UKC

The government rejected PHE advice for a tighter lockdown.

https://www.theguardian.com/world/2020/may/28/government-rejected-radical-l...

Treason. They are all guilty of Treason against the populace.

"In law treason is criminal disloyalty, typically to the state. It is a crime that covers some of the more extreme acts against one's nation or sovereign."

Be interesting to see exactly who in government made those decisions.

It does seem somewhat mad. A late ineffective shutdown and seemingly no real attempt to protect those most at risk indeed in some ways the opposite. Sending people back from hospital to the care homes without proper tests.

And also valid reasons why they did not do it.Having been in some of those homes they clearly did not have suitable places for employees to stay 24/7 and I doubt of the 53,000 homes all of of them had the capacity to do this effectively.Some homes did adopt this procedure themselves, it would be interesting to find out if this worked or not.

Not an easy one.

Also agency staff moving around different care homes seems particularly daft in the midst of a pandemic… 

Unfortunatley that is the way that the care home and care sector operates to cover staff abscences etc. I doubt it was avoidable to eliminate that risk. Altlhough I suspect those homes which are well managed will have addressed and managed that issue.Please remember that for some staff it suits them to be agency staff.

That some dont have the places or capacity doesnt really seem an argument just to give up as opposed to try and cover as many as possible.

Be expensive but then the question would be how many lives saved and whether by heavily sheltering them restrictions on everyone else could have been lessened.

The article reads like what would be really good things to do but possibly aren’t practical in the real world.

A bit like the fact that extensive testing would have been a very good idea early on in the outbreak but wasn’t possible due to lack of resources.

It really depends on the type of care home and to an extent who is running it. 
 

I’ve heard some shocking stories of owners who are really only interested in the money. They’re more interested in making sure they’re running at capacity than the residents and staff are safe. I’ve also heard stories of care homes who locked down well before the first death in the UK and stocked up on PPE. 
 

I have both examples where I work where two colleagues have their fathers in care homes. One of them had to bring a change clothes with them and change before visiting back in February. 
 

I would suggest the idea was impractical unless voluntarily done( which is what happened with those where the staff wanted to do it and they had the capability). So some did it,let us not forget that. Those that did not probably fitted into the category of staff not wanting to do it or not having the facilities to do it ( some of thes places are not exactly great buildings).

It is  a new disease. We might be able to do it when better info/research  is in place.

All well and good as a rhetorical argument but, back to reality, some homes that tried to lock down early were threatened by the Care Quality Commission (the government health quality quango). Home owners have posted to the media dodgy advice they received from the DHSC and other government bodies, some homes got no advice at all when they asked about specifics several times. Homes were broadly unable to access testing or source adequate PPE for a very long time. Agency staff were forced due to a lack of testing and nuance for care homes on staff isolation rules.

The estimate today is 27000 excess deaths in care homes during the pandemic. Every one of them was a responsibility of the DHSC, like any other citizen.

'A bit like the fact that extensive testing would have been a very good idea early on in the outbreak but wasn’t possible due to lack of resources.' Like a lot of things, that isn't strictly true. We may not have had enough resources but we had more than we actually used for quite a while - any number of independent and university labs were offering testing services but were ignored. 

I do not doubt there was chaos. And it will have been inconsistent, some good some bad.But locking down like that could not have been imposed on organisations that are seperately run with no centralised management. Impractical in the extreme for those few weeks.

Round where I am I can think of 2 care homes who would have coped well. The others, not a cat in hells chance , it would never have got off the ground. Badly managed and resourced in the first place.

That would have been a fair enough point for the potentially avoidable deaths in care homes in the other countries in the world who did much better than us. Unfortunately you are defending the country with the worst protection of care homes in the world (by numbers  of deaths and in terms of per capita for all the countries hit seriously). I am really confused why you feel the need to keep callously defending this UK government's disaster.

Care homes - a cash cow for investors, where 'what is practical' usually equates to 'what least penalises my profit margin'. Whatever the protestations of Johnson et al, Covid-19 is by dint of its varied impact on diverse populations, a political issue. Hard to see the response to situation affecting care homes as anything other than a core aspect of herd theory.

I've been asked by my care home manager (I'm a volunteer) to come up with some "suggestions for the future".

What she really means I think is that they have about 25% occupancy because it opened in the last six months and no prospect of any interest in the near future, for obvious reasons, so they want to know how to solve the problem.

Unfortunately for them, they won't be getting what they are hoping for, some simple miracle suggestions to turn the clock back and get a house full of customers. Instead they'll be getting an in-depth review of their external environment and a proposal to restructure their business so it has some chance of surviving, aimed at the group directors rather than the care home staff.

I'm hoping to post an anonymised and generalised version on UKC so it can be ripped apart, as one would expect, and maybe gain some useful insights. The main themes will be integration with the NHS, and a "from independence to end of life care" coordinated service for the elderly and their families. For example, I'll be telling them that they'll be needing to provide in-home care as well as residential; in other words, a service business model not a hotel one.

These ideas so far are somewhat lacking in coherence, as a favourite tutor once remarked, but I think it's a starting point?

Persuade other people to move from their care home to yours if you offer a better package so to speak. Autumn is the time when people are looking for care homes. 

I just have a more nuanced approach than yours which is that everything the gov touches is a disaster. It is clearly not. It is mixed. 

Really? The UK furlough scheme has gone well so far, arguably one of the best in the world.... in stark contrast with care home deaths where we look to be the worst in the world. How about explaining your nuance and show where I'm wrong. 

Except the bits of the real world that didn't shrug their old folk off to the wolves, where they took difficult decisions and kept people safe. Never forget our response and it's outcome isn't normal, we're not arguing over details, it is the most botched, deadly, negligent failure in the developed world. It stems from exceptionalist populism and carelessness, the hollowing out of competence and the lionisation of liars flowing from brexit. 

Was possible but instead of organising the logistics to draw on existing labs and teams we chose to centralise at scale, that still isn't working properly. 

Jk

I am talking generally. And please remember  that there is a counterpoint to the lockdown of care homes which has been talked about which is the physcological issues/ social issues about keeping locked down residents away from their family  ‘s. I cannot imagine how my parents would have coped without their daily visits. My Dad would have said nuts to that and walked out . 

As it is I have an 81 year old uncle in excellent health who cannot visit his 30 year son who is in permanent care due to mental and a host of physical disabilities.

This side of permanent lockdown is never really discussed in the press, although I recall Whitty talking about it early on.

I do not know what the right answer is,but it must be difficult trying to figure out a balancing act.

There was a fascinating interview with one of the professors at the big automated labs that process 20,000 to 30,000 tests a day. Turnaround is within a couple of hours as they are automatically processed.But delays occur becuase a label for example has not been put on correctly by the tester. Or the cap on the tube has been put on wrongly and the sample leaked. This results in long delays becuase the testing has to be done manually.
 

he said that what the govt needed to do was focus this  automated capacity on hot spots, not waste time on offering it to all and sundry..........

None of my tests have required any labelling by the tester or the subject??? I've only had swab tests but surely all tests operate similarly to minimise mistakes or contamination?

For the swab tests, the tester hands you a double sealed transparent bag. You open it, take out the transparent tube which is prelabeled and open the lid. You take the swab and tear open the packet. You do the swab and put the swab in the tube. You put the lid back on the tube and seal the two presslock bags.

If someone is incapable of doing that, how are they getting dressed in the morning? There isn't anything remotely difficult and it would be easy for the subject and the tester to see if they had done it wrong. The number of tests that are spoiled should be tiny.

So we have the highest C19 care home deaths in the world with only Spain close (a country that had way less warning than us) because it's a difficult balancing act? The effects of isolation on mental health are tragic but you don't have a mental health if you are dead. As for the press not talking about it, every major media outlet I look at has had multiple content on the subject, emphasising the horrible mental anguish but sensibly balanced towards saving lives first. Why can't you just admit our government has got its handling of care homes in this crisis badly wrong?

I will go and ask the professor of the testing house as to which tests he is referring to. I am assuming it’s the ones people do themselves. 

There have been plenty of similar cases in other country’s do you want me to say it’s been a disaster globally for this in care homes. More than happy to do that . I do not consider the U.K. a particular exception based on reading of stuff from elsewhere. Perhaps you should acknowledge that as well. 
 

I will post you an article which may be of interest. 

Why do you continue to lay the blame for care home deaths on the government alone?

Do some care home providers not share some of the blame?

Or are you privy to the results of an inquiry that hasn’t taken place yet?

https://www.google.com/amp/s/amp.economist.com/europe/2020/05/09/many-covid...

intersting stuff

https://www.economist.com/science-and-technology/2020/05/21/the-risk-of-sev...

this one is better. 
 

https://www.economist.com/science-and-technology/2020/05/21/the-risk-of-sev...

It also has an interesting chart showing that as a % of care home deaths the U.K. is doing better ok compared with others ( including Germany)

I find these type of numbers still hard to comprehend by the way. To unemotional for the people concerned. 

I really want to know what's going on between the different regions of the UK. That story could apply equally well to Scotland.

Certainly in Scotland pretty much exactly the same policy is being followed and exactly the same remedies suggested but to no avail. I doubt it is any different in Wales or NI but it would be good to know.

The government doesn't really care about care home deaths. Unless of course it results in bad publicity as at the present.  

Elderly care home residents rarely cast their vote and they are generally not people of influence.  And most care home residents die within a few years after being admitted.

This is an extraordinary situation.  In view of this I think there should be no time delay on publication of all cabinet papers once the pandemic is no longer a major threat in this country so the country can know the truth.

These restrictions only serve to reduce any accountability for misgovernment during emergencies

I agree it cannot be government alone. I thought that it would require an individual Doctor to actually discharge someone from hospital into a care home.  Is this not the case? I do see that the emphasis on protecting the NHS may have become the over riding factor that influenced everyone involved and that may have been driven by government policy but to ONLY blame the government seems misguided.

Al

Some care home providers will share a small portion of the blame. 

But the ones who have succeeded in preventing outbreaks in their homes have mostly done so only by acting directly against government advice from the start. Some of them were threatened with prosecution when they introduced restrictions while Johnson was still enjoying his holiday and pretending there was nothing to worry about.

The homes who had adequate PPE had it because they sourced it themselves back in January or February before it was too late. Again, against government advice.

This failure is the government's. Tens of thousands of people are dead (so far) because of the government's failure to prepare and their failure to react effectively.

Just talking to people who run and work in care homes (online because they haven't been home or seen their families in weeks).

An inquiry is all well and good and will be essential when this is all over. But it will take years before any conclusions are released (if ever, where is the Russia report?).

People are dying in their thousands now. An inquiry is too late for them. The government must be held to account for their failings now before it is too late to prevent more people dying unnecessarily.

Johnson's attempt at the last PMQs to deflect the blame on to the doctors discharging patients was disgusting. What other choice did the doctors have?

The government will take its share of the blame when the results of an inquiry are announced.

Probably several years down the line.

I believe that some care home providers will also be deemed responsible for the deaths that have occurred.

Most care homes are privately owned and although regulated, advised and inspected by the government they make their own decisions.

The idea that care homes were threatened with prosecution seems unlikely.

Most care homes will have had experience of infectious outbreaks before and should have been prepared for another one.

To ignore the role of care homes in this crisis by laying the blame at the government’s door simply increases the chances of more old people dying.

To not discharge them perhaps? I don't know.  Were they threatened with dismissal or some form of sanction?  If they were I would join you in condemning the government wholeheartedly and lay the blame fairly and squarely at their door.  My suspicion is that the Doctors were also caught up in the perfectly reasonable desire to not overwhelm the NHS.

Al

I don't pretend to understand it, but there I have noticed in the public sector, and enterprises linked to public sector e.g. in primary care,  there is quite a strong tendency to believe that government 'guidance' has to be obeyed; that some dark unspecified sanctions will be applied of they don't. Never understood that myself. 

My understanding of care homes - based on our two Mums and Dad being in several different one a few years ago - is that they are a pretty mixed bag, which is actually what you would expect, even though it would be good to be confident that they all have minimum standards.

Among other things, if we can afford to recruit 25,000 track and tracers, we can certainly afford to put a massive effort into care homes right now. Have clearly defined protocols, rapid access to testing (and the results), standards for PPE, standards for social distancing, and clearly defined instructions about dealing with possible infections. If necessary it might mean requisitioning hotels to provide extra capacity - how a busy care home in some converted Victorian villa is supposed to be able to quarantine or isolate a few residents I have no idea.  In addition there should be regular inspections and reviews - at least weekly is probably appropriate - but  inspections, as in the 'helping and supporting' type rather than the more traditional public sector 'blaming and punishing'. 

I agree.

Along with renationalised railways and utilities maybe the government can retake control of care homes as well.

Not to return to the old underfunded council run homes of the past but modern facilities working alongside the NHS to provide an integrated health care system that really does provide care from the cradle to the grave.

It’s about time we actually started looking after our old people.

Edit - And while we’re at it we can put more effort into helping those with mental health problems.