Covid Inquiry: 'Generational slaughter' as patients sent into care homes

Bereaved relatives have described their heartbreaking final moments with loved ones in care homes during the pandemic.

The Covid-19 Inquiry heard from families and care workers how the virus swept through homes “like wildfire”. Care workers held up iPads and got elderly people to touch the screen during video calls with loved ones when they couldn’t say their final goodbyes in person. The latest module on the care sector will hear testimony from bereaved families who were unable to see loved ones in their final days as parties were being held in Downing Street. The first wave of the pandemic saw the virus sweep through care homes as untested residents were sent there from struggling hospitals.

The barrister representing bereaved families quoted testimony from a top government official who said what happened was a “generational slaughter” in care homes.

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Pete Weatherby KC, representing Covid 19 Bereaved Families for Justice UK, said: "Although the phrase ‘generational slaughter’ within care homes may sound hyperbolic or rather colorful language, it chimes with the experience of thousands of our families.

He added: “We call out the callous way that family members were treated by politicians and policy makers, referring to them as bed blockers and people nearing the end regardless of the virus. This statement reflects that those in charge of policy lost their moral compass in dealing with those receiving care.”

During the first peak between March and June 2020 some 66,000 people died in care homes, with a third of those deaths attributed to Covid-19.

Geraldine Treacy's mum Margaret Stewart died in a care home in Northern Ireland. She said: “My mum was 87 and she had dementia and it was the week before Mother's Day. “The home phoned me and said they were closed. We believed my mum was going to be protected and this was the best thing for her. The home phoned me about a week later to say someone in the home had contracted Covid.”

“It had to accept people from the hospital, who hadn’t been tested and subsequently they became very sick. A week later they called and they said that my mum had Covid. We didn't think that it would be so sudden.”

Module 6 of the inquiry will explore how the decision was made to discharge untested hospital patients into care homes.

Geraldine added: “I went in and dressed with the apron in the hat and the mask and the gloves. She couldn't see who I was and she was very, very upset. I'd never seen my mum so upset. “She was 87 and she was screaming for her mom.

“Later I got a phone call from the home to say that my mum was dying and that there wasn't much time I went up, I sat there for half an hour. She died but I wasn't sure and I had to go. I had to leave. I couldn't go back. And they said that the room was closed and it wouldn't be opened again. Everyone was grieving but we were all very alone.”

A 2022 High Court judgement that ruled the care homes discharge policy was unlawful as it failed to take into account the risk to elderly and vulnerable care home residents of asymptomatic transmission of the virus. Between early March and early June 2020, nearly 20,000 care home residents in England and Wales died with Covid-19. That's about a third of all care home deaths during that period.

One care home worker said: “We all knew that Covid was everywhere and a staff member could bring it in from their family, but to actually knowingly import it into the home, it was a shift in risk for for all of us - residents and staff. The staff were outraged but none of them could afford to lose their jobs.”

The opening day of module 6 at Dorland House in Paddington, west London, heard video testimony from families and care workers. Another care home worker said: “Once it came into the dementia unit, you can't prevent everyone from going into anyone else's room. You can't lock doors. It just transferred really quickly.”

The inquiry heard how care home staff were left without PPE or testing kit early in the pandemic when frail residents were left exposed to the virus.

An impact statement from a care home worker in Durham said: “My care home eventually lost 25 residents to Covid 19 in just three weeks. The care home was completely overwhelmed by the virus. My colleagues and I were devastated because we saw the residents as extended family, and I cared for some of them for over nine years.

“Once Covid 19 was in our care home, it spread like wildfire and we could not do anything about it. At one point, 67 out of 87 residents tested positive… and probably about one third of the staff at the time. We were all terrified it would take the virus home to our families.”

The inquiry heard of the burden on staff who had to tell families their loved ones were dying and they couldn’t come in to say goodbye.

A care home worker said: “A significant proportion of my time during the outbreak was spent facilitating zoom calls between residents and their family some time so they could say goodbye when they were at the end of life when they were unable to do it in person. I often cried alongside them.

“On one shift, five residents were all on end of life care at the same time. I was going between the rooms to check they were still breathing and a clean and comfortable knowing that each time I left the room, and next time I returned, they might have died.

“I recall, in particular a resident whose daughter was devastated that she couldn't hold his hand when he was dying. I sat with him on a zoom call to his daughter and told his daughter to put her hand up to the screen.

“I lifted his hand up to the screen of the iPad she was using and I said his daughter this was the closest thing to holding hands that I could do for her. It's a memory which has stayed with me and which I will never forget.”

Addressing the inquiry chair Baroness Heather Hallett, Jacqueline Carey KC said lack of tests meant checks could not be done on people entering care homes until around April 2020. She said: “Your ladyship may wish to consider whether the focus on freeing up hospital capacity came at the expense of protecting vulnerable people in the community in adult social care.

She added: “Module six is undoubtedly going to be emotive and distressing for many people participating in and following these proceedings.

“A care home is not a hospital, it's a person's home. Just as you and I feel safe when we go home and put the key in the front door, the same should be true for people living in care homes. They are however very different environments where disease can spread easily and quickly.”

The barrister said it later emerged that hospital discharges were not the main route of which Covid infections made their way into care homes. She continued: “It's obvious that there were no easy decisions here. But if you cannot test everyone at the outset and you don't know for certain yet how the virus transmits… but you do know that residents in care homes are much more likely to die if infected, then the importance of good infection control measures becomes all the more crucial. And testing is an important part of infection prevention.”

The inquiry will also look at why blanket do not resuscitate (DNR) orders appear to have been placed on elderly residents without their consent.

Office for National Statistics data indicates that 46,000 care home residents in England and Wales died with Covid-19 between March 2020 and January 2022. This module of the inquiry will hear from 55 witnesses including eight bereaved witnesses

Former health secretary Matt Hancock will give evidence on Wednesday and Covid-19 Bereaved Families for Justice UK have called for him to “tell the truth”. A spokesperson for the group said in a statement: “This is a moment we’ve waited years for. Our loved ones died in unimaginable circumstances, and we were locked out of care homes, powerless to protect them.

“So far, nobody has taken responsibility for the decision to discharge untested NHS patients into care homes.

“Matt Hancock is giving evidence on Wednesday. We need him to take responsibility and finally tell us the full story. He told us there was a protective ring around our loved ones, even though thousands of untested NHS patients had been discharged into the care homes where we thought they were safe.

“That wasn’t a protective ring. It was a death sentence.”