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UK Dementia Congress 2020

11 Nov 2020

Bournemouth

Testing times

By guest blogger JEF SMITH

In mid-May the secretary of state for health and social care famously claimed that the government had thrown a “protective ring” around care homes to guard them against the coronavirus. Well, if that was protection, heaven knows how badly the care sector would have suffered without such (in)attentive ministerial surveillance. Twenty thousand deaths in homes; could it have been worse?

Even at this stage of the pandemic it is clear that elementary lessons have not yet been learned. Among recent worries, the deficiencies of the testing programme have been regularly laid bare, with residential care homes again getting a service which comes nowhere near meeting the dangers they continue to face. The government’s belated announcement last Friday that regular testing will shortly be available for all staff and residents over 65 – other people with disabilities will have to wait until some time in August – comes much too late and is likely to prove too little.

The key issues were thoroughly set out in the report of a survey of National Care Forum (NCF) members which was published last week.

The government’s programme of whole home testing went live on 11 May but on 25 June, NCF reported, 9% of staff and 13% of residents in NFC members’ homes had still not been tested. The time spent awaiting results varied between two and 28 days. Happily, only relatively small numbers of people showed positive results but, of these, 53% of staff and 30% of residents were asymptomatic.

The goverment’s own study, Vivaldi 1: Covid-19, also published last week, confirmed much of what NCF found, though its figure for residents who tested positive being asymptomatic was, at 80.9%, worryingly higher than NCF’s and, as it was based on a larger sample, probably more representative. Although the report found that transmission of infection from residents to staff is relatively rare, such unknowing carriers of the virus remain a danger and one time testing simply does not cut the mustard.

Off-duty workers of course continue to move around in the wider community and could therefore easily bring the virus into a home. Bank staff travelling between homes constitute an even greater threat, but many homes still cannot manage without them. The only safe way to proceed, Vic Rayner, NCF’s executive director points out, again stating what should be obvious, is through regular and routine testing or both staff and residents.

Vivaldi 1 also finds that “emerging data suggests that the … return of residents to the care home from hospital may be [an] important risk factor”. It is surprising that this is long known fact, which should indeed have been recognised from the outset as pretty much common sense, is still expressed so tentatively.

The process of testing vulnerable residents is of course not straight forward. Swab tests are time-consuming to administer and often distressing to the older people tested. To someone with dementia, the necessarily invasive entry to the mouth or nose may feel threatening and is bound to be somewhat painful. Mustering the gentle persuasion and reassurance which is often required in these circumstances is another element in what is gradually being recognised as the highly skilled task of providing good care.

“It is our priority to protect care residents and staff and testing is a crucial part of that,” said care minister Helen Whatley at the launch of the new testing programme, but for ministers to boast in such bland terms is both empty and dangerous. Much more needs to be done before the confidence of staff, residents and relatives, so seriously undermined over recent months, can be in any way restored.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

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