UK care home bosses threaten to quit over return of coronavirus patients

Care home managers have threatened to resign over new government guidelines that state they have to accept residents who have coronavirus.

The guidance also says hospitals will not routinely test residents entering care homes, meaning managers will not know if returning residents are infectious but asymptomatic.

“Some [returning] patients may have Covid-19, whether symptomatic or asymptomatic,” the guidance says. “All of these patients can be safely cared for in a care home if this guidance is followed.”

The guidance also states that if a home has more than one symptomatic resident, health protection teams may arrange swabbing for up to five residents to confirm the existence of an outbreak. “Testing all cases is not required as this would not change the subsequent management of an outbreak,” the guidance says.

The advice comes after hospitals, Public Health England and local councils were accused of putting care homes under intense pressure to readmit residents who have tested positive for Covid-19 and to accept residents who have not been tested at all.

Simon Whalley, the owner of Birtley House in Bramley, Surrey, said it was impossible to maintain social distancing in the care home. He said the guidance had been issued with a “complete lack of real understanding and no attempt to understand what the care sector can and cannot do”.

“They’re just expecting us to cope without giving us any support at all,” he added. “Our first responsibility is to the residents we currently have. You can’t just put a new resident in an empty room next to a resident who is clear of the infection. And what about the ambulance people who bring the resident into the home? We won’t know if they’re contagious either.”

Another manager of a nursing home in Buckinghamshire, who did not want to be named, called the guidance “preposterous and disgraceful”.

“I will either resign or refuse to abide by these new guidelines,” she said. “Why would I risk the lives of all my residents, not to mention my family and my staff and their families?”

The guidance says infected residents can be safely cared for as long as homes follow social distancing measures for everyone in the home and follow “shielding guidance” for those who are extremely vulnerable.

The Buckinghamshire manager said: “We have residents who are doubly incontinent, can’t walk or move and are non-verbal. How can we socially distance ourselves from them?”

She currently has two residents in hospital who doctors want to return to the home, without testing them. “I’m going to give both residents notice tomorrow morning so we don’t have to take them back,” she said.

“We’ve been fighting the hospital for a test to show they’re not carrying the virus before we accepted them back but now I have no choice but to refuse to take them back at all.”

The guidance says care homes should monitor every asymptomatic resident twice daily. For residents returning with symptoms, they should be isolated and staff should “immediately instigate full infection control measures”.

Peter Kyle, the MP for Hove in East Sussex, has written to Boris Johnson telling him that just five tests for residents was not enough: “I cannot stress this strongly enough,” he wrote, “our system of social care, dependent as it is on temporary and agency staff, is responsible for spreading contagion.”

An elderly resident in a care home in Kyle’s constituency recently died of Covid-19 after waiting 10 days to be tested. He had been cared for by agency staff, all of whom also work in other care homes. Kyle is concerned that during those 10 days, the agency staff infected residents in other care homes.

He wrote: “Bluntly speaking, when Covid-19 enters a care home it will kill those it infects.” He added that the only way to stop it was to allow only workers who have tested negative inside care homes.

The Department of Health and Social Care has been approached for comment.