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1240974

registered interest
date	06/10/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of the decision for inspectors from the Care Quality Commission to be permitted to visit care homes without having undergone a COVID-19 test; and what evidence they have that this does not pose a risk to the residents of those homes.
tabling member printed	Lord Alton of Liverpool
uin	HL8798
answer	answer is ministerial correction date of answer 19/02/2021 answer text <p>Our first priority continues to be to reduce the risk of COVID-19 transmission in care homes and prevent future outbreaks, and to ensure the health and safety of both care workers and residents. To help reduce the risk of transmission, we have provided the Care Quality Commission (CQC) with test kits so CQC inspectors can undertake weekly polymerase chain reaction asymptomatic testing.</p><p>Regular testing will help identify positive cases in the CQC’s inspectors without symptoms and enable action to be taken to limit the spread of the virus, supporting the CQC to continue their vital work in ensuring services meet fundamental standards of quality and safety. As with all testing policies, this remains under review.</p> answering member printed Lord Bethell question first answered 19/02/2021 12:31:25 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1240216

registered interest
date	05/10/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of the findings of Amnesty International's report As if expendable: the UK Government's failure to protect older people in care homes during the COVID-19 pandemic, published on 4 October.
tabling member printed	Lord Alton of Liverpool
uin	HL8700
answer	answer is ministerial correction date of answer 15/10/2020 answer text <p>Since the start of this pandemic we have been working closely with the sector and public health experts to put in place guidance and support for adult social care. We have taken steps to ensure residents and staff are protected, including testing all residents and staff, providing 208 million items of personal protective equipment, ring-fencing £1.1 billion to prevent infections in care homes and making a further £3.7 billion available to councils to address pressures caused by the pandemic – including in adult social care.</p><p>Residents’ individual circumstances must be considered in any decisions, ensuring that their human rights, personal choices, safety and dignity are upheld. Early in the pandemic, we outlined the importance of this through the Adult Social Care Ethical Framework.</p><p>We keep our policies under continuous review based on the emerging international and domestic evidence and will consider Amnesty’s report as part of this. On 18 September, we published our Adult Social Care Winter Plan which included several additional measures to support care homes during the pandemic.</p> answering member printed Lord Bethell question first answered 15/10/2020 15:06:28 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1226161

registered interest
date	20/07/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of reports that during the peak of the COVID-19 pandemic more than 4,000 people were discharged from hospital into care homes without being tested for the virus.
tabling member printed	Lord Alton of Liverpool
uin	HL6991
answer	answer is ministerial correction date of answer 10/08/2020 answer text <p>Throughout our COVID-19 response we have worked with the care sector and public health experts to put in place measures to reduce transmission and save lives. It has been our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place. Wherever possible, people who are clinically ready should be supported to return to their place of residence, where assessment of longer-term needs will take place. This approach follows the ‘Discharge to Assess’ model, to support timely and appropriate discharge from hospital.</p><p>The Hospital Discharge Service and staff should clarify with care homes the COVID-19 status of an individual and any COVID-19 symptoms, during the process of transfer from a hospital to the care home. As testing capacity was being built priority for testing was given to the most clinically vulnerable patients:</p><p>- all patients in critical care for pneumonia, acute respiratory distress syndrome (ARDS) or flu like illness;</p><p>- all other patients requiring admission to hospital for pneumonia, ARDS or flu like illness; and</p><p>- where an outbreak has occurred in a residential or care setting, for example long-term care facility or prisons.</p><p>As set out in the Adult Social Care Action Plan on 15 April, all patients are now required to be tested prior to discharge to a care home.</p> answering member printed Lord Bethell question first answered 10/08/2020 10:00:05 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1222164

registered interest
date	08/07/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of reports (1) that care home managers have not followed COVID-19 safety procedures, (2) that care home staff and residents had concerns about exposure to COVID-19 which warranted investigation by the Care Quality Commission, and (3) that care home providers may be subject to compensation claims for alleged negligence of resident and staff safety.
tabling member printed	Lord Alton of Liverpool
uin	HL6601
answer	answer is ministerial correction date of answer 22/07/2020 answer text <p>Many care homes have been doing an excellent job of keeping people safe.</p><p>The Care Quality Commission (CQC) reduced the number of physical inspections it conducted during the crisis in order to limit the number of people going in and out of care homes. It did continue to inspect a small number of settings where serious concerns have been identified. Some of these were linked directly to concerns raised with the CQC from staff and members of the public.</p><p>Furthermore, during this crisis, Care Quality Commission (CQC) inspectors have contacted more than 80% of all providers – over 20,000 care providers – to offer support, advice and guidance, including help accessing personal protective equipment and advice on infection control.</p> answering member printed Lord Bethell question first answered 22/07/2020 13:34:06 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1204164

registered interest
date	16/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what assessment they have made of the remarks made by the Rt Hon Jeremy Hunt MP on 12 June that “whilst the impact of such discharges meant the NHS was never short of beds or ventilators, it seems extraordinary that no one appeared to consider the clinical risk to care homes despite widespread knowledge that the virus could be carried asymptomatically.”
tabling member printed	Lord Alton of Liverpool
uin	HL5739
answer	answer is ministerial correction date of answer 07/07/2020 answer text <p>Throughout our coronavirus response we have kept our policies under continuous review based on the emerging international and domestic evidence and have worked tirelessly with the care sector and public health experts to reduce transmission and save lives.</p><p>On 15 April, we published COVID-19: Our Action Plan for Adult Social Care. This set out that all patients are required to be tested prior to discharge to a care home. A copy is attached.</p><p>Patients are discharged when it is clinically safe and they no longer need acute care. Wherever possible, people who are clinically ready should be supported to return to their place of residence, where assessment of longer-term needs will take place. This approach follows the ‘discharge to assess’ model, to support timely and appropriate discharge from hospital.</p><p>As our understanding of the virus has changes throughout the course of the pandemic, we have continued to develop our policy. Our current policy is that due to evidence of asymptomatic spread, during periods of sustained transmission we recommend that all residents being discharged from hospital or interim care facilities to the care home and new residents admitted from the community should be isolated for 14 days within their own room. For care home residents, around 70% of people living in care homes for the over 65s have dementia. It is important they return to their familiar environments when they are clinically ready, with the personalised support and daily activities in place that help them to live well with dementia. This can be better achieved in their care home, rather than the hospital.</p><p>We have made £1.3 billion funding available via the National Health Service to help patients who no longer need urgent treatment to get home from hospital safely and quickly. We have also made £3.2 billion available to local authorities so they can address pressures on local services caused by the pandemic, including in adult social care. On 13 May we announced an additional £600 million to support care home providers through a new Adult Social Care Infection Control Fund.</p> answering member printed Lord Bethell question first answered 07/07/2020 17:15:53 answering member 4708 label Biography information for Lord Bethell attachment 1 file name covid-19-adult-social-care-action-plan.pdf title Adult Social Care Action Plan
tabling member	738 label Biography information for Lord Alton of Liverpool

1201001

registered interest
date	08/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what assessment they have made of the statement by Age UK that (1) some residents of care homes are being asked to pay more than £100 a week in extra fees to cover the costs of COVID-19, and (2) the inability of residents to meet these costs could precipitate closures of care homes leaving residents homeless.
tabling member printed	Lord Alton of Liverpool
uin	HL5344
answer	answer is ministerial correction date of answer 18/06/2020 answer text <p>When choosing to charge, a local authority must not charge more than the cost that it incurs in meeting the assessed needs of the person. A local authority must also regularly reassess a person’s ability to meet the cost of any charges to take account of any changes to their resources.</p><p>We know the social care sector is under pressure due to growing demand from both older people and those of working age. We are providing councils with a £1 billion grant for adults and children’s social care on top of maintaining £2.5 billion of existing social care grants for 2020/21. We have provided £3.2 billion to local authorities to help with COVID-19 pressures, and a £600 million Infection Control Fund for care homes, 75% of which must be distributed on a 'per bed' basis, including to social care providers with whom the local authority does not have existing contracts.</p> answering member printed Lord Bethell question first answered 18/06/2020 11:18:05 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1201002

registered interest
date	08/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what steps they took in response to the information published by Public Health England in February advising that (1) people should not be discharged from hospitals into care homes if there was risk of COVID-19 transmission, (2) it was not safe to discharge untested individuals to care homes from hospitals where there was between five and 25 cases, and (3) there should be no discharges to care or residential homes.
tabling member printed	Lord Alton of Liverpool
uin	HL5345
answer	answer is ministerial correction date of answer 18/06/2020 answer text <p>The scenario set out in Public Health England’s (PHE) National Infection Service document, issued on 24 February, related to hospital-acquired COVID-19 outbreaks during the containment phase of COVID-19, prior to 12 March, when there was no sustained community transmission in the United Kingdom. There was no evidence of recorded cases of hospital-acquired COVID-19 outbreaks during the COVID-19 containment phase and before 19 March when the COVID-19 hospital discharge service requirements were published.</p><p>On 12 March the Government announced that we were moving our COVID-19 response from the ‘contain’ to ‘delay’ phase. On 13 March PHE published new guidance to care homes. We subsequently published the COVID-19 hospital discharge service requirements on 19 March.</p><p>Since the start of the outbreak we have been working closely with the sector and public health experts to ensure we have the right guidance and support in place for care homes.</p> answering member printed Lord Bethell question first answered 18/06/2020 11:21:39 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1201003

registered interest
date	08/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what plans they have to publish their response to the letters sent by the National Care Forum on (1) 26 March, and (2) 10 April which (a) stated that care homes were “being pressured into taking hospital discharge patients who had not been tested for the virus, even though they were exhibiting symptoms”, and (b) called for discharged patients to be tested or risk litigation over the “avoidable deaths” of residents who subsequently became infected.
tabling member printed	Lord Alton of Liverpool
uin	HL5346
answer	answer is ministerial correction date of answer 22/06/2020 answer text <p>The Department does not have record of the correspondence from the National Care Forum.</p> answering member printed Lord Bethell question first answered 22/06/2020 10:42:21 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1201004

registered interest
date	08/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what assessment they have made of the letter sent to the Secretary of State for Health and Social Care by Cathy Gardner questioning the legality of discharging patients with COVID-19 into care homes, including the one in which her father died on 3 April, and calling for a retraction of the statement that a “protective ring had been thrown around care homes”; when they intend to respond; and what advice they have (1) sought, and (2) been given, by Government law officers in response to that correspondence.
tabling member printed	Lord Alton of Liverpool
uin	HL5347
answer	answer is ministerial correction date of answer 18/06/2020 answer text <p>The Government does not comment on litigation matters.</p><p>Every death from this virus is a tragedy. It is our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place. Patients are discharged when it is clinically safe and they no longer need acute care.</p><p>We have provided extensive support and guidance to care homes throughout the COVID-19 pandemic. We have also provided local authorities with £3.2 billion to help them deal with the impacts of COVID-19, as well as £1.3 billion via the National Health Service to enhance the NHS discharge process. On 13 May, we announced an additional new £600 million Infection Control Fund for care homes to tackle the spread of COVID-19.</p> answering member printed Lord Bethell question first answered 18/06/2020 11:18:54 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool

1200314

registered interest
date	03/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Care Homes: Coronavirus
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government whether patients were discharged to care homes by NHS hospitals in the 30 days before ministers introduced routine COVID-19 testing; if so, why; and what assessment was made of the preparedness of the social care sector for the arrival of such patients.
tabling member printed	Lord Alton of Liverpool
uin	HL5152
answer	answer is ministerial correction date of answer 18/06/2020 answer text <p>It has always been our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place. On 19 March we published the <em>COVID-19 Hospital Discharge Service Requirements</em> to support the safe and rapid discharge of patients who no longer need acute care. This specified that, wherever possible, people who are clinically ready should be supported to return to their place of residence (this could be a care home), where assessment of longer-term needs will take place. This follows the ‘Discharge to Assess’ model. Where a patient had been tested for COVID-19, we specified that results – whether negative or positive – should be included in a patient’s discharge documents.</p><p> </p><p>To support the sector, this guidance also sets out the steps that care providers should be taking, and we provided £1.3 billion to support the process. We have provided advice to care homes throughout the pandemic in response to the latest conditions and emerging evidence and data.</p><p> </p><p>On 2 April we published our <em>Admission and Care of Residents during COVID-19 Incident in a Care Home</em> guidance. This set out further advice on infection control procedures for care homes e.g. limiting visits to essential visits only unless exceptional circumstances and providing advice on isolation, decontamination, cleaning and protective measures for staff. We recommended that all symptomatic residents in care homes should be immediately isolated for 14 days from the onset of symptoms, including patients discharged from hospital.</p><p> </p><p>On 15 April we published our Adult Social Care Plan which included a commitment to all patients being tested prior to discharge to a care home. A copy of <em>COVID-19: Our Action Plan for Adult Social Care </em>is attached.</p><p> </p><p>Copies of the <em>COVID-19 Hospital Discharge Service Requirements</em> and <em>Admission and Care of Residents during COVID-19 Incident in a Care Home</em> are attached.</p> answering member printed Lord Bethell attachment 1 file name COVID-19_hospital_discharge_service_requirements.pdf title Hospital Discharge Service Requirements 2 file name admission-and-care-of-residents-during-covid-19-incident-in-a-care-home.pdf title Admission and Care of Residents during COVID-19 3 file name covid-19-adult-social-care-action-plan.pdf title Action Plan for Adult Social Care question first answered 18/06/2020 11:21:02 answering member 4708 label Biography information for Lord Bethell
tabling member	738 label Biography information for Lord Alton of Liverpool