Care homes were “thrown to the wolves” at the height of the coronavirus pandemic, a cross-party committee of MPs has argued.
A new report by the Public Accounts Committee said that “years of inattention, funding cuts and delayed reforms” had left the sector badly exposed to the virus.
And they condemned an “appalling” decision to allow some patients to be discharged from hospitals to care homes without being tested for Covid-19.
But the government said it had worked to offer “guidance and support for adult social care” amid an “unprecedented” health crisis.
The fate of England’s social care sector has been a key focus of the political debate over ministers' response to the coronavirus.
Boris Johnson angered some care organisations earlier this month after he said “too many care homes didn’t really follow the procedures” to contain the spread of the virus.
And the prime minister drew further criticism after claiming that “nobody knew” the extent to which Covid-19 could be transmitted by people who did not display symptoms in the early stages of the pandemic.
But the report by the PAC said it was “already becoming clear in late March, and certainly from the beginning of April” that coronavirus could be transmitted asymptomatically.
And it therefore condemns the “appalling error” of allowing some patients to be discharged from hospital into social care without testing them first.
“Shockingly, government policy up to and including 15 April was to not test all patients discharged from hospital for Covid-19,” the report finds.
“In the period up to the 15 April, up to a maximum of five symptomatic residents would be tested in a care home in order to confirm an outbreak.
“Belatedly, after discharging 25,000 people from hospitals to care homes between 17 March and 15 April, the [Department of Health and Social Care] confirmed a new policy of testing everyone prior to admission to care homes.”
The report adds: “The department does not know how many of the 25,000 discharged patients had Covid-19.”
The committee orders ministers to review which care homes received discharged patients and then went on to have Covid-19 outbreaks and then “report back to us in writing by September 2020”.
'Confusion and stress'
The MPs also say that a failure to give “consistent and coherent guidance” to care homes throughout the pandemic had left providers facing “confusion and poor central control over critical elements of the pandemic response”.
It was, the committee says, “unclear who was leading on the social care response”, with the government presiding over a “fragmented system” that heaped “confusion and stress” on staff on the frontline grappling with issues including an inadequate supply of personal protective equipment.
And the committee issues a fresh plea to break England’s long-standing political deadlock over social care funding, warning that the pandemic has “shown the tragic impact of delaying much needed social care reform”.
Social care has, the committee argues, been seen as the NHS’s “poor relation”, with a “stark contrast” between the help provided to the health service and that offered to care homes.
“It is simply unacceptable to hear reports of inadequate PPE, lack of testing and insufficient guidance on training,” the PAC said.
“There have been warnings of an increased risk of provider failure in the care sector, and the Local Government Association and NHS Providers have reiterated the need for urgent reforms to put social care on a sustainable footing after years of under-funding. “
The government is told to set out in writing by October “what it will be doing, organisationally, legislatively and financially, and by when, to make sure the needs of social care are given as much weight as those of the NHS in future”.
Launching the report, committee chair Meg Hillier said: “The failure to provide adequate PPE or testing to the millions of staff and volunteers who risked their lives to help us through the first peak of the crisis is a sad, low moment in our national response. Our care homes were effectively thrown to the wolves, and the virus has ravaged some of them.”
The Labour MP added: “Vulnerable people surviving the first wave have been isolated for months, in the absence of a functional tracing and containment system. Yet there were bold and ambitious claims made by ministers about the roll out of test, track and trace that don’t match the reality.
“The deaths of people in care homes devastated many, many families. They and we don’t have time for promises and slogans, or exercises in blame. We weren’t prepared for the first wave. Putting all else aside, government must use the narrow window we have now to plan for a second wave. Lives depend upon getting our response right.”
'Minister must act'
Fellow committee member Sarah Olney, a Liberal Democrat MP, said: "People deserve better. Ministers must read and act on this report before it is too late to prepare for a second wave. That means rapidly upscaling the strategy to test, trace and isolate every case of coronavirus to keep people safe and prevent new surges.”
And she added: "To improve public confidence, the prime minister must set out a timetable for the independent inquiry into the government’s actions. With that, we can ensure the same mistakes never happen again."
The call to shake-up the funding system for social care in England funded was echoed by the NHS Confederation, which represents organisations working in the healthcare sector.
Director Layla McCay said: “This report makes difficult reading but at its heart is the need for social care reform.
“Politicians from all parties have ducked this for far too long – we need decisive action now to ensure social care services and staff have the support and resources they need.”
A Department of Health and Social Care spokesperson said: “Throughout this unprecedented global pandemic we have been working closely with the sector and public health experts to put in place guidance and support for adult social care.
“Alongside an extra £1.3bn to support the hospital discharge process, we have provided 172 million items of PPE to the social care sector since the start of the pandemic and are testing all residents and staff, including repeat testing for staff and residents in care homes for over 65 or those with dementia.
“We know there is a need for a long-term solution for social care and we will bring forward a plan that puts social care on a sustainable footing to ensure the reforms will last long into the future.”
Officials said patients were only discharged when it was clinically safe to do so and when it was deemed that they would no longer need acute care — with the government’s 15 April Adult Social Care Action Plan requiring all patients to be tested before being released into a care home.
Matt Honeycombe-Foster is acting editor of CSW's sister title PoliticsHome, where this article first appeared.