Care homes visits during Covid about managing risk, inquiry hears

A public health agency official has told the UK Covid-19 inquiry that visiting in care homes during the pandemic was about "managing risk".

Heather Reid, the interim director of Nursing, Midwifery and Allied Health Professionals, gave evidence on the adult social care sector on behalf of the Public Health Agency (PHA) on Thursday.

Ms Reid said visiting was "one of the most challenging, complex and important areas" and it was about "balancing the risk of infection towards that vulnerable population along with the potential harm due to isolation".

The ongoing inquiry in London is considering the consequences of government decision-making on those living and working within the adult social care sector during the pandemic, including the restrictions which were imposed.

Decisions concerning capacity in hospitals and residents in adult care and residential homes will also be addressed, as well as the steps taken to prevent the spread of Covid-19 and examine the capacity of the adult care sector to respond to the pandemic.

The inquiry heard that the PHA led the forum for discussing normalised visiting, which included engaging with families of residents and health trusts.

Ms Reid told the inquiry that the issues around visiting were "really important" not just for the pandemic but moving forward in terms of care home management and support for care homes more generally as outbreaks, including respiratory and winter viruses, so happen.

Ms Reid said it was "hugely important" to have engagement with a range of stakeholders and to have "that breadth of views from the outset where possible".

"It's really difficult and challenging to get a one size fitting all because we had, on one hand, some relatives who were wanting to visit more, and other relatives at the other end of that spectrum who were very keen for isolation and protecting their loved ones at all costs," she added.

The inquiry also heard that the PHA did not have access to definite data regarding how many people were in receipt of care in the social care sector and how many people worked in the sector, including their role.

Ms Reid said there was a "particular gap", and it would have been helpful to have that information.

She explained that reporting of deaths data in care homes was "quite a complicated area" and the information collated on the reason for the deaths is "quite difficult" to understand.

"In that population, deaths would not be that uncommon so it was quite difficult to tease out exactly which deaths may have been associated with Covid and which may not have been associated with Covid," she added.

In Northern Ireland, the Northern Ireland Statistics and Research Agency (NISRA) is the primary body responsible for reporting on deaths.

The inquiry also heard that there has been a "significant restructuring" across the PHA.

"It's always very difficult to get that balance between working effectively in a business as usual and also in preparing for what the next major incident might be", she said.

"Obviously this was one of the biggest events that any of us will ever see in terms of a public health emergency so it's really quite difficult to balance that but certainly I think that the new structures that are in place very much support and address that," said Ms Reid.