Carers are to be banned from working in more than one home

Carers are to be banned from working in more than one home to halt Covid spread after claim outbreaks in first lockdown were fuelled by staff employed at multiple sites

  • Government understood to be drawing up laws to make staff movement illegal 
  • ONS found care homes with agency staff had higher Covid rates than others 
  • But some care home bosses said legislation could force them out of business 

Carers are to be banned from working in more than one home after claims outbreaks in the first lockdown were fuelled by staff employed at multiple sites. 

The Government is understood to be drawing up legislation to make it illegal for care homes to employ staff who work at multiple sites.

A study by the Office for National Statistics showed that care homes that used agency staff in the first wave had higher rates of Covid than others.

The Government is understood to be drawing up legislation to make it illegal for care homes to employ staff who work at multiple sites. File pic  

But some care home bosses told the Daily Telegraph they would be stuck ‘between a rock and a hard place’ if the practice was banned. 

They said some homes would struggle to abide by the new law and properly care for residents and may need close entirely because of staff shortages.

Caroline Abrahams, a charity director at Age UK, said: ‘There is a massive level of vacancies within social care – 112,000 – and a horrifying 30 per cent annual rate of churn, so the challenge is how they can provide good care in a way that is consistent with infection control.

‘Consider the impact too of having staff members needing to self-isolate because, say, a family member contracts the virus, and you can see how hard it is for care homes to remain adequately staffed.’

Kate Terroni, Chief Inspector of Adult Social Care at the Care Quality Commission, was asked about the plan on Radio 4’s Today programme this morning. 

She replied: ‘I think it’s critical to reduce as much as possible staff moving between different homes to it’s essential that people are not doing that. 

‘We’re working with Government to think about what our role as the regulator could be in ensuring that happens.’   

In May, the Government produced guidelines stating that care home staff and agency workers should only work in one care home ‘wherever possible’.

The planned legislation comes as the Government prepares for a second wave of coronavirus, with a surge in over 65s being admitted to intensive care across the country. 

A recent study by Imperial College London found an eight-fold increase in Covid cases among the over-65s compared with September.

Under the planned legislation, care homes would reportedly be expected to ask workers to sign ‘exclusive’ contracts, banning them from working at more than one site. The legislation could be introduced within weeks.

Care homes that fail to comply with the regulations would face warning notices from the Care Quality Commission (CQC) and ultimately the threat of closure or withdrawal of funding.

A Department of Health and Social Care spokesperson said: ‘Stopping staff movement in and between care settings is critical to minimise the risk of infection of COVID-19, and our Adult Social Care Winter Plan, backed by an extra £546 million, is clear that providers should limit all staff movement unless absolutely necessary.

‘We have said that limitations on staff movement will be enforced through regulations and we will come forward with detailed proposals in due course.’

More than 20,000 care home residents are thought to have died from COVID-19 during the first wave of the pandemic.  

WHAT WENT WRONG FOR CARE HOMES? A TIMELINE OF FAILINGS

FEBRUARY – SAGE scientists warned Government ‘very early on’ about the risk to care homes

Britain’s chief scientific adviser, Sir Patrick Vallance, revealed in April that he and other senior scientists warned politicians ‘very early on’ about the risk COVID-19 posed to care homes.   

He said: ‘So very early on we looked at a number of topics, we looked at nosocomial infection very early on, that’s the spread in hospitals, and we flagged that as something that the NHS needed to think about. 

‘We flagged the fact that we thought care homes would be an important area to look at, and we flagged things like vaccine development and so on. So we try to take a longer term view of things as well as dealing with the urgent and immediate areas.’

The SAGE committee  met for the first time on January 22, suggesting ‘very early on’ in its discussions was likely the end of January or the beginning of February. 

MARCH – Hospital patients discharged to homes without tests

In March and April at least 25,000 people were discharged from NHS hospitals into care homes without getting tested for coronavirus, a report by the National Audit Office found.

This move came at the peak of the outbreak and has been blamed for ‘seeding’ Covid-19 outbreaks in the homes which later became impossible to control.

NHS England issued an order to its hospitals to free up as many beds as they could, and later sent out joint guidance with the Department of Health saying that patients did not need to be tested beforehand. 

Chair of the public accounts committee and a Labour MP in London, Meg Hillier, said: ‘Residents and staff were an afterthought yet again: out of sight and out of mind, with devastating consequences.’ 

MARCH – Public Health England advice still did not raise alarm about care home risk and allowed visits

An early key error in the handling of the crisis, social care consultant Melanie Henwood told the Mail on Sunday, was advice issued by Public Health England (PHE) on February 25 that it remained ‘very unlikely’ people in care homes would become infected as there was ‘currently no transmission of Covid-19 in the UK’.

Yet a fortnight earlier the UK Government’s Scientific Pandemic Influenza Modelling committee had concluded: ‘It is a realistic probability that there is already sustained transmission in the UK, or that it will become established in the coming weeks.’

On March 13, PHE advice for care homes changed ‘asking no one to visit who has suspected Covid-19 or is generally unwell’ – but visits were still allowed.

Three days later, Mr Johnson said: ‘Absolutely, we don’t want to see people unnecessarily visiting care homes.’

MARCH/APRIL – Testing not readily available to care home residents

In March and April coronavirus swab tests – to see who currently has the disease – were rationed and not available to all care home residents suspected of having Covid-19.

Government policy dictated that a sample of residents would be tested if one showed symptoms, then an outbreak would be declared and anyone else with symptoms presumed to be infected without a test.

The Department of Health has been in control of who gets Covid-19 tests and when, based on UK testing capacity. 

MARCH/APRIL – Bosses warned homes didn’t have enough PPE 

Care home bosses were furious in March and April – now known to have been the peak of the UK’s epidemic – that their staff didn’t have enough access to personal protective equipment such as gloves, masks and aprons.

A letter sent from the Association of Directors of Adult Social Services (Adass) to the Department of Health saw the care chiefs accuse a senior figure at the Department of overseeing a ‘shambolic response’. 

Adass said it was facing ‘confusion’ and additional work as a result of mixed messaging put out by the Government.

It said the situation around PPE, which was by then mandatory for all healthcare workers, was ‘shambolic’ and that deliveries had been ‘paltry’ or ‘haphazard’.

A shortage of PPE has been a consistent issue from staff in care homes since the pandemic began, and the union Unison revealed at the beginning of May that it had already received 3,600 reports about inadequate access to PPE from workers in the sector.

APRIL – Care home deaths left out of official fatality count

The Department of Health refused to include people who had died outside of hospitals in its official daily death count until April 29, three weeks after deaths had peaked in the UK. 

It started to include the ‘all settings’ measure from that date and added on 3,811 previously uncounted Covid-19 deaths on the first day.

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