Care home owners protest over pressure to admit hospital patients

Care home owners in Wales have protested they are being put under pressure to admit patients from hospitals when they haven’t got access to tests and enough personal protective equipment to shield residents and staff from the coronavirus.

Mary Wimbury, the chief executive of Care Forum Wales, has written to First Minister Mark Drakeford saying they Welsh Government appeared to be willing to sacrifice 20,000 vulnerable care home residents.

She called on Prof Drakeford to disclose the Welsh Government’s own risk assessment in relation to discharging patients from hospitals to care homes.

While she understood the importance of creating more capacity in hospitals and saluted the courage and dedication of NHS staff, Care Forum Wales was concerned that sufficient attention was not being given to a larger threat than to the general population of Wales.

According to Ms Wimbury, care homes for the elderly looked after residents who were in the extreme high risk category for Covid-19 as they were predominantly over the age of 70 and had underlying conditions.

She said: “Our members already report being pressured into admitting patients from hospitals and following  publication of the discharge guidance this may well increase. “But they feel they can only safely do so with adequate personal protective equipment (PPE) and appropriate use of testing.

“This is in order to fulfil their duty of care to existing residents, who have already been physically parted from family members and friends for some time to protect them from the virus.

“But it is also to reassure staff, who have their own health and families to consider, that is sufficiently safe for them to continue working.

“There has to be joined-up thinking around hospital discharges, which is not happening at present.

“We have real concerns that, without improved planning and liaison with the sector, the current approach will quickly lead to an avoidable disaster as we have already seen in care homes in Liverpool and Glasgow, and more starkly in Paris and Madrid.

“At present, CFW is unable to reassure its members, as we have no evidence that Welsh Government – through its agencies – will provide the significant resources that will be needed when care homes have, as they surely will, significant number of residents with the infection.

“Nobody disputes that increased NHS bed capacity is likely to be required in the next few weeks, and therefore that hospital discharges may be necessary.

“What, however, is less clear to our members, their staff and residents’ families is how the risk of these current discharges – to environments with highly vulnerable existing residents – is a proportionate risk.

“Our members are deeply concerned that, without clear explanation by NHS Wales and Welsh Government of its risk assessment and resourcing arrangements, the current discharge approach – without tests and without sufficient full PPE – gives the appearance of ‘sacrificing’ the 20,000 older people in care homes in Wales, quite apart from putting staff at risk. This cannot be right, and is not consistent with the UK-wide policy of seeking to protect the most vulnerable.

“Whilst we recognise the situation regarding PPE is improving, it is from a very low base and at present, our members feel they are barely receiving sufficient PPE to care appropriately for existing residents in the changed infection climate.

“Some hospital discharge managers are putting huge pressure on our members to accept these new residents. Care homes want to help, but they have to do so in a way that is as safe as possible, accepting that these are unprecedented circumstances.

“The situation is extremely difficult. We are caring for our residents in a ‘lockdown’ environment with supply shortages, including difficulties obtaining hand sanitiser, thermometers and food as well as PPE.

“Staff and their families are being infected by the virus and accordingly having to go into self-isolation. This is a perfect storm that we cannot manage without significantly more resources support and clarity.

“The care home sector needs action and delivered resources, and it needs it fast. This cannot be ignored; our members need to be supported to contain the spread.

“If care homes fail their staff, residents and their families the situation will add to, rather than decrease, the pressure on the NHS.

“We suggest that the next weeks are a window that must not be missed: the situation could be sorted out before the number of infections in care homes increases significantly.

“The workforce is already down, and may be expected to decrease further as we have not reached the peak yet.

“We have asked the First Minister to look into this issue as a matter of urgency, to clarify the policy, the risk assessment and Welsh Government’s proposals to avert the additional crisis we are concerned about.”