Partial, confusing, incomplete. The long-promised data published recently by the Care Quality Commission are worse than useless in understanding how care homes responded to the Covid pandemic. This from England's care regulator, although, thousands of care home residents died and tens of thousands are still prevented from seeing their loved ones.
It took the CQC six months to provide this information and, very grudgingly, it finally published one new, confusing and partial table, which reveals almost nothing about the impact of the pandemic on the care homes it regulates.
The regulator has argued ferociously for months that it could not provide the data under a Freedom of Information request, for fear of it being misinterpreted. And, yet, from these statistics it has published, it looks like a case of all that fuss about nothing. The percentages of deaths appear to relate quite closely to the percentage of care homes in each 'rating'. But the CQC's new information is so pared down, you have to wonder what the regulator is hiding.
According to these carefully-selected figures, residents in all types of care home – from Outstanding to Inadequate – had very similar experiences. But, from the CQC's own recent reports on care homes, we know this is not true. There have been some horrific inspection reports into some homes, which saw numerous deaths. And many many homes had no deaths.
But the information is so sparing, so carefully-tailored it is insulting to imagine that it answers any of the perfectly legitimate questions about how care homes coped during Covid and why so many people died in some homes - but not in others.
For a start, the table published relates only to percentages of deaths in care homes by overall rating. The CQC gives no information about:
· How many people actually died – either overall or in each category.
· How many care homes in each category actually experienced deaths – (there were no deaths in many homes, so without this information any statistics are useless).
· How many care homes in each category saw Covid outbreaks, not just deaths – which, again, would give a greater insight into the impact of the pandemic.
· How many residents died outside of care homes. This may be important, we don’t know.
· The average number of deaths per care home in each category – this would allow insight into the spread of Covid.
· Deaths/incidents over time – this would allow understanding of how the sector coped over time. Although early on, Covid may have been spread by hospital releases, how did homes across the sector cope?
· How many incidents and deaths took place in homes by ‘Safety’ rating, rather than just overall rating. Many homes have poor Safety ratings which, otherwise, have positive grades.
And, critically, the CQC says nothing about which homes had no deaths or outbreaks. What category were they in?
There is so much about CQC’s response that is unsatisfactory and yet it has all of this information to hand. The CQC is nothing if not highly digitised – although it refuses to answer Freedom of Information requests.
An OLM reader points out: ’In their report on infection prevention and control, the CQC explain that the sites inspected as potential ‘good practice’ examples included some with no outbreaks/deaths. The ‘high-risk’ sites visited are said to be those with “concerns about safety” etc., but we aren’t told whether this criterion included relatively high Covid-19 death rates...
‘Perhaps the CQC should be open about whether and how they have taken account of these death rates in selecting the high-risk homes for inspection and, if they have not done so, why not.’
Elsewhere in last month’s report, the CQC reveals, more than one third of care homes are still not taking appropriate steps in terms of Covid control. And that is based on the ‘assurance’ of the care homes that they are doing a good job, ie two thirds tell the inspectors that all is well and the inspectors believe them.
Great job, CQC. Time for a few more FOI requests.
Dear Philip Patrick
Thank you so much for your reply. The way older people are treated in our society, should be a source of shame. And those with responsibility for taking care of vulnerable people are too often, the most culpable. As you say, it's important not to give up, but take care.
Best wishes
Sarah
This extensive review of the Care and Quality Commission is the most difficult I have ever written as my personal experience in seeking their help is truly horrendous. Hence that is why it has taken so long to write objectively. My late Mother spent the last 2 years of her life in a local nursing home when I could no longer care for her due to the onset of dementia. Upon one of my frequent visits I noticed bruises on both her wrists that were clearly the shape and outline of hands. It was obvious that my Mother had been physically manhandled but was incapable of telling me what happened. As evidence, I took photographs of these bruises on my mobile p…