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Health inspectors have uncovered multiple problems with infection control and the use of personal protective equipment in care homes in England ahead of a second spike in Covid-19, which is starting to be detected in care facilities across the country.
The Care Quality Commission (CQC) found homes where PPE was not being worn and that had out-of-date infection prevention policies and were failing to take steps to protect black and minority ethnic residents and staff who have been identified as potentially more vulnerable to the virus.
The checks took place last month in 59 English care homes and were triggered by concerns about safety and quality or complaints by residents, staff and relatives.
The checks precede a government announcement within days of a winter infection control fund that is expected to broadly match the £600m already committed this year. The fund will pay additional staff costs stemming from using less highly mobile temporary workers who have been shown to spread the virus.
Official figures showed rising infections in care homes, largely among staff, according to operators, leading to fears the virus will shortly spread to resident populations.
In the week ending 6 September, 4.2% of infections in England were in care homes – equivalent to 513 cases, Public Health England data showed. The previous week the proportion was 2%, equivalent to 159 cases. Infections rose further last week, according to a government briefing to the sector, and one national care chain, which spoke on condition the Guardian would not name it, said infections had spiked from just four two weeks ago to 78 now, 54 of them staff members and all asymptomatic.
Boris Johnson said in parliament on Wednesday that he was “concerned about the rates of infection in care homes” and wanted to “see a toughening up of the rules governing the movement of workers from one care home to another”, which has been shown in studies to have spread the virus, and that he is concerned about rising infections in the facilities.
A series of measures to improve protection against Covid-19 in social care this winter is expected to be announced later this week and will include free backup supplies of PPE to care homes to ensure that no home has less than a two-week stock, a Whitehall source said.
Labour’s shadow care minister, Liz Kendall, said: “With infections in care homes rising again, and winter and the flu season fast approaching, it is essential that care services get the resources they need to cope with the extra costs of Covid. Ministers must ensure the infection control fund continues beyond September. This critical funding has been a lifeline for many care homes.”
However, the CQC inspections found PPE being worn inconsistently by staff members, limited supplies of masks in some places and a failure to store PPE safely away from infection risk.
“We found examples of infection prevention and control policies that were out of date,” the inspectors said. “Some had been updated early on in the Covid-19 outbreak but had not been amended since and so contained out-of-date information. This posed a risk to the staff and people who live in the care home. Others had not been updated since 2019. One care home had completed a [contingency] plan, but it only covered the hot weather and did not include preparations for autumn and winter.”
There were positive signs hospital patients are now being admitted safely in most homes, with sufficient testing and isolation of new residents. People discharged into care homes without tests was one likely cause of infection spread in the spring when over 15,000 people died of confirmed or suspected Covid-19 in care homes in England.
“It is vital all providers get this right to ensure that everyone receives safe, effective and good quality care,” said Kate Terroni, chief inspector of adult social care at CQC. “We have pointed care providers to guidance on how to prevent, control and protect care workers and those they care for from Covid-19 infection, highlighting the importance of risk assessments which consider factors, including ethnicity, which could mean that people are at increased risk from the virus. Where we have concerns, we can and will take regulatory action to ensure that people are safe.”
“The vast majority of providers that we hear from have PPE and have their staff trained in its use,” said Nadra Ahmed, chairwoman of the National Care Association, which represents independent care groups. “They are better prepared than they were. They have supplies to last a month to six weeks and staff will grow in confidence in how to wear PPE.”
Source: The Guardian
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