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Lies, damned lies and COVID-19 care home statistics

By freelance social care writer Eleanore Robinson

Getting national social care statistics has been one of the key challenges during the Coronavirus crisis. While daily figures for infection rates, testing and, sadly, deaths were regularly produced for the NHS, for the first month data on the impact on social care was scant. Rates in care homes were combined with other community deaths and came with the caveat that that Coronavirus was only suspected of being the cause. So why was it initially so difficult to produce an accurate, up-to-date picture?

A lack of pre-existing data and infrastructure meant the Care Quality Commission, which records all care home deaths, had very little to build on and did not have historical information with which to compare the current figures, the watchdog said. A spokesman explained: “This makes it more difficult to get an accurate data set – and the lack of established data gathering infrastructure adds to this challenge.”

CQC said that it wanted to ensure reporting data did not to add to the significant pressure care home providers were under and the data gathering systems had to be set up quickly without the normal level of planning and engagement.

An informed response
However, timely, reliable data is crucial for planning a response to the crisis. Liz Jones, policy director at the National Care Forum (NCF), said: “It just feels really unjust, like the Government focus was on hospitals, and care homes were just not visible in planning.” As an example, she said it was not clear how the available data  on social care was being used, and in particular, to give a sense of where the virus was, the characteristics of care homes with infected residents, the type of care they offered or the geography.

William Laing, founder and chairman of healthcare consultancy LaingBuisson, said access to testing would have helped inform this dataset directly and indirectly and, along with tracking the virus, could have slowed down the spread. “All the main focus was on the NHS but they could have relied on Office for National Statistics (ONS) data”, Laing said. “They (the Government) could have put more resources into ONS.”

A Department for Health and Social Care (DHSC) spokesman responded saying that the NHS, as a public body, is network of publicly-owned providers. This facilitates data collection as there is access to more frequent and timely data. In comparison, social care is largely delivered by private providers and therefore it can take more time to compile data through these channels, the spokesman said.

Since mid-April, the CQC and ONS have published national data on care home deaths. CQC said it was confident that this weekly reporting ensures a “more complete and timely picture of the impact that COVID-19 is having on social care”. It is also now working with ONS to understand the impact of the outbreak, publishing data in early June on the number of deaths of people with learning disabilities and autism.

Laing added: “The story you have to consider is not just coronavirus deaths but other excess deaths.” This could be from a lack of medical assistance being available, such as ambulances and GPs. LaingBuisson modelling shows that by the end of June there will be around 50,000 excess deaths as a result of the crisis and half of these deaths will have been care homes residents. “This figure is not only to do with Coronavirus but also collateral damage”, he said.

NHS England’s Capacity Tracker tool is now being utilised to report care home bed availability, and staff and PPE shortages. However, only the NHS and local authorities can access the results and around a third of councils have yet to sign up, says the NCF, despite 98 per cent of its members supplying information.

Policy director Liz Jones said: “If we had a minimal dataset, we would have more consistent information about the people we care for. It would be worth investing in a central infrastructure. Providers are willing to give data if they have a clear line of sight where it is going.”

Jones added that providers needed to be involved in interpreting the data so the intricacies and nuances of care provision can be explained.

CQC is now reviewing death notifications and how it works with providers to ensure the data is both accurate and accessible, including the impact on autistic people. The DHSC says it is committed to giving the care sector the technology and data it needs.


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