Over the past four weeks, the Covid-19 inquiry has examined how the care sector was affected by a lack of testing and protective equipment and by the decisions that led to a surge of infections.
Among the core participants were bereaved groups who said “their loved ones who died cannot raise their voices so they seek truth and accountability on their behalf”.
Matt Hancock defended his controversial decision to send untested patients into care homes
The former health and social care secretary’s evidence was the most highly anticipated of this stage and ultimately disappointing for bereaved groups who said it was “full of excuses and completely devoid of accountability”.
Hancock said sending untested hospital patients into care homes to free up bed space was the “least worst decision that could have been taken at the time”. He insisted that “he still can’t find a better option” and said it was in line with the guidance from medical experts at the time.
The policy was blamed for causing outbreaks of Covid in care homes, with one civil servant saying the 46,000 deaths in the sector were a “generational slaughter”.
Hancock placed the blame firmly on Public Health England, saying its recommendations had not kept up with the reality of the unfolding situation. “I got so frustrated with PHE I abolished them,” he said. “There wasn’t enough testing, there wasn’t enough PPE. The public health authorities had the wrong attitude and the wrong doctrine. All of these things needed fixing and one by one we did everything we could to fix them.”
Helen Whately, the care minister at the time, said hospital patients being discharged into care homes “shouldn’t have happened” and care homes should not have been expected to “serve the NHS in this”.
Care home staff were “terrified” by the lack of testing and distress of residents
The inquiry heard that many care homes experienced “clinical abandonment” during the pandemic.
In some of the most distressing evidence heard by the inquiry, a care home owner and manager from Wrexham described the unfolding chaos and how staff struggled to provide care without adequate PPE and testing.
Helen Louise Hough claimed she was told that her residents “would not be considered for ventilation” if they became seriously ill with Covid and she could not get her local GP to attend in person to provide care.
In one particularly harrowing incident, she said the home’s first resident to die with Covid was left gasping for breath and begging for help in her final hours after Hough had been denied a prescription for oxygen. Her husband, Vernon, witnessed the resident’s distress and later took his own life as the toll of the pandemic wore on.
Many staff members worked long hours and stayed in an attic and in a caravan on site to reduce the risk of bringing the disease into the home. But with testing unavailable in the early weeks there was no way of telling who had Covid.
Caroline Abrahams, of the charity Age UK, said “being in a care home turned out to be almost the worst place you could be during a pandemic”.
Blanket policies banning visits led to rapid declines in physical and mental health
Members of bereaved groups spoke powerfully about the impact of being unable to visit their relatives for months at a time, in many cases missing out on seeing them in the last weeks of their lives.
Jane Weir-Wierzbowska, of Covid-19 Bereaved families for Justice, said her mother, who had dementia, deteriorated rapidly when her visits stopped. She could only look on from outside her room – talking through a mobile phone wrapped in a bin bag and placed on her mother’s shoulder – as she neared the end of her life. “I just felt like I’d let her down so badly and that guilt is with me always,” she said.
The inquiry heard that dementia patients suffered the most from the ban on visits and there was a disproportionate amount of excess deaths in this group. People with dementia accounted for a quarter of all Covid-related deaths in England and Wales.
Residents also described the distress caused by long periods stuck in isolation to try to stop the spread of Covid – one woman said she was placed in solitary for 65 days and felt like “a caged animal”.
Joanna Killian, the chief executive of the Local Government Association, said the trauma of separation was “inhumane and can’t happen again”.
Rolling back of legislation meant individual rights “were sidelined”
Laws such as the Care Act 2014 and the Equality Act 2010 were eased during the pandemic to help the care system manage the pressure of the pandemic.
But Helen Wildbore, the director of Care Rights UK, said this meant that “people’s rights became negotiable and sidelined” and individual needs were neglected.
She said the pausing of routine inspections removed vital impartial oversight of care, and enforced supervision during visits meant it was harder for people to report abuse or neglect.
Disability rights groups said “no government should have legislated to allow local authorities to cease meeting pre-existing eligible needs” and that disabled people felt their lives were less valued.