CQC issues warning about care home staff working with Covid

Care watchdogs are investigating concerns that staff with Covid-19 have been working with care home residents as operators said absence levels are as high as 70% owing to sickness and self-isolation, increasing pressure to get staff back to work.

The Care Quality Commission has ordered several councils to investigate allegations about the practice, which puts lives at risk, and possible breaches of the Care Act relating to abuse or neglect of residents. It is understood to be dealing with fewer than 10 cases.

A summary of rebuttals offered by the Anti-Virus website to selected claims made by sceptics – detailed in full on the site.

Claim: The infection fatality rate (IFR) is very low – 99.5% of people who get it survive
Response: The 0.5% figure has been challenged by significantly higher recent estimates, and it understates how lethal Covid is to older people who get it. The IFR is being kept low by lockdown – and if the virus were allowed to spread, the death rate would be higher because there wouldn't be enough space in hospitals to treat those who need it.

Claim: 91% of Covid ‘cases’ are false positives. This is a ‘casedemic’
Response: This theory is based on a statistical misunderstanding, and since during the summer (when Covid cases were low) only 0.3% of tests were showing positive results, it cannot be that a much greater proportion of positive tests are now “false”. In any case, the huge rises in hospitalisations and deaths disprove the idea that people aren’t really getting sick.

Claim: There are no excess deaths
Response: The ONS recently estimated 14% more deaths in the previous year than the baseline from the previous five years – and that happened even though in the latter part of the year, deaths from causes other than coronavirus actually fell.

Claim: Lockdowns cause more deaths than they prevent
Response: This contradicts all the evidence that virtually all of the excess deaths we have seen have been attributable to Covid. Suicide rates have not risen, and violence may have fallen. Pressure on the NHS is being increased by coronavirus, not lockdown, and would only grow if restrictions were lifted.

Claim: Danish study shows masks don’t stop the spread
Response: The study was only testing protection for the wearer, not others in the vicinity. Problems with its design were pointed out before it was conducted, and there is lots of evidence from around the world that mask-wearing is associated with a lower rate of increase in the spread of the virus.

But the regulator has issued a warning to all care homes in England with the Department of Health and Social Care and council social services chiefs that “under no circumstances should staff who have tested positive for Covid-19, regardless of whether they are displaying symptoms or not, work in a care setting” until their self-isolation has ended.

The Rights for Residents group said on Thursday it had been contacted by a carer whose boss had asked her to return to work only a few days after a positive test because of staff shortages. She refused and no longer works for the care home.

In many homes, a quarter of staff are sick or self-isolating, with the ratio as high as 70% in some cases and operators are bringing in friends and family to try to cover shifts, said Nadra Ahmed, executive chairman of the National Care Association.

Public Health England data on Thursday showed there were 504 suspected or confirmed Covid outbreaks in care homes in England in the week to 24 January. The number remains twice as high as in late October, but has fallen for the second consecutive week.

There was a fall in suspected outbreaks in work settings but the 12 recorded cases in prisons was the highest since data was first published in July.

Data on Covid deaths in care homes in England and Wales, which lags behind the outbreak figures, meanwhile showed a surge to its highest level since last May, with 1,719 residents dying from the virus in the week to 15 January, according to figures released on Tuesday.

In social care, infections have led to thousands of staff taking time off sick or being forced to self-isolate, with thrice-weekly testing picking up many more cases. It has placed increased pressure on rotas and Ahmed said that while staff shortages were “not an excuse for not following the rules”, they were a serious issue.

“We have shortages of people in the sector and wanting to work in the sector and we have a staff group whose immunity will be compromised because they are exhausted,” said Ahmed. “With this variant we have more staff testing positive but also staff being ill and getting long Covid symptoms as well.”

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Ahmed said that some home care operators had been shortening visits to clients’ home to compensate for the squeezes on rotas.

A snapshot survey by the National Care Forum, another industry group, earlier this month found rates of absence ranging from 11% to over 50% and services refusing new admissions from hospitals and using agency staff to cope. It represented a huge increase in absence rates in November of 7%.

Last year half of care workers earned less than £8.72 an hour. On Thursday, Northern Ireland joined Scotland and Wales in announcing a £500 payment bonus in recognition of their efforts. England is now the only home nation not to make the gesture.

“Pressure on staffing is huge,” said Mike Padgham, chairman of the Independent Care Group, an industry association in Yorkshire who said using Covid-positive staff was “wrong”, adding: “The advice is you shouldn’t be asking Covid-positive people to come into work.”

The cases emerged from whistleblowers and inspections and CQC is working to understand how widespread the problem is. Kate Terroni, chief inspector of adult social care at CQC, said “it is unacceptable for Covid-positive staff to be in contact with residents”, but indicated that in some cases local authorities had known about the practice.

“We know that care homes are not making these decisions in isolation,” she said.

CQC said in a statement that “where we have concerns that Covid positive staff are in contact with residents we will take swift regulatory action”.

Christina McAnea, general secretary of the Unison trade union, which represents care workers, said: “Some employers are paying poverty wages and only offering staff needing to isolate statutory sick pay of £96 a week. It’s little surprise employees are now being pressured to work when they’re ill.”