Care home staff ‘under pressure’ to accept hospital patients without negative Covid test, investigation finds

Staff at care homes in Wales say they felt under pressure to accept hospital patients without a negative coronavirus test during the height of the pandemic.

In an exclusive survey for ITV Cymru Wales/Y Byd ar Bedwar, figures show 53% of staff at homes felt pressured by their health board to accept people straight from the hospital without a Covid-19 test. 

Social care has been under the spotlight since the start of the pandemic - with more than 700 coronavirus deaths in care homes in Wales.

More than 60 care home managers responded to the survey and 85% of those had accepted residents directly into their care home from the hospital since March. Of those residents, 39% had not been tested at all for coronavirus before leaving hospital.

Lorrainne Dutton is the manager of Plas Garnedd Pentraeth care home on Anglesey. Credit: ITV Cymru Wales

Lorraine Dutton, a care home worker at Plas Garnedd Pentraeth on Anglesey, feels like the elderly were forgotten about during the pandemic, particularly at the beginning of the pandemic. She says that, for the sake of residents in her care home, she battled with medical staff to refuse patients from hospitals who had not had a Covid test.

“I was under enough pressure as it was, without having to battle with people in the hospital in order to protect the people we care for. They didn’t see the impact it was having on us."

Lorraine says she felt confident to hold her ground and it became obvious she was making the right decision. 

She said: “I did go into battle on one occasion because I was really concerned they wanted to send somebody back that was on a red ward, which means there were positive cases on that ward.

"And they were just adamant that she should be coming back but thankfully the discharge hub intervened and she was tested and put into isolation while in hospital and she was tested positive, so I was really thankful I stood my ground and said no.”

ITV Cymru Wales Credit: Kim Ombler from Care Forum Wales

Meanwhile, Kim Ombler from Care Forum Wales says she is not surprised to hear that care homes in Wales have felt under pressure to accept hospital patients without a negative test result.

"We were pressurised into taking in residents in in the beginning that weren't tested because there were no tests available so yes homes were pressurised into taking residents in with no tests.

Mark Drakeford MS confirmed there was 'clinical value' in testing in larger care homes. Credit: Senedd TV

The First Minister has faced scrutiny when it comes to social care due to the change in testing procedures offered in care homes.

In April, Mark Drakeford told the Plenary testing would not be offered to everybody in care homes because there was "no value" in doing so.

He told the virtual Senedd: "The reason we don't offer tests to everybody in care homes, symptomatic and asymptomatic, is because the clinical evidence tells us that there is no value in doing so. 

"Because of that, we don't do it. We offer the testing where the advice to us is that it's clinically right to do that. 

However, the decision was changed on 16 May to allow coronavirus testing to be extended to all care home residents and staff in Wales. Until then it was only residents and staff in care homes with confirmed cases of the virus who were being tested.

Mark Drakeford has insisted the Welsh Government followed the advice it was given at the time and commented he did not have "the virtue of hindsight" during a briefing in June. 

"Early in the pandemic the advice was to test symptomatic patients. Anybody who had symptoms was tested before they left hospital, and the advice early on was that the testing of people without symptoms would not have given useful outcomes that could have been used in making decisions about where people would be discharged to live.

"When the advice changed, we changed the practice. I think we changed our practice probably three times during the coronavirus crisis in relation to care homes."By now, the policy has changed again and it is a requirement to test staff every fortnight, or weekly, for those care homes within the Betsi Cadwaladr catchment area. 

A Welsh Government spokesperson said: "Our testing policy for Wales has been informed by the latest medical and scientific advice, which has evolved as we have learned more about the virus.

“We extended testing to people being discharged from hospital to a care home, for those being transferred between care homes and for new admissions from the community when the evidence changed on 22 April.

“Our current policy states that anyone being discharged from hospital to a care home requires a negative Covid-19 test. This policy remains unchanged and we would expect any resident being discharged from hospital or being newly admitted to a care home to first have a negative Covid-19 test before being granted entry to the care home.”

Care home manager, Lorrainne, says testing her staff has become a worry for her.

“What’s the point testing someone if they don’t send the results back for a week, in that time it could have spread through the entire home. Sometimes we are waiting a week, a fortnight and that then puts our residents and our staff at risk.

"If that’s the best we can get, it’s simply not good enough. We need more accurate tests.”

Care homes across Wales were asked to give their honest opinion on the situation. When staff were asked how satisfied or unsatisfied they were with the Welsh Government response to Covid-19, the majority from the 62 respondents answered dissatisfied. 

  • Very satisfied - 6%

  • Satisfied - 24%

  • Neither satisfied or dissatisfied - 26%

  • Dissatisfied - 37%

  • Very dissatisfied - 6%         

The majority of staff said they were unsatisfied with the Welsh Government response to Covid-19. Credit: ITV Cymru Wales

When asked how confident they were of the Welsh Government protecting care homes, residents and staff during the Covid-19 pandemic, the combined majority said they were not. 

  • Extremely confident - 3%

  • Very confident - 7%

  • Somewhat confident - 41%

  • Not so confident - 38%

  • Not at all confident - 11%    

A Welsh Government spokesperson, said: “Everyone working in social care has worked tirelessly to protect some of the most vulnerable people in Wales from this pandemic. We have provided a wide range of support for the sector, including extra nursing staff where necessary and free PPE for care homes across Wales. We have also provided over £130m to help the sector respond to the virus.

“We will continue to work tirelessly with care providers to identify and provide any additional support they need to protect the people they care for.”