The sixth report of the Covid inquiry has issued a critical assessment of how the UK government managed the protection of people living in care settings during the pandemic. Approximately 500,000 individuals resided in care homes at the pandemic’s outset, with an additional million receiving care in their own homes. The inquiry concluded that protective measures were implemented too slowly, resulting in severe consequences for vulnerable populations.
The report identifies multiple systemic failures in the care sector’s pandemic response. Staff shortages were widespread due to longstanding workforce fragility, high vacancy rates, and turnover prior to the pandemic. A workforce already stretched thin became further strained when efforts to reduce infection transmission by limiting staff movement between facilities exacerbated staffing shortages. Financial constraints in the care sector left workers vulnerable, as many operated under zero-hours contracts without sufficient support to remain home when infection risks were present. The fragmented nature of the care system, overseen by numerous councils and providers rather than centralized government oversight, kept the sector more distant from decision-making processes than the NHS.
The inquiry found significant oversights in infection control procedures. When hospital patients potentially infected with Covid were discharged to care homes to free up hospital beds, official guidance in March 2020 in England, Wales, and Northern Ireland failed to mandate isolation and testing protocols. Additionally, staff faced severe shortages of personal protective equipment, forcing makeshift substitutions including bin bags and painters’ overalls. More than 43,000 recorded deaths involving Covid occurred in care homes between March 2020 and July 2022.
Restrictions on visiting residents, while initially justified by infection control concerns, persisted longer than evidence supported. By September 2020, evidence indicated visitors posed a marginal risk, with staff identified as the primary infection vector. Despite four UK nations relaxing guidance, many care homes maintained strict visiting bans, contributing to measurable declines in resident health and wellbeing. The inquiry also documented concerning evidence of blanket do not resuscitate orders being imposed on care home residents without individualized assessment, with such orders increasing from 16,800 to 26,500 in the pandemic’s first nine months.
Care home staff faced severe psychological strain from working during the crisis. Many relocated into facilities where they worked, and workers reported experiencing significant distress from witnessing high resident mortality rates and providing end-of-life care simultaneously to multiple individuals.
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