Coronavirus West Berkshire: 8 care settings have experienced coronavirus outbreaks

Push to discharge patients to care homes 'may have been compromised'

EIGHT places providing care in West Berkshire have had a Covid-19 or suspected Covid-19 related death as of last Tuesday.

West Berkshire Council's executive member for adult social care Graham Bridgman (Con, Burghfiled and Mortimer) announced the figure in a virtual meeting this morning (Thursday).

Mr Bridgman said that the deaths had been in care settings, which includes a hospital, care home with nursing, care home or home.

The Health and Wellbeing Board also heard that 32.6 per cent of care homes in the district had experienced a coronavirus outbreak and that the push to discharge patients from hospitals to care homes was "potentially compromised".

Mr Bridgman said that the council did not have a 'place with caution' category that relates directly to coronavirus for care settings in the district.

Mr Bridgman said: "Obviously we are working with providers to understand what is going on in the care homes, where there are outbreaks and what measures are being taken by care homes to deal with outbreaks or to avoid outbreaks.

"So we are ensuring that when we place a client into a care setting we are doing that appropriately and we are not placing clients at risk into an inappropriate setting."

Speaking about coronavirus-positive people being discharged into care homes Mr Bridgman said: "My understanding is for the North Hampshire and Berkshire healthcare trusts patients aren't being discharged if they have tested positive and they are retested until they test negative."

Berkshire West Clinical Commissioning Group chief officer Cathy Winfield said the procedure for the Royal Berkshire NHS Foundation Trust was "all patients are now tested and their results are received before they are discharged from the Royal Berks and the close liaison with the care homes is in place".

She said: "People can be discharged if they are Covid positive, but only on the basis that the care home can implement the appropriate infection control procedures, so it's a pretty tight process."

Mrs Winfield also spoke about the priority to not overwhelm the NHS in the first stages of the pandemic.

She said: "I think the priority in the early part of the pandemic was to ensure that the NHS wasn't overwhelmed.

"We were able to step up the critical care capacity at the Royal Berks, and indeed other hospitals that serve the West Berkshire patch, and the NHS was not overwhelmed and we were able to meet those care needs.

"We didn't have to send patients to any of the large Nightingale hospitals that were set up."

She said there was then a move to "rapidly discharge patients from hospital where that was safe to do so" into care homes.

"I think one of the key bits of learning is it would have been sensible to have considered infection control issues in relation to that discharge programme," she said.

"At that time we didn't have in place the routine screening of patients, the swabbing of patients, before they left the hospital.

"That big discharge push occurred before that was in place and I think before care homes had had the opportunity to have the training, PPE and the testing regime that we have now got in place.

"So their ability to cope and possibly cohort patients effectively was potentially compromised or not as robust as it could have been.

"There's quite a lot of learning coming from that big discharge push, but nevertheless the capacity was created."

When asked about scrutiny and transparency in care homes Mr Bridgman said that Public Health England notified councils of where there had been an outbreak.

He said that the council's adult social care team kept a log to track suspected or confirmed outbreaks, how many residents and staff had been affected, how many had recovered and how many had died.

"That's not to say that a death may directly be Covid, even though a home has had an outbreak," Mr Bridgman said.

"I think we all know the difficulty, particularly at the outset when essentially three tests were treated as a Covid outbreak. Someone died – the death certificate might say Covid, it might not say Covid, there might be a suspicion of Covid."

He said that the council and Berkshire Healthcare NHS Foundation Trust were working with all providers to make sure that effective control measures were in place, with sufficient PPE, and that it was being used correctly and that staff were appropriately trained in its use.

Mr Bridgman said: "I'm satisfied that there is scrutiny and transparency, that there is adequate PPE and that the staff have the training and have access to the training to know how to use that PPE adequately."