Care home operators have accused the UK government of “a complete system failure” over testing for Covid-19 after officials repeatedly deflected responsibility for the task and left vulnerable residents unchecked.
As ministers admitted it will be more than three weeks before all homes are offered tests, care home managers said lives have been put at risk and conditions for dementia sufferers worsened because of the government’s failure so far to test hundreds of thousands of staff and residents.
The programme was announced by the health secretary, Matt Hancock, two weeks ago but only tens of thousands of people have been tested.
Public Health England (PHE), the Care Quality Commission (CQC) and the Department of Health and Social Care (DHSC) have repeatedly passed the buck about who should carry out the tests, according to correspondence with care homes seen by the Guardian.
In one email to a care manager sent on Thursday a CQC official admitted to “continued confusion” in the system.
Matthew Nutt, managing director of Accurocare which runs homes in Oxford and Basingstoke, was told eight times by PHE that CQC was responsible for the programme and four times by CQC that it was PHE’s job.
“The left hand doesn’t know what the right is doing,” he said.
Last Thursday a DHSC official told him PHE was in charge and another said it was CQC. That contradicted what CQC told him 24 hours earlier: that its involvement in testing care staff ended on 25 April.
His organisation has been trying to obtain about 200 tests since 28 April, when Hancock announced that testing for all care workers and residents would be available regardless of whether they are showing symptoms of coronavirus. So far he has received none.
On Tuesday Hancock claimed “the performance on testing has been unbelievably positive”.
“It has been a complete system failure,” said Nutt. “We don’t know when we are going to get test kits. The government’s plan to lift the lockdown says all homes will have testing by 6 June. It’s far too slow. How many more people have to die?”
More than 400,000 people live in care homes, looked after by a workforce of 1.5 million but the number of tests carried out so far remain in the tens of thousands, the government said on Monday.
The extension of testing beyond just people with symptoms was initially welcomed by care managers because it promises better infection control. Care home fatalities increased to almost 10,000 in the UK on Tuesday.
When Nottingham Community Housing Association (NCHA) tried to get tests for its care home residents and staff, a PHE official said it didn’t know anything about testing residents, before pointing them to the CQC. PHE then changed its mind again saying it would send the tests, but when they failed to arrive, PHE reversed again saying CQC was responsible.
“It is very frustrating because we can’t effectively manage the risk without knowing [who has the virus],” said Holly Dagnall, director of homes and wellbeing at NCHA.
John Guy, chairman of the trustees of the Fairfield care home in Oxford, also said his facility had requested swabs for home testing four times since Hancock’s announcement but none had arrived. Previously his staff had been told to drive 60 miles to Twickenham to a testing centre.
Labour’s shadow care minister, Liz Kendall, said the accounts revealed “total chaos” in the system.
“Weeks into this epidemic ministers still haven’t got to grips with the basics of testing residents and staff,” she said. “Reports from the frontline show total chaos as national bodies squabble over who is responsible, leaving care home managers and staff struggling to cope. The government’s own ‘recovery strategy’ document says they won’t guarantee every care home will even be offered testing until 6 June. This is not good enough.”
The government has showed signs of shifting its strategy after originally saying CQC was “leading co-ordination of testing for the care sector”. On Thursday it gave local public health directors the role saying the system needed to be “more joined up”. In a letter, the care minister, Helen Whately, described it as “a significant change” and said that soon there would be capacity for 30,000 tests of care home residents and staff a day.
However, even that appeared to be miscommunicated as some public health directors did not receive the letter until Sunday.
“It has been totally shambolic,” said one director of public health. “The care minister’s letter has been interpreted as an admission of the failure of testing in care homes.”
CQC said in a statement that it was only provided some administrative support for the DHSC, between 10 and 25 April, in contacting care homes and offering to order a testing kit for them and to enable providers to refer their staff for testing at DHSC testing sites.
A DHSC spokesperson said: “The government is working around the clock to make sure care homes and our frontline care workforce are getting the support they need to protect residents and tackle coronavirus. We have launched a new online portal to make it easier for care homes to arrange deliveries of coronavirus test kits. All care home staff and residents can now be tested, whether they have symptoms or not.”