Swan statement on the Amnesty International report “As If Expendable”

As social workers, service users and carers we welcome the publication of Amnesty International’s report which exposes the government’s criminal failure to protect elderly and vulnerable people in care homes during the pandemic. The report makes very difficult reading as it lays out the statistical evidence for deaths in care homes during the pandemic. 18,562 deaths from Covid in care homes from December 2019 to June 2020 , the vast majority of these people over the age of 65. This represents 40% of the total number of Covid deaths. 13,884 (76%) died in care homes the remainder in hospital after leaving care homes. The actual number of Covid deaths likely to be much higher as the number of Covid “excess deaths” was 28,186 a 46% increase on the number of deaths in care homes for the same period last year. These are shocking statistics and it needs to be remembered that each number represents a human life lost and the devastating effect this has on family and carers.

Amnesty International rightly challenge Matt Hancock’s assertion that the government placed a ring of steel around care homes to protect their residence. The government knew that the UKs 400,000 care home residents were particularly vulnerable to the Covid virus.

Amnesty cites the following as the evidence of the governments failure to discharge its Article 2 and Article 3 towards UK citizens with regard its positive duty to protect life and protect its citizens from inhumane and degrading treatment:

Mass discharges from hospital into care homes of patients infected or possibly infected with COVID-19 and advice that “[n]egative tests are not required prior to transfers / admissions into the care home”.

Advice to care homes that “no personal protective equipment (PPE) is required if the worker and the resident are not symptomatic,” and a failure to ensure adequate provisions of PPE to care homes.

 A failure to assess care homes’ capability to cope with and isolate infected or possibly infected patients discharged from hospitals, and failure to put in place adequate emergency mechanisms to help care homes respond to additional needs and diminished resources.

A failure to ensure regular testing of care home workers and residents.

Imposition of blanket Do Not Attempt Resuscitation (DNAR) orders on residents of many care homes around the country and restrictions on residents’ access to hospital.

 Suspension of regular oversight procedures for care homes by the statutory regulating body, the Care Quality Commission (CQC), and the Local Government and Social Care Ombudsman.

SWAN supports the demands of Amnesty International including a full and independent public inquiry.

We are now entering the second wave of the pandemic and this criminal negligence must not be repeated. We support the immediate demands of Amnesty International:

Equal access for care home residents, staff, and visitors to regular testing.

Adequate representation and involvement of the social care and care home sector in the decision-making processes related to matters which impact care home residents at all levels.

 Adequate and continued supply of PPE for care homes to enable them to comply with national guidance and ensure all staff have undertaken training on its purpose and correct use.

Adequate mechanism to assess and build the capacity of care homes to deliver appropriate infection prevention and control, including in regard to their ability to isolate new or returning residents effectively and limiting the movement of staff as much as possible between care homes; and to provide adequate care for residents with COVID-19 and other residents.

Full access for care home residents to the NHS services to which they are entitled.

A thorough review of DNAR forms that have been added to care home residents’ care plans and medical files since the beginning of the pandemic to ensure they have been completed with the full knowledge, consideration and consultation of the resident and/or their family or independent advocate where they do not have mental capacity, according to the terms set out in the Mental Capacity Act. Ensure all staff working in the home understand when and how DNARs apply and that they do not in themselves indicate that a patient does not want to be taken to hospital or does not want to receive (non-CPR) medical treatment.

 Empowerment of care homes to develop visiting policies which respect and fulfil residents’ human rights and which give voice and agency to them, their families, and/or their legal guardian, while ensuring their safety and that of their fellow residents.

Full transparency in the collection and publication of all relevant data related to the deaths of older people in care homes during the COVID-19 pandemic.

The balancing of human rights is complex, peoples right to life needs to be protected and we understand that social distancing and shielding the vulnerable are necessary steps to protect infection. But the protection from abuse and the right to contact with our families are also important. Adequate funding for ongoing testing in care homes and for local authority staff could ensure that safe visiting takes place. Social workers, healthcare professionals, families and representatives could safely have “eyes on” visits to ensure residents wellbeing and undertake statutory protection of the vulnerable.

SWAN believes that this was an avoidable tragedy and the blame for what has happened lays firmly with the current Conservative government. 40 years of neo liberal policies in social care and public health have undermined the capacity of public services to protect the most vulnerable in our society which has been compounded by over a decade of austerity. The government’s negligence, belief in herd immunity and prioritising the handing of contracts to private firms is further evidence that concern for profits overrides concern for human life.

We ask our members and supporters to read the full report from Amnesty, share this statement and ask our trade unions and professional bodies to do the same.

SWAN believes that these tragedies will continue until we have fully funded national care service that is accountable to service users, carers and the public.


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