Concerns raised over care home coronavirus management across Cambridgeshire
PUBLISHED: 11:49 13 May 2020 | UPDATED: 11:49 13 May 2020
Concerns have been raised over the arrangements in place for care home residents who have or are suspected of having Covid-19 in Cambridgeshire.
The county council’s service director for adults and safeguarding, Charlotte Black, told the authority’s adult committee on Tuesday (May 12) that some people who are known to have the virus are going into care homes if the home’s provider believes it can isolate them effectively.
Experts say residents of care homes are particularly vulnerable to the virus owing to factors such as age and an increased prevalence of underlying health conditions.
Councillor Graham Wilson told the committee that he believes the proportion of deaths involving Covid-19 in the county’s care homes is “very high”.
The councillor noted figures from the Care Quality Commission and Office for National Statistics which show that between April 10 and May 8 there have been 202 deaths recorded in Cambridgeshire’s care homes, 63 of which – or 31 per cent – have involved a confirmed or suspected case of Covid-19.
The county council has procured around 340 beds in care homes to reduce so-called “bed blocking” in hospitals and relieve pressures.
Ms Black told the committee: “We currently have an agreement with the hospitals that certainly the expectation is that, in line with national guidance, someone won’t be discharged without having had a test and with a clear test result.
“And if they are Covid positive they have what’s called a Covid care plan, that’s the national guidance. So we are literally in the process of working that out with NHS colleagues at the moment, and working out what will a Covid care plan look like.”
She said the council is working on that “this week”.
She added: “At the moment some care homes are taking people who they know are positive because it’s their home and they think they can get them safely home and socially isolate them as they would as if they are going back to their home.
“But some of them are obviously very nervous, so it’s very much a case by case approach I think, and a risk assessment on the basis of each person.
“At the moment the acute hospitals I understand are not completely full, so we are not feeling the full pressure of that at the moment, but I think that will come in time.”
Lib Dem Councillor Lucy Nethsingha has raised concerns, including in a council committee last week, over the processes in place for care homes where it will not be possible to isolate individuals who have or are suspected of having Covid-19.
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Cllr Nethsingha told the Local Democracy Reporting Service that she was aware of a case at the beginning of May where a resident of a care home who had been taken to hospital was told by doctors there that they were showing signs of having the virus.
The person received a test, Cllr Nethsingha said, but was told the result would not come for 48 hours. The care home was then left to decide if it could take the resident back in, despite suspecting the patient had the virus.
Cllr Nethsingha said the council, in line with government guidance, did help in that circumstance, but that there was no clear process in place and the matter, which first arose around midday, was not resolved until midnight.
Cllr Nethsingha said finding alternative accommodation, in line with government guidance, was “extremely difficult” and said “the long wait for a solution put the care home in question under extreme pressure”.
“I think a key question here is that if the appropriate accommodation is extremely difficult to find, government expectations are very very difficult to put into practice,” she said.
A spokesperson for the Department for Health and Social Care said that where a person has been discharged from hospital and a care home is unable to take them, the local authority is responsible for finding alternative accommodation.
But in this case the person was not an inpatient, and Cllr Nethsingha said that while she recognised the situation is “extremely difficult and we are all learning fast”, she said it shows “there is more to be done to make sure that we are keeping people in care homes safe”.
A Cambridgeshire County Council spokesperson said: “We are working with the NHS to ensure the government’s Action Plan for Adult Social Care guidance is being followed. Each patient requiring discharge will be considered on an individual basis and this guidance will be followed.”
The county council said it would not comment on individual cases, and it did not directly respond to questions about what processes are in place to provide alternative accommodation, and instead it directed the Local Democracy Reporting Service to the government’s guidance.
The guidance says: “Local authorities need to have a clear picture of all alternative local provision that could be used in the case of an outbreak.
“Where local authorities are unable to meet the emergency needs of a care provider, they should report into their Strategic Coordination Group of the Local Resilience Forum for additional support.”
The guidance does not specify the nature of that provision.
The Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) has said that inpatients moving from hospitals to care homes are tested 48 hours prior to their anticipated discharge date.
The CCG has not responded to a request from the Local Democracy Reporting Service to clarify when the last known patients went into care homes in the county without being tested.
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