A dramatic collapse in standards at a care home where a dozen people died from Covid-19 has been revealed by inspectors who discovered hungry and thirsty residents living with infected wounds in filthy conditions.
Infection control was inadequate, residents with dementia were left only partially dressed and one family complained of finding their loved one smeared in dried faeces at Temple Court care home in Kettering, which is operated by Amicura, a branch of Minster Care which runs more than 70 homes in the UK.
Amicura said the home had been “completely overwhelmed” by Covid-19 infections which it said arrived with 15 patients discharged from hospitals in the second half of March. At that point government guidance did not require people to be tested for the virus before being discharged into care homes, where more than 16,000 people have died of Covid-19 across the UK.
Ten of the discharged patients died from confirmed or suspected coronavirus, with the first death coming on 28 March, Amicura said, adding the entire staff were infected with the virus. From early April the manager and all of the senior care team were absent, leaving the home relying on agency staff.
(February 25, 2020)
Public Health England issues guidance stating that it was “very unlikely” care homes would become infected. The guidance was not withdrawn until 12 March.
(March 31, 2020)
Despite a lack of official statistics about fatalities, care homes warn that they are at “breaking point” and MHA, the country’s biggest charitable provider, says it has suspected cases in more than half of its facilities.
(April 2, 2020)
The Department of Health and Social are guidelines on discharging hospital patients into care homes states: “Negative tests are not required prior to transfers/admissions into the care home.”
(April 14, 2020)
Chief medical adviser Chris Whitty says that more than one in ten care homes (13.5%) now has at least one case of Covid-19. Whitty says: “Care homes are one of the areas where there are large numbers of vulnerable people and that is an area of risk and therefore we would very much like to have much more extensive testing.”
(April 15, 2020)
Testing is expanded into care homes but only for people with symptoms.
(April 21, 2020)
Five of the largest care home providers say they have now recorded a total of at least 1,052 deaths
(April 28, 2020)
Care home deaths are included alongside deaths in hospitals after a sharp rise of more than 4,300 deaths over a fortnight in England and Wales. Testing is extended to staff and residents without symptoms.
(May 3, 2020)
Launch of a national delivery system for personal protective equipment to care homes is hit by a delay of up to three weeks
(May 13, 2020)
Academics report that more than 22,000 care home residents in England and Wales may have died as a direct or indirect result of Covid-19 – more than double the number stated in official figures.
(May 18, 2020)
An unpublished government study which used genome tracking to investigate outbreaks revealed that temporary care workers transmitted Covid-19 between care homes as cases surged. In evidence raising further questions about ministers’ claims to have “thrown a protective ring around care homes”, it emerged that agency workers – often employed on zero-hours contracts – unwittingly spread the infection as the pandemic grew, according to the study by Public Health England.
(June 11, 2020)
A report by care homes bosses says that thousands of people lost their lives “prematurely” because care homes in England lacked the protective equipment and financial resources to cope with the coronavirus outbreak.
“They were overrun,” one relative told the inspectors. “They were short-staffed and then with the influx of people, they couldn’t cope.”
The conditions discovered by the Care Quality Commission on 12-13 May were so poor that surviving residents were moved out immediately. The CQC report into the service, published on Friday, found multiple breaches of the health and social care act. Northamptonshire police have launched an investigation to identify whether any offences may have been committed.
Residents’ wounds had become necrotic and infected, requiring hospital treatment and several people had experienced falls, some of which resulted in injuries needing hospital treatment, the inspectors found.
One resident’s relative told the inspectors: “Sometimes we would visit around 1.30- 2pm. [Family member] was still in bed had been doubly incontinent and was covered in dried faeces.”
Some residents were malnourished. After community nurses were sent in several were hospitalised with dehydration.
“One person’s relative told us their family member never had a drink within reach when they visited and was always very thirsty,” the inspectors said. “They would immediately get them a drink, which they gulped down saying how thirsty they were.”
Medicines were missed, including for prevention of blood clots, heart conditions, stroke and “infection control risks were not adequately managed” with personal protective equipment not being properly disposed of, the inspectors found.
Deanna Westwood, head of inspection for adult social care at CQC said there were “serious failings which led to people suffering harm”.
“The situation at the home was unacceptable and we support the joint decision of the clinical commissioning group and local authority to move people to other services,” she said. “No one is using the service currently and we will not give permission for it to admit new residents, unless we are fully assured that they can be cared for safely.”
The CQC has previously been criticised by patient groups for suspending routine inspections at the start of the pandemic.
It said: “Although we are not conducting routine inspections during the pandemic, if we have evidence that people are at immediate risk of harm, we can and will take action to ensure that people are being kept safe”.
A spokesperson for Amicura claimed the regulator had overlooked the fact the home had been overwhelmed by Covid-19.
“An influx of residents from the NHS in late March led to an outbreak of Covid-19 which affected existing residents and a large proportion of staff, including the manager and entire senior team,” they said. “This left the home disproportionately reliant on the use of available agency staff, with very little opportunity to adequately train them on our policies and procedures.”
Amicura said it had asked for help from the local authority and the NHS on 30 April “when it became clear to us that the home could no longer cope, and care and governance had become inadequate”.
It added that after this point up to 50% of staff were provided by the authorities and the CQC inspection took place when care was being directed by the local authority and NHS.
