The global COVID-19 pandemic has been a difficult time for everyone and it has been particularly difficult for people who need care due to disabilities or illness. It is well known that those with underlying health conditions are at greater risk of developing severe symptoms if they contract COVID-19, and this means most people living in residential care – who predominately are older – are at significant risk from the pandemic.
There have been inconsistent messages to older people by the Government during this pandemic. Many are unclear whether they should leave their homes even to do grocery shopping, meaning many older people have been unable to get food. This has been exacerbated by the fact that for many their care support systems have broken down.
In England and Wales, the care sector was paid little attention back in March at the start of the pandemic. The NHS rightly received considerable national focus as they were at the frontline treating those with COVID-19, yet the care sector – which is just as much on the frontline – received little to no attention. Until April, care home figures were not even included in the national coronavirus infection or death statistics, and when they were finally included it became clear that there was a real problem.
While there are some issues in determining the number of deaths in long-term care facilities given the delays in testing, a recent report by LaingBuisson predicts that by Autumn more than half (57%) of all COVID-19 deaths will be in care home settings.
Social care has a difficult history in the UK, with significant undersupply, underfunding and complex funding and provider structures leading to successive governments' continued promises of reform yet to be fulfilled. The 2011 Dilnot Report offered a credible and costed way forward to address the difficult issues in social care, but nearly a decade on the issues addressed in this report remain unresolved.
So the care sector that was already struggling before the COVID-19 pandemic has over the last few weeks been in crisis mode. The sector has struggled to order enough personal protective equipment (PPE) resulting in both staff and residents in care homes being put at risk of infection.
Getting tested for coronavirus has been variable and, in certain parts of the country like Cumbria, people have had to travel more than two hours to the nearest testing centre, and then wait days for the results. Government testing targets saw a push for everyone in the care sector to be tested once, rather than establish a system whereby staff and residents were being tested on a regular basis. Only now, three months into the crisis are some of these issues regarding PPE and testing starting to be resolved.
People with dementia have been particularly hard hit. More than 70% of people in residential care homes suffer from some form of dementia and, according to The Alzheimer's Society, one in four of those who died from COVID-19 in the UK had dementia, most of whom were probably in a residential care facility. Due to early lack of reporting, we cannot know for certain what the official coronavirus death toll figures have been in residential care facilities, but the information we do have confirms that this sector was very badly hit during this crisis.
To help with the costs of the pandemic, the Government has launched its support package of £600m to care homes, as well as access to a clinical lead. However, while this is a good start, this support has come too late and comes after thousands have died already. The care home sector ought not have been ignored in planning for the pandemic, and this crisis has shown how much further we need to go to ensure the care sector receives the support and recognition it deserves.
The pandemic has laid bare quite how deep the care crisis runs in the UK. It is time for urgent reform of the care sector to address fundamental structural problems and to ensure far stronger integration with the NHS and national coordination and proper resourcing of the service. The social and economic costs of failing to act are simply too high to ignore.
Baroness Sally Greengross OBE is a cross-bench peer and chief executive of International Longevity Centre UK
