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COVID-19's impact on care homes was not inevitable

Written by: | Published:

Lucinda Allen Lucinda Allen, Policy Officer, the Health Foundation

The grim toll that the pandemic has taken on people in care homes was set out starkly in data from the Care Quality Commission (CQC). It showed that 6,765 homes in England registered at least one resident death between 10 April 2020 and 31 March 2021.

Controlling infectious diseases in communal settings, such as care homes, is challenging. People with care needs have faced higher risks from COVID-19 than the general population. And, as CQC highlighted, the effects of COVID-19 on care homes have been closely linked to the prevalence of COVID-19 in the community – with some areas hit harder than others.

But what national policymakers do to protect people who use and provide adult social care still matters – and the scale of the impact of COVID-19 on social care was not inevitable. Central government support for social care during the pandemic was often too little, too late – particularly during the first wave. The Government’s claim of putting ‘a protective ring’ around care homes was never grounded in reality.

Social care staff including nurses have had to provide care under extremely demanding conditions, without the same recognition as NHS staff. Health Foundation analysis has shown that some national policies to protect social care staff improved following the first wave. In December 2020, in a boost for national leadership for social care, Professor Deborah Sturdy took up a new post of Chief Nurse for Adult Social Care. Yet some significant gaps remain. For example, poor pay and employment conditions in social care mean that not all staff have been guaranteed pay if required to self-isolate.

The social care system that entered the pandemic was underfunded, understaffed, and undervalued – scarred by decades of political neglect. There were around 112,000 vacancies in adult social care at any given time in 2019/20, including 4,200 registered nurse vacancies. These longstanding structural issues shaped the policy response to COVID-19 and amplified the effects of the pandemic on people in social care.

Reform to adult social care in England is now long overdue. This reform must be comprehensive – not narrowly focused on preventing older people selling their homes to pay for care – including measures to increase access to publicly funded social care and improve staff pay and conditions. The Prime Minister must now fulfil his promise to bring forward plans to reform social care this year.

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