most needed it."
The 287-page report, published on Tuesday, also found that preventing visits to care homes "caused incalculable harm to residents and their loved ones and often resulted in a significant decline in the health and wellbeing of residents, especially those with complex cognitive conditions such as dementia".
Shortages of personal protective equipment (PPE) for care workers "led to the wholly unacceptable position that care workers had to work either in unsuitable or poor-quality PPE, or with no PPE at all", with some resorting to using festival waterproof ponchos, painters' overalls, and gloves bought online as well as homemade PPE from fabric, bin bags, bed linen and other household items.
Do not attempt cardiopulmonary resuscitation (DNACPR) decisions "made during the pandemic based on a person's age, disability or health conditions, or without a personalised assessment to consider the person's wishes and feelings, caused considerable distress and confusion for the individual, their loved ones and staff". The inquiry branded this "unacceptable" and said it "must not happen again".
Support for the approximately 5.8 million unpaid carers across the UK "came too late" and the impact of the pandemic on them "was pronounced" as they faced having to give more complex care for longer hours "with less – if any – respite care". Many of the at least 1.5 million care workers in the pandemic "put their lives at risk to provide care" but a lack of centrally recorded data on the number of care workers who died from the virus "hindered the ability of the UK government and devolved administrations to understand the severity and transmission of the virus and its impact on the social care workforce".
Lady Hallett said: "Many millions of people across the UK receive adult social care. This includes older people, people with dementia and people living with physical and learning disabilities. For them and the people who dedicate themselves to providing their care, the pandemic totally disrupted their daily lives and had a devastating impact. 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. 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. During the pandemic, the action taken by the UK government and devolved administrations to try and protect workers and users of adult social care came too late. The failures were the direct result of an absence of proper pandemic planning for the adult social care sector. It underlines why my recommendations in this report must be acted upon now before the next pandemic strikes."
Among her recommendations, Lady Hallett called for better pandemic planning by UK governments, including how bed capacity and staffing levels would be tracked in care homes and homecare; an assurance of the "safe and timely isolation of care home residents, including following discharge from hospital"; ensuring financial support to adult social care staff to self-isolate; and for governments to publish guidance on visiting restrictions in care homes based on the principle that residents have the "right to in-person visitors, except in the most grave or exceptional of circumstances".
She also said there should be mandatory end-of-life care training for health and social care professionals including around decisions on DNACPRs, and called for a voluntary workforce register for adult social care workers "in order to strengthen the professionalisation and recognition for those working in the care sector".
Data published in July showed the public inquiry into the Covid pandemic has cost the Government more than £122 million to respond to so far, including costs for legal advice and dedicated staff working on preparing evidence. That amount is on top of the estimated £200 million cost of the inquiry itself.
