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The Continuing Testing Shambles in Care Homes

The failure of the government to get to grips with testing of residents and social care workers in care homes and in the community shows no signs of letting up.

Care home operators have accused the UK government of “a complete system failure” over testing for COVID-19 after officials repeatedly deflected responsibility for the task and left vulnerable residents unchecked.

As ministers admitted, it will be more than three weeks before all homes are offered tests, care home managers said lives have been put at risk and conditions for dementia sufferers worsened because of the government’s failure so far to test hundreds of thousands of staff and residents.

Confusion in the system

A major problem leading to confusion lies behind government announcements of what providers believe is imminent action, when in reality there can be weeks of delay. The Testing programme announced by the health secretary, Matt Hancock, two weeks ago has resulted in only tens of thousands of people being tested, when there are more than 400,000 people living in care homes, looked after by a workforce of 1.5 million.

Nor is it just the failure of government to meet testing targets, it is the frustration felt by care providers when they try to identify who is responsible for carrying them out.

Public Health England (PHE), the Care Quality Commission (CQC) and the Department of Health and Social Care (DHSC) have repeatedly passed the buck about who should carry out the tests.

Matthew Nutt, managing director of Accurocare which runs homes in Oxford and Basingstoke, was told eight times by PHE that CQC was responsible for the programme and four times by CQC that it was PHE’s job.

“The left hand doesn’t know what the right is doing,” he said.

Last Thursday, a DHSC official told him PHE was in charge and another said it was CQC. That contradicted what CQC told him 24 hours earlier: that its involvement in testing care staff ended on 25 April.

His organisation has been trying to obtain about 200 tests since 28 April, when Hancock announced that testing for all care workers and residents would be available regardless of whether they are showing symptoms of coronavirus. So far, he has received none.

On Tuesday Hancock claimed, “the performance on testing has been unbelievably positive”.

“It has been a complete system failure,” said Nutt. “We don’t know when we are going to get test kits. The government’s plan to lift the lockdown says all homes will have testing by 6 June. It’s far too slow. How many more people have to die?”

Who is responsible?

Ultimately the government is responsible for the strategy on testing, but it is continually changing its mind on who should be responsible for coordination of the tests.

Labour’s shadow care minister, Liz Kendall, said that accounts from providers revealed “total chaos” in the system.

“Weeks into this epidemic ministers still haven’t got to grips with the basics of testing residents and staff,” she said. “Reports from the frontline show total chaos as national bodies squabble over who is responsible, leaving care home managers and staff struggling to cope. The government’s own ‘recovery strategy’ document says they won’t guarantee every care home will even be offered testing until 6 June. This is not good enough.”

The government has showed signs of shifting its strategy after originally saying CQC was “leading co-ordination of testing for the care sector”. On Thursday it gave local public health directors the role saying the system needed to be “more joined up”. In a letter, the care minister, Helen Whately, described it as “a significant change” and said that soon there would be capacity for 30,000 tests of care home residents and staff a day.

A lead for every care home

A further shift in strategy has recently occurred. This week the government announced that every care home will be linked to a lead person, who presumably will advise providers on arrangements on testing.

Summary

On Sunday I noticed that the general publics rating of the government handling of the COVID-19 pandemic had dropped from 60% to 29%, and no wonder. The drop in the rating I believe can be contributed to the mishandling of the catastrophe in care homes. The shambles in testing and confusion about who is responsible for co-ordinating the system continues. This lack of clear responsibility is contributing to residents and social carers loss of life.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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