Coronavirus and care homes

[WinnieHarlow]

Having just read the awful situation where 15 residents in a care home have died, surely allowing loved ones to visit could exacerbate this situation? Its a dreadful situation. Is a solution to seek alternative accommodation for the loved one in care, until Covid is over?

[quote WinnieHarlow]@RiaRoth so there care in the community article I linked to is naive?[/quote]
Yes it is totally unrealistic. There is not enough care in the community at the present so bringing people out of care homes would add to the burden.

Also half hour visits 4 times a day is not enough for many people, they would be on their own for the rest of the time, not able to mobilise go to the loo or basic needs. Many people do not have the accommodation or have inappropriate accommodation. My house does not have doors wide enough for wheel chairs to go through. My bathroom is upstairs and my mother can not walk, so a commode downstairs but no means of bathing etc. She needs two people to help her shower and use the loo......

The article is unrealistic

DoLS assessments have continued. You can find the statistics for that. This is the legal framework for ensuring people who lack capacity to make certain decisions are protected. It’s not been paused due to Covid.

@HitchikersGuide I agree with you completely. But in this situation (Covid) could home care not be supported and provided on temporary basis? Is a (hopefully) short term struggle for the carer preferable to potential death/mental anguish in a struggling care home? I’m talking about residents whose needs to not reach an overly complex threshold.

Ok @RiaRoth - I’ve got you telling me the article is unrealistic, and @schuyler telling me that it’s so realistic, that it’s actually happened already - and is telling me to find the stats as @schuyler can’t provide the evidence herself.

@WinnieHarlow Do you read any of the replies?

[quote WinnieHarlow]@HitchikersGuide I agree with you completely. But in this situation (Covid) could home care not be supported and provided on temporary basis? Is a (hopefully) short term struggle for the carer preferable to potential death/mental anguish in a struggling care home? I’m talking about residents whose needs to not reach an overly complex threshold.[/quote]
There aren't loads of people in care homes with simple needs, this is where you seem to be confused. Most people want to stay at home. Therefore if they can they do.

To move into a care home and be under dols they don't have capacity and therefore have significant mental impairment and the only option is for 24 hour care for their safety. How many families can offer than kind of 24/7 assistance and supervision?

@RiaRoth

I agree with this, we're struggling to find agencies to support our terminal and highly at risk patients in their own homes. There is not enough home care provision as it is.

Let me give you an example @WinnieHarlow my grandmother is 90. Her “only” issue is very poor mobility. She walks with a frame but only a few steps. She falls often. She needs at least 1 person, sometimes 2 people to get up off a chair and her bed. She needs help using the toilet and showering. won’t go into details for obvious reasons. She gets up 2 to 3 times in the night and needs help. She cannot carry a drink from the counter to the table which is less than a metre.
My grandmother lives at home with a full time carer in a flat that’s suitable for her; level access in and out of the flat, level access to the garden, wet room, toilet at the correct height and rails etc. She’d fortunate because she has plenty of money to pay for these things but if she was in a care home, there’s no way I could have her with me. I cannot even have her visit my house any more because there is a step to my front door, too steep for a ramp and a step down to the downstairs toilet. I’ve had both assessed by the gradient I’d too steep. She can’t use the stairs to get to the shower, she’d have to strip wash which she’d bloody hate. Totally undignified for her. Even if I could magically install a stairlift, she may not be able to get on and off it.

@riaroth I read the Guardian article where families have attempted to do this 5 months ago and were prevented. So clearly there are elderly residents with less complex needs. And yes I’ve read the replies on here, and I value them all in terms of arguing my view.

Speaking as someone who has a elderly parent with dementia ,immobile and very frail.
It might of worked for you but you need to get real not every can do this. People who say thing like this just compound guilt for carers making them struggle on at home .
Home is not always the best place quite often the house isn't suitable for caring .
Stairs, inadéquat bathroom facilities .and if someone shits themselves it's a 2 person job to change them safely.
The covid risk is huge being at home numerous cares and family members.
Not every one can do what you did and found it so easy .
I find it patronising and enraging to suggest we all can .

@Haenow it’s about where the elderly residents care/needs/safety are best met - and if this could potentially been back with a family member, this option should have been made easier/available.

[quote WinnieHarlow]@Haenow it’s about where the elderly residents care/needs/safety are best met - and if this could potentially been back with a family member, this option should have been made easier/available.[/quote]
@WinnieHarlow

What do you mean it’s not where? It’s where and how! How would you make my house accessible? Most care home residents no longer have homes, so where do they go?

@rwalker I’m sorry, I really don’t intend to be patronising and enraging. Of course not every person can do this, but if it CAN happen, it should happen - and support should be put in place. I’m just sad to read about the care home in Wales where 15 residents died, I’m sad to read that people have tried to remove their relatives and been prevented from doing so - and the support wasn’t there for people who would want to achieve this.

[quote WinnieHarlow]@riaroth I read the Guardian article where families have attempted to do this 5 months ago and were prevented. So clearly there are elderly residents with less complex needs. And yes I’ve read the replies on here, and I value them all in terms of arguing my view.[/quote]
You cannot lawfully unilaterally decide to remove an incapacitous adult from their primary residence.

You cannot lawfully unilaterally decide to remove an incapacitous adult from their primary residence.

This. In buckets.

With all due respect op, this is not how the legal side of safeguarding, MCA & DoLs works.

@haenow I’m not talking about your specific situation, I’m talking about where it could be achieved with support.

For many residents, the best interests qualifying requirement will no longer be met, because continued detention will cause harm rather than prevent it. Coronavirus is not the only “relevant circumstance” and there will be a myriad of other considerations. But there is no doubt that coronavirus is now a major consideration which local authorities ignore at their peril.

In addition, responding to the coronavirus pandemic, the European Committee for the Prevention of Torture (CPT) has published a statement of principles relating to the treatment of people deprived of their liberty. The CPT calls on all relevant authorities to take concerted efforts to find alternatives to deprivation of liberty, including reassessing the need to continue involuntary placement of psychiatric patients and, wherever appropriate, discharging residents of care homes into community care. Similarly, the UN Committee on the Rights of Persons with Disabilities has called on states to “accelerate measures of deinstitutionalization of persons with disabilities from all types of institutions.”

Furthermore, the state (which includes local authorities and all organs of the NHS such as clinical commissioning groups and NHS trusts) has an ongoing duty to protect each person’s right to life, under Article 2 of the European Convention on Human Rights. The state must not only refrain from taking life, but it must proactively take steps to protect people against threats to life. Given that coronavirus threatens the lives of everyone in long-term care facilities, the state has a duty to reduce that threat, and has a duty to take action now.

Where local authorities have failed to take sufficient or speedy action to protect life, they can expect legal claims against them for negligence and under the Human Rights Act 1998, by families of residents who have died in care homes.

The other difficulty in reality is that it is not only the very complex physical needs of most care home residents that is the issue. Sometimes, even if potential carers could overcome the physical barriers for caring for people at home - from having the time, space, safe layout, physical capability and knowledge, to accessing the correct equipment - and often paying for it because social care often does not provide anything but the most basic aides - they simply can't cope with it. Understandably. We live to a great age in our society, but often in poor health where the last years can be pretty horrific.

[quote WinnieHarlow]@haenow I’m not talking about your specific situation, I’m talking about where it could be achieved with support.[/quote]
My situation isn’t that specific, it’s fully representative of care home residents. You’re thinking of people who are getting a tad older, can’t cope as well and move into sheltered accommodation for company and security. People who live in care homes predominantly have care needs that cannot be met at home. There might be a few self funding people who are low needs but they are a tiny minority.

@HitchikersGuide - again I really like your posts. How do other cultures cope? - and what would have happened 40 years ago without the advent of care homes?

@Haenow

You can think what you like but it’s wrong. You’re suggesting that we schlep older, frail and vulnerable people out their homes to another place where it might not be safe. It might not even be what they want. People who live in care homes are still allowed their views.

Yes they are allowed views and locking them up indefinitely in care homes is not giving them choices is it!!! 🙄 When most people moved into care homes they would never have imagined a scenario where for 8 months they would not be allowed out or to see their relatives! I imagine SOME people may have made different choices had they known.

In my experience there are often a number of individual in care homes who move into them at the same time as their much more frail partner. Particularly where there is dementia involved.

The op isn't suggesting that every single care home resident should move back out into private homes! Just that where that IS an option then they should be allowed to do so.

I strongly suspect that the way we are currently treating those in care homes will be found to be illegal and against human rights!

@compulsiveliar2019 - thank you!!

Part of the problem here is also greedy care home owners. They have milked money out of the system for years by charging residents and the state high fees while paying staff peanuts. They could have invested in facilities to enable some form of contact or visiting but chose not to.
One home owner locally (an ex-nurse) has been very vocal that she shared advice to buy PPE and on infection control with other homes well ahead of the crisis but was ignored. Meanwhile another owner has decamped to their holiday home saying it is too dangerous to stay here yet doing nothing in response to complaints from families about the separation from their elderly relatives.

We should not allow home owners to shirk their share of the responsibility

@QueenOfTheDoubleWide Great post - thank you too

@compulsiveliar2019

There will be legal challenges as a result of both article 2 and article 8.
There will be those who challenge allowing visitors in and out of care homes under article 2 of the Human Rights Act.
We don’t know yet what the case law will say until people bring about challenges which they should!

What evidence do you have that there is a significant number of people (who have capacity) wanting to move out and being outright banned? If that is happening, a safeguarding should be raised ASAP. That is unacceptable. In my job, I’ve continued to help people move in and out of various care homes and supportEd living environments, even through lockdown. Younger adults with physically able parents returned to the family home. Some people actually moved to their own homes, finally. It’s been harder because home care agencies have had extra staff sickness due to Covid but people moving has always happened and hasn’t changed.