Care homes

“They Were Dishing the Sedatives Out Like Smarties”: Cornwall’s Care Home Scandal

We’re publishing a piece today by Cornwall resident Natalie White on the appalling conditions suffered by care home residents in the county during the pandemic and the unmanageable pressures staff were forced to work under. Then along came the vaccine mandate.

The care homes faced increasing pressure to take more and more people to free up beds from the hospitals. Unable to cope, some care homes started giving the sedative Midazolam to residents.

“They’re dishing them out like smarties,” one friend told me as she sniffed back tears. “We just can’t cope. It’s the only way to get on top of everything.”

Patients with dementia, who can often become frustrated, angry and confused, and prone to wandering off, were often dosed with Midazolam, but it wasn’t long before some care staff were being bullied to give them to all residents. According to the Daily Mail, “out-of-hospital prescribing of the drug midazolam increased by more than 100%” in April 2020. It is thought by some that this was a deliberate attempt to euthanise the elderly, but that’s disputed by those I’ve spoken to in the sector.

“It was never the intention to harm or kill anybody,” I was told. “I don’t know of any cases where Midazolam caused death. But we were encouraged and sometimes bullied into giving them to residents when we were overwhelmed with residents needs, and understaffed, because it gave us more time to get to everyone.”

On June 22nd 2021, ITV News reported that Kenwyn care home, where 94% staff and 100% residents were vaccinated, experienced a significant outbreak of Covid infections.

Nevertheless, by October 2021, the Care Quality Commission declared that all care staff, from cleaner to care, had to be vaccinated by November 11th (Remembrance Day, no less) or they would be sacked. That they had risked their lives, and the lives of their families, for those most in need, and that most of them had almost certainly been exposed to Covid during this time and now had antibodies, seemed not to matter.

The combined years of experience, training and devotion of the people effected by this were irreplaceable. The people I know who chose not to get vaccinated and left the care sector weren’t ‘anti-vaxxers’; they were people who had had every other vaccine offered to them or their children. They weren’t ‘conspiracy theorists’ who spent hours down David Ike rabbit holes on social media – they worked too hard to find the time for that. They were just hard-working, caring people who were reluctant to take a vaccine they knew little about. Many I spoke to felt that forced vaccinations were against their basic principles of informed consent and bodily autonomy.

Still, the Government and the CQC continued with their plan to fire any staff who didn’t get vaccinated by November 11th. The already understaffed and overrun care industry looked set to lose around 60,000 care staff across England.

This is when things started to look like the plot of a disaster movie.

Worth reading in full.

Hospital and Care Home Visiting Restrictions Are “Cruel, Inhumane and Unnecessary”, Doctors Tell MPs

The Pandemic Response and Recovery All-Party Parliamentary Group met this week to hear about visiting restrictions still being imposed by many care homes and NHS Trusts. Co-chaired by Rt Hon Esther McVey MP and Graham Stringer MP, the Group listened to evidence about the devastating effects visiting restrictions in hospitals have on patients and their loved ones. MPs also heard how visiting restrictions in care homes, along with the continued use of rolling lockdowns and over interpretation of testing guidelines, is leading to isolation, neglect and abuse of the residents.

Leandra Ashton, who co-founded The People’s Care Watchdog, Dr. Ammar Waraich, a medical registrar in the West Midlands, Carol Munt, experienced Patient Partner and Advocate and Dr. Ali Haggett, community mental health and wellbeing specialist, told MPs of the obstacles still in place when trying to visit a loved one and the shocking impact on vulnerable hospital patients, care home residents and their families.

All the speakers voiced serious concerns that obstacles are still in place in some healthcare settings. Politicians heard harrowing accounts of the harmful effects of isolation and loss of social contact on physical and mental health, safeguarding problems with medication, dehydration, hygiene and lack of basic care and the failures to uphold existing legislation to protect those who lack capacity.

Leandra Ashton’s mother was arrested in November 2020 for taking her grandmother out of her care home a day before the second lockdown. Two years on, many residents are still being isolated from their loved ones. She told MPs:

Discharging Untested Patients to Care Homes Ruled Unlawful by High Court

Government policies on discharging untested patients from hospital to care homes in England at the start of the Covid pandemic have been ruled unlawful by the High Court. BBC News has more.

The ruling came after two women took Public Health England and the Health Secretary, then Matt Hancock, to court. Dr. Cathy Gardner and Fay Harris said it had caused a “shocking death toll”.

Prime Minister Boris Johnson renewed his apologies for all those who lost loved ones during the pandemic.

When Covid hit in early 2020, patients were rapidly discharged into care homes without testing, despite the risk of asymptomatic transmission, with Government documents showing there was no requirement for this until mid-April.

Dr. Gardner and Ms Harris said there had been failures in protecting residents and brought the legal challenge. They partially succeeded in claims against Public Health England and the Secretary of State for Health and Social Care.

Speaking outside court, Dr. Gardner said she “believed all along that my father and other residents of care homes were neglected and let down by the Government”.

“The High Court has now vindicated that belief, and our campaign to expose the truth,” she said.

In their judgment, Lord Justice Bean and Mr. Justice Garnham found the decisions of the then Health Secretary to make and maintain a series of policies contained in documents issued on March 17th and 19th and April 2nd 2020 were unlawful.

They ruled this was on the grounds the drafters of those documents failed to take into account the risk to elderly and vulnerable residents from non-symptomatic transmission, which had been highlighted by Sir Patrick Vallance in a radio interview as early as March 13th.

Sir Patrick told the Today programme that “it’s quite likely that there is some degree of asymptomatic transmission”.

A barrister representing Dr. Gardner, from Sidmouth in Devon, and Ms. Harris, from Medstead in Hampshire, told the court at a hearing in March that more than 20,000 elderly or disabled care home residents died from Covid between March and June 2020 in England and Wales.

Jason Coppel QC also said in a written case outline for the judicial review that the care home population was known to be “uniquely vulnerable” to Covid.

“The Government’s failure to protect it, and positive steps taken by the Government which introduced COVID-19 infection into care homes, represent one of the most egregious and devastating policy failures in the modern era,” he added.

Worth reading in full.

Doctors Claim NHS Facing Worse Crisis Since Records Began – But it’s Nothing to Do With Covid!

An exodus of social care staff to better-paid jobs in supermarkets, retail and hospitality is fuelling the worst NHS crisis since records began. The Times has more.

Leading doctors told the Times that the “frightening” situation in A&Es was now worse than during the Covid peak but said the solution was to “give money to social care – not us”.

Social care is due to receive only £5.4 billion of the government’s new £36 billion package for healthcare reform, funded through a rise in national insurance that was introduced this month.

NHS chiefs warned that the “bottleneck” in hospitals would deteriorate further unless social care capacity was increased so that patients could be safely discharged from wards.

Medical organisations said it was vital that carers receive a pay rise so they earn more than they would “stacking shelves in Tesco”.

Some 410,000 staff quit social care last year. Vacancies in the sector have almost doubled in the past year, with one in ten posts now empty – a shortage of about 160,000 staff.

Widespread labour shortages and the cost-of-living crisis means staff are being lured to jobs in supermarkets with higher wages, while companies such as Amazon are offering “golden handshakes” of up to £3,000.

This has reduced capacity in care homes, with four in ten refusing to take on new admissions – meaning elderly and vulnerable patients end up stranded on hospital wards.

NHS England figures show a record 13,000 patients a day are taking up beds because they cannot be discharged, creating a logjam in hospitals and ambulance services that is “costing lives”.

Worth reading in full.

Stop Press: Many people have claimed that this crisis has been caused by the Government’s insistence that care home workers had to be jabbed from November 11th 2021 as a condition of remaining employed. That may well be a contributory factor, but it’s worth pointing out that that policy was revoked on March 15th.

Lockdown for 10 Days After Two Cases, Quarantining of Mothers’ Day Gifts – The Ludicrous, Harmful Rules Still Being Followed by Care Homes

Care home residents are still being kept in their rooms for 24 hours a day and having their Mothers’ Day gifts ‘quarantined’ under an “endless cycle” of lockdowns. The Telegraph has the story.

Last month, the Government announced its “Living with Covid” plan, which removed the legal requirement to isolate if people test positive. From next week, the provision of free tests for most of the public will also end.

However, care home guidance, which forces homes into lockdown if they have two or more cases, is yet to be updated.

During an outbreak, homes must stop communal activities, restrict visitors and close the home to new admissions, under UK Health Security Agency (UKHSA) rules.

The guidance was tweaked last week to shorten the lockdown period from 14 days to 10, but families, relatives associations and care home providers said it does not go far enough.

Julien Smith was unable to bring his mother flowers for Mothering Sunday because her care home said all gifts needed to spend 72 hours in a “quarantine room” before they can be delivered.

“By the time she gets them, they’ll be dead,” he said.

Apart from anything else, why didn’t the UKHSA update its guidance a long time ago when it became clear that SARS-CoV-2 does not spread much via surfaces and objects?

The rules for care home residents have long been among the most inhumane, trying (largely in vain) to protect them from catching the virus at the expense of everything that makes their lives worth living.

New guidance is due by April 1st. Let’s hope it’s sensible. Or better still, that they scrap it altogether so we stop treating COVID-19 as a special threat.

Worth reading in full.

Government Criticised For Not Ruling Out ‘No Jab, No Job’ By Back Door

The Department of Health and Social Care (DHSC) has been criticised by the House of Lords for failing to clarify whether thousands of carers who were sacked for not getting a Covid vaccine can have their jobs back and whether ‘no jab, no job’ for new health and social care recruits is being sneaked in by the back door. MailOnline has more.

The House of Secondary Legislation Scrutiny Committee has said there are still “a lot of loose ends that must be addressed”.

Up to 40,000 workers were effectively fired when the highly controversial “no jab, no job” policy was introduced in November.

Health chiefs then U-turned on the legislation, which was also going to be placed on NHS workers from April 1st. Hospital staff weren’t affected by the mandate because it had yet to come into force, but care homes had already been forced to get rid of any unjabbed carers.    

Industry bosses warned it was too late because many wouldn’t bother coming back to the hugely understaffed sector, which was already short of 100,000 carers before Covid struck.  

Baroness Bakewell of Hardington Mandeville, one of the committee’s members, praised the DHSC for the information and scientific evidence behind the decision to revoke the jab mandate policies. But she said: “There are issues that still give cause for concern.”

In a memorandum provided to the committee, the DHSC said it is “engaging with the NHS” to review recruitment policy to consider “vaccination status” when hiring new staff.

Baroness Bakewell said that any such move “needs proper evaluation in light of the pandemic experience”. And she said it was “disappointing” that the DHSC remained silent on whether sacked staff can or should be reinstated. The DHSC said that the matter of rehiring staff was to be decided by “each individual employer”.

Why is the Government not making clear that now we are ‘living with Covid’ there is no place for excluding people from health and social care work due to their vaccination status? Ministers must ensure ‘no jab, no job’ is not being brought in by stealth, as it is unnecessary and detrimental to the sector.

Worth reading in full.

Covid Deaths “Impossible to Calculate” as Authorities Used 14 Different Definitions, Say Oxford Researchers

The number of people who have died from Covid in the U.K. during the pandemic is impossible to determine because of the inconsistent definitions of what is meant by a coronavirus death, researchers at Oxford University have concluded. The Telegraph has the story.

Experts from Oxford University discovered that public health and statistics organisations across the U.K. are operating under 14 different definitions to classify a death from Covid.

Freedom of Information (FOI) requests, collated for a new report published on Saturday, show that many people who died in the first wave never tested positive for the virus, particularly older people who died in care homes.

Instead, their deaths were registered as Covid simply based on a statement of the care home provider, and because coronavirus was rife at the time.

In some care homes, more than half of the Covid deaths were registered in people without pre-existing conditions, which the report authors said was “implausible” for people who needed residential care.

The authors also point out that it is unlikely that a Covid infection on its own could cause death in the absence of contributing factors, such as other illness, or the infection leading to a more deadly condition such as pneumonia.

The report also found that in some trusts, up to 95% of Covid deaths were in people with Do Not Resuscitate (DNR) orders.

The team said the confusion meant they were unable to separate deaths caused by Covid from those triggered by the pandemic response, and called for a proportion of deaths to be verified by post-mortem in future pandemics to determine the true reason.

Worth reading in full and find the report here.

Vaccine Mandate For NHS Workers and Care Home Workers Scrapped

Mandatory vaccination for health and social care workers will be scrapped in a fortnight following a Government U-turn. The Mail has the story.

Ministers were accused of undermining public confidence after Health Secretary Sajid Javid told MPs in January that the “no jab, no job” policy was “no longer proportionate”. 

Now it has been confirmed that compulsory jabs will no longer be a condition of employment from March 15th. 

It comes after an estimated 40,000 workers were fired when legislation over being fully vaccinated came into effect in November. 

Mr Javid said that it had been the “right policy when the original decision was taken”.

But he added that things had changed following “clinical evidence regarding the current Omicron variant of COVID-19, which is intrinsically less severe than Delta, and the high rate of vaccination across the population”. 

Pat Cullen, General Secretary of the Royal College of Nursing, said the change was the “right decision” but said it had come “too late for those who have already lost their jobs”.

She added: “Ministers must now urgently address the health and social care workforce crisis which is undermining nursing staff’s ability to care safely for their patients. There are tens of thousands of nursing vacancies across those services.”

Previously the NHS vaccine mandate had been paused ahead of an anticipated large number of staff losses at a time of crisis. The policy was put out to consultation, and the Government decision has now been announced, with the care home worker mandate, which had come into effect in the autumn at the cost of an estimated 40,000 workers, also being scrapped. This will allow any sacked workers who want their old jobs back to offer their services again.

Good news – but it’s a tragedy that hard working staff were put through this at all. And a further tragedy that care home residents have had to suffer the consequences of under-staffing, which alongside the rigours of Covid protocols will have taken its toll.

Vigilance will be required to ensure mandates don’t creep in via professional bodies or other means.

Worth reading in full.

Care Homes With the Fewest Covid Deaths Had the Highest Total Deaths Because So Many Died of Isolation, Study Finds

Researchers from the University of Notre Dame in America have analysed the deaths data from U.S. nursing homes and come to a disturbing, if not unexpected conclusion. While ‘higher quality’ nursing homes generally had lower Covid deaths, they had higher overall deaths, and this appears to be because the brutal Covid isolation protocols they followed to reduce transmission proved deadly in their own right. Furthermore, while the difference between the Covid death rates in higher and lower quality nursing homes diminished after the first wave, the difference in total overall deaths continued to increase, suggesting, tragically, that the brutal protocols were continued long after they ceased offering any benefit at all.

The background to this tragedy is that on March 13th 2020, the U.S. Centers for Medicare and Medicaid (CMS) recommended that nursing homes restrict “visitors and non-essential personnel” from entering the home and cancel “in-person dining and other group activities”. These policies, the researchers write, came at a considerable cost in human wellbeing: “An abundance of qualitative evidence from nursing home staff, administrators, and resident family members suggests that the lack of in-person contact with loved ones and other residents not only generated feelings of loneliness, isolation, and despair, but may have also expedited death.

They continue:

Existing research shows that social isolation increases both dementia severity and the likelihood of adverse outcomes among those with Alzheimer’s and mortality among the elderly. According to CDC provisional data, there were 56,464 excess deaths (i.e., realised deaths above that which is predicted using historical averages) among Alzheimer’s patients through early October of 2021; however, only 22,709 or 40% had a corresponding positive COVID-19 diagnosis, leaving 60% of these excess deaths not directly related to the disease but to other aspects of the pandemic.

Respond to the Government Consultation on the NHS and Social Care Vaccine Mandates

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The Government has opened a consultation on the NHS and social care vaccine mandates, entitled: “Revoking vaccination as a condition of deployment across all health and social care.” You can respond here.

It closes on Wednesday (February 16th), so if you intend to respond, don’t delay. Ex-footballer and lockdown and vaccine sceptic Matt Le Tissier has tweeted about it, questioning the reason for the short timeframe. If the Government intends (as it appears to) to revoke the mandates, however, then a shorter consultation may mean it can get on with it, ending the uncertainty and relieving the staff shortages in social care.