To think care home bosses should take some responsibility for Covid infections in homes

[JustAsking1837]

This is just in response to criticism over Boris Johnson's comments. Sorry if this has already been done but I've not found any threads on this surprisingly. I am no fan of Boris or the Government but day in day out I have listened to the press savagely criticise the Government no matter what it does or doesn't do and is blamed for everything. However everyone is in uproar when Boris has suggested that many care homes may have not done everything they should have to prevent infections. I am not necessarily saying they are to blame, as I don't know, but think it should be fair game for discussion.

We have had management work on the floor, in the other part of our care home. They too have had to do jobs of housekeepers, who have been off sick.

So did we, ours are registered nurses as well as managers and company owners, they worked when many of us were off sick with Covid and some went on to get sick with it too.
I hope all the people on here trying to stick the knife in come back and appologize after it all comes out how we got the short end of the shitty stick.
Remeber they blamed the firefighters for Grenfell.
The blamed the fans for Hillborough
They blamed the village for Aberfan.

So it all sounds very familiar.

OP are you another new joiner just joining to create an online focus group or are you too ashamed to bash care workers under a regular name?

@JustAsking1837

I remember reading somewhere about a month ago that covid deaths in care homes were concentrated in about 25% of care homes. Does that mean that 75% of homes were coping with it in a better way?

None of the care homes in my area were affected. I suspect it's because they're a good 30 mins away from the nearest hospital so didn't get hospital discharges.

I can’t help wondering how easy it is to test people with any degree of dementia past the early stages, when they won’t have a clue what’s going on or why, and may well be resistant to perfectly normal procedures, like getting washed/dressed/brushing their teeth.

I haven’t been tested myself, but I gather that it’s not comfortable.

And if such a person did test positive, I dread to think how terribly distressing it would be for many such to be isolated - which would almost certainly mean locking them in their room, since they’d never be able to remember that they must stay there. Especially when pacing or endlessly wandering up and down is so often a feature of the disease.

I (used to) visit a lot of care homes for my work. It was fairly random which ones had large Covid outbreaks (20 or so residents dying) and which did not. From my prior knowledge it didn't seem related to quality of care. Many of the homes I think are the best at dementia care had the worst outbreaks and some I think provide crap care did not. One locked down straight away when most of us thought they were over-reacting. Still had 22 deaths.

Infection control would dictate sterile environments, staff in PPE and ideally residents isolated in their rooms. Whereas good quality of life is exactly the opposite: homely environment, social interaction, families welcomed etc Maybe that's why some decent places had big outbreaks.

Right now many residents in care homes are having a really shit time. No family visits for months on end. No group activities or meals. Getting isolated in your tiny room 24-7. That is also a tragedy. Some of my patients say they'd rather take a risk of dying and be able to hug their grandkids than have a few extra months like this.

In Italy and in Spain some residents were found abandoned in care homes after staff left if you recall. That did not happen in the UK but it easily could have done. The LA had to step in to run some homes here as they did not have enough staff with everyone off sick and isolating and if they got agency in were criticised for spreading infection. When you read of managers allegedly pressuring staff to come to work with symptoms think about the alternative. If there were no staff to care for them residents would be abandoned and neglected. What is a care home manager supposed to do? Risk of infection or neglect?

I think care homes had no real chance to avoid this. They could not get PPE- even the NHS was running out, guidelines were confusing and changing every day.

There was a huge push to clear out hospitals for younger people. It was a deliberate policy decision. Early on there were no tests. No-one could get one outside an acute hospital or ITU. Later when they did start to test before discharge there was still insane pressure to accept transfers without knowing the result because 'you can isolate them anyway' ignoring that very demented wandering people cannot be effectively isolated.

Care homes can only survive because residents are placed there by hospitals and by the LA. If they were blacklisted as a provider they would go under. Only those very fortunate and very expensive places that are private only can afford to say no to the CCG and the LA. Private it cate homes are largely in London and the South East where property prices are such that astronomical fees can be sustainable. Not many private care homes in poor cities in the North.
So that's poor people thrown under the bus again.

The government holds all the power here and they are squarely to blame.

The test is horrible, swabbed right at the back of the throat and swab right up and back of the nose. We did try to test a few of the residents with dementia and none of them could handle it.

It would be an utter disaster if it ever came into our home.

Several care homes in my area reported ambulance services turning up in the middle of the night (usually around 3am) with vulnerable elderly people in tow saying they were under strict orders to discharge them back to the home. When refused readmission on Covid grounds in the middle of the night, on one occasion, the ambulance staff took the resident back to hospital then turned straight back around and took them back to the care home. The care home was reported by the ambulance crew and a “safeguard” was raised for refusing admission to a vulnerable elderly person in the middle of the night...which was promptly thrown out by the LA and the CQC as clearly the home was trying to prevent a death.

Later on, the same home, and the same ambulance driver when Covid did get in (due to an asymptomatic Covid positive patient with dementia being readmitted a few days prior to lockdown) was telling agency staff to “walk out, the place is riddled with Covid and you’ve got nothing to lose, you are only agency.” This man was literally suggesting staff abandon dementia patients.

Agency staff HAD to be used because regular staff were isolating with symptoms or advised to shield or had sick family members. It’s not a case of “only bad homes used agency staff”...it’s a case of the home needed staffed 24/7 or either that there would have been NO staff.

The homes where staff moved in permanently for 3 or 4 months, abandoning their own children and dependents and sacrificing that for their residents were not a manageable model for most homes. It’s amazing and testament to those carers and homes that did so but those were the exception, not the rule.

@MatildaTheCat

My DF died from Covid in a care home and whilst I completely hates the place for many reasons, I don’t think they could have acted differently in the crisis.

Their staff and residents were dropping like flies, the only PPE they had were paper masks and plastic aprons ( in hospital staff had full PPE for known virus cases by then). The care the residents required meant social distancing was impossible and the layout of the building would have made distancing impossible in many areas and also very difficult to keep properly cleaned.

So no, they needed more support desperately. I’m sure many of the staff will suffer from PTSD after what they experienced.

My FIL is in another nursing home and that was extremely well resourced. He still got the virus (and recovered at 92!). They are now too scared to reduce their strict rules and the residents are getting virtually no visits and no social time. He’s been a ‘prisoner’ in his room for months. So that’s pretty shit too.

Boris needs to apologise.

I'm so sorry for your loss @MatildaTheCat, and I hope the situation changes soon so your FIL can have visitors

I haven't RTFT. The care home and staff have been left to take the brunt some traumatised from the experience.
The majority of victims never got to an acute hospital the staff nursed them through their death.

There was a huge push to clear out hospitals for younger people. It was a deliberate policy decision

Yes exactly. And as you say, care homes were struggling to push back on hospitals especially in a climate where they can be blacklisted for not "cooperating". Care homes were going bust before the pandemic and were not responsible for government's failure to address social care in old age. Certainly around here hospitals were discharging people into care homes without testing but saying they were not infected and subsequently they took infection into the home.

Care providers were also not able to get PPE partly due to chaos early on and the lack of a stockpile (decision to cut stock pile taken last year by current government). Suppliers were told to prioritise NHS for stocks and carers simply couldn't get the kit. Carers were going to work unprotected and wearing bin bags for aprons in some cases.

Then there was also a failure to manage costs so small care agencies were being asked to may tens of pounds for PPE items which normally cost pennies per unit. In France the government controlled prices of critical items, here it was left exposed to rampant profiteering.

So frankly, even if you find an incompetent care home manager that pales into nothing compared to the shambles and incompetence in the government's management and lack of preparedness.

The worst thing for me was that we knew about patients being found abandoned in Spanish care homes, some of them (and some staff) dead in their beds. It was clear from the news stories that care homes were an area of vulnerability both due to the greater risk to residents and because of the risk of staff did decide to leave/not undertake appropriate control measures. I remember being horrified by stories of relatives standing outside care homes having been told informally there was an outbreak but not doing if their family were affected, and I thought we would be able to take steps to avoid similar because we had a couple of weeks to prepare.

And sure there have not been the same stories of the army having to go in to get cafe homes under control but the government sure as hell don't seem to have used that time wisely when it came to care homes.

I don’t know how Johnson dare shove the blame on care homes after his failure to manage the entire COVID crisis at every step of the way and in every possible way.

I thought I couldn’t despise the man any more but after this latest blame shifting, I have managed to find some more loathing for him.

No one is to blame for any covid
infection
Unless they have deliberately ignored guidelines or done out of their way to infect someone
People in homes are in the last few years of life and sadly a cold killed my mum in the end. I didn't go after the person who came to work that week with sniffles or her boss

What precautions were there in care homes to prevent staff from infecting each other during tea breaks/lunch breaks etc?

In France the government controlled prices of critical items, here it was left exposed to rampant profiteering.

2nd July -
"A collective of French health care workers said Thursday it is seeking a broad legal inquiry into France’s failure to protect its members and their colleagues by providing adequate masks, gloves and other protective equipment as the coronavirus swept across the country."

"More than 60 other legal complaints have been filed so far over how France, which has reported the fifth-highest number of virus deaths worldwide, managed its virus outbreak."

apnews.com/65200b5980d2a88ac3465b2587539b55

@Clavinova

Staff were not supposed to take breaks together and were clearly expected to social distance when they could. Of course it’s not always possible during care giving but certainly in breaks staff were not all sitting round having cosy chats and physically on top of each other. They were to distance and wear masks the vast majority of the time.

Care homes were also expected to pay for taxis etc rather than allow their staff to travel on public transport.

Yes Clav why aren't we seeing similar in the UK ? though there is a apparently a judicial review being sought, crowd funded.

The govt is refusing point blank to engage in any sort of enquiry into the CV debacle and remember, our excess deaths total is way above that of France as is our per capita death toll too.

Now is not the time, nor will it ever be.

IF we ever do see a public enquiry, it will be in many years hence, under a different administration, even the Grenfell one is 3 years later still on going and far less controversial.

Yes Clav why aren't we seeing similar in the UK?

From the link;

"The professional association, Collectif Inter Urgences, (Inter-Emergencies Collective), said it was filing a four-count civil complaint alleging manslaughter, involuntary harm, voluntary failure to prevent damage and endangering the life of others."

OP are you another new joiner just joining to create an online focus group or are you too ashamed to bash care workers under a regular name

I've not said anything to bash care workers. I have referred to care home bosses, those who make the strategic decisions within the care home

manslaughter, involuntary harm, voluntary failure to prevent damage and endangering the life of others

Do you think Johnsons Govt isn't guilty of the above?

Actual and excess deaths way over that of France and Germany, that should have to be explained in a court of law.

"A collective of French health care workers said Thursday it is seeking a broad legal inquiry into France’s failure to protect its members and their colleagues by providing adequate masks, gloves and other protective equipment as the coronavirus swept across the country."

Fascinating dear, but what does this have to do with teh French government's quick action on controlling prices of critical supplies?

I appreciate your commitment into jumping onto every thread to defend even the least defensible actions of the current government but try to make the point vaguely relevent next time you google.

@JustAsking1837

Most care home bosses are absent from day to day running, so in the two care homes my mum worked at, one was owned by venture capitalists and the other by a restaurant owner.

The care home manager made the decisions.

The scandal which is the care home industry is well documented, with many owners not even in the UK, the Govt allowed this.

Guidance from PHE was that CV posed little to no risk to staff or patients, care home managers and nursing staff actions were based on that advice, by the time that advice changed, the damage was done, even now, staff and patients are not being are not being routinely tested, forget about agency staff, they don't exist in Johnsons world.

You make some very valid points Jasjas

I've not said anything to bash care workers. I have referred to care home bosses, those who make the strategic decisions within the care home

From your post:
Boris has suggested that many care homes may have not done everything they should have to prevent infections

He actually stated rather than suggested and you didn't distinguish care home owners/managers from the staff.

jasjas1973
Do you think Johnsons Govt isn't guilty of the above?

No, I don't, but you posted;
"why aren't we seeing similar in the UK?" / "The govt is refusing point blank to engage."

As far as I can tell the French government haven't got a choice in the matter.

C8H10N4O2
Fascinating dear
I agree.

try to make the point vaguely relevant next time you google.
It was.

forget about agency staff, they don't exist in Johnsons world

Yes and they deliver the bulk of social care to the elderly in the UK. The way social care is costed and delivered is bids from lots of small agencies with the cheapest selected (unless the client can pay their own way). This creates a constant push down on cost and results in low pay, poor conditions and inadequate visits for many recipients. Carers regularly express their frustration and not being able to do a better job as they have to whizz from one patient to the next.

Social care is a shambles in England and a disgrace to a modern, wealthy economy.

I also agree with your distinction between care home owners/managers for the large chains (for whom the properties were a simple capital asset benefit) although there are still many homes individually owned by people whose careers have been in the sector or in healthcare.