Covid-19 death tolls at individual care homes are being kept secret by regulators in part to protect providers’ commercial interests before a possible second coronavirus surge, the Guardian can reveal.
Robert Booth www.theguardian.com
England’s Care Quality Commission (CQC) and the Care Inspectorate in Scotland are refusing to make public which homes or providers recorded the most fatalities amid fears it could undermine the UK’s care system, which relies on private operators.
In response to freedom of information requests, the regulators said they were worried that the supply of beds and standards of care could be threatened if customers left badly affected operators.
The CQC and Care Inspectorate share home-by-home data with their respective governments – but both refused to make it public.
Residents’ families attacked the policy, with one bereaved daughter describing it as “ridiculous” and another relative saying deaths data could indicate a home’s preparedness for future outbreaks.
“Commercial interest when people’s lives are at stake shouldn’t even be a factor,” said Shirin Koohyar, who lost her father in April after he tested positive for Covid at a west London care home. “The patient is the important one here, not the corporation.”
June Findlater, whose 98-year-old father died from coronavirus at a care home near Glasgow, said: “I would be terrified of any relative going into a care home without that information, because it does speak volumes … There were care homes with no deaths and that’s not a coincidence. Regulators should absolutely be able to provide this information.”
There is growing evidence linking the way care homes operate with infection rates. Research last month showed coronavirus outbreaks were up to 20 times more likely in large care homes, while a study reported on Thursday by the Guardian, points to an association with occupancy and staff-to-resident ratios.
While data on Covid deaths at individual hospital trusts is published, information about fatalities at specific care homes has so far emerged only sporadically.
The highest confirmed death toll was 26 at Melbury Court, a Durham home operated by HC-One, the UK’s largest private provider, which recorded more than 1,000 deaths in total. Seventeen people died at Bupa’s Sunnyview House care home in Leeds.
Some of the largest providers have supplied aggregate figures for confirmed and suspected Covid fatalities. Four Seasons Health Care recorded 567 Covid deaths, and Care UK, which operates 123 homes, recorded 642 deaths. Bupa reported 266 confirmed cases, declining to reveal suspected deaths.
“It is surely only right that [residents and families] should receive information about the Covid status of the home to help inform their decision about where they live,” said Helen Wildbore, the director of the Residents & Relatives Association. She said it was distressing for residents and families to only hear about deaths in homes through other sources.
The regulators’ stance emerged after freedom of information requests were made by the Guardian. The CQC said release of home-by-home mortality figures would “likely prejudice the commercial interests of care providers” and “risks creating confusion as to the prevalence, spread or impact of the virus”.
UK care homes recorded 17,721 coronavirus deaths during the spring pandemic. With further outbreaks feared this winter and beyond, a worst-case scenario drawn up by the industry analyst Knight Frank forecasts a slump in demand that could leave providers with 180,000 empty beds by the end of 2021.
The 10 largest for-profit providers make up nearly a quarter of the supply of care home places. Along with smaller chains and private providers of one or two homes, they have seen occupancy rates fall and staff and equipment costs soar, leading to fears in government for the stability of the sector going into winter.
“Without understanding the size and occupancy of the home, the underlying health conditions of its residents and circumstances like local outbreaks, the data would not help judge providers’ response to the pandemic,” the CQC said.
It said the data could be used “in ways which could drive behaviour which is detrimental to the wellbeing of vulnerable people and to wider public health”, citing the possibility that families might remove loved ones from homes where there had been deaths, to others that they mistakenly perceived to be safer.
However, it said it was continually reviewing its position and has told operators it may disclose provider-level deaths data if they do not proactively “share appropriate information with families regarding outbreaks and deaths”.
Scotland’s Care Inspectorate said transparency would “substantially prejudice services commercially” and without information such as residents’ underlying health conditions it could cause confusion about the safety of homes and jeopardise the provision of beds.
Asked about the CQC’s concern over prejudicing providers’ commercial interests, Ivan Pointon, whose father died from Covid in a Bupa care home, said: “Perhaps they [homes] should if they haven’t done very well. Nobody has been held accountable for this and it is the business structure that has caused the problems – the policies and procedures.”
Debbie Ivanova, the deputy chief inspector for adult social care at the CQC, said: “We regularly share our data with the Department of Health and Social Care, other national and local partners, and researchers … This includes data on notifications of deaths by providers in individual care homes that is used to monitor, plan and respond to the pandemic.
“On its own, the number of deaths at a care home does not provide an assessment of quality or safety. Where we have concerns we will inspect and make our findings public. Where people are at risk we will take immediate action to protect them.”