Photo: Leeds online. One of the largest hospitals in the world, St. James's Hospital in Leeds is at the forefront of the fight against the Covid-19 epidemic. Founded as a workhouse in the nineteenth century, the hospital is now a leader in modern medicine.

UK care home staff was “under constant pressure” from the NHS to take in coronavirus-positive and untested patients, while nurses were instructed not to resuscitate them, a new study has revealed.

In a study whose key findings were first published by the Independent, the Queen’s Nursing Institute (QNI) surveyed nurses and managers working in 163 care homes across England, Wales, and Northern Ireland.

The staff at 70 care homes, 43 percent of those surveyed, said that they received patients discharged from hospitals who were not tested for Covid-19 during March and April, when the outbreak first hit the country and peaked. A fifth of care homes said they received patients who tested positive.

The study revealed that in some cases, seriously ill patents were brought into care homes from the hospitals even when the homes warned that they were incapable of looking after them. One nurse reported “constant pressure to admit people who were Covid-positive.” Another similarly said that “the acute sector pushed us to take untested admission.”

The staff reported that hospitals instructed them to change the status of all residents to “do not resuscitate .” One nurse said that such guidelines would “automatically” apply to all suspected or confirmed Covid-19 patients. Some of the surveyed nurses said that they refused to comply and challenged the instructions as “unethical.”

At the same time, care homes were told that hospitals had a blanket “no admissions” policy during the height of the outbreak.

QNI Chief Executive Crystal Oldman told the paper that the alarming findings were “symbolic” of how the government and the NHS viewed the care home system.

Nearly 19,400 care home residents died from Covid-19 in England and Wales between March 2 and June 12, according to the most recent government data. The grim statistics were coupled with multiple reports about care home staff struggling to get vital protective gear, such as masks and gloves.

The death toll in the care sector sparked constant criticism of the government, with Labour Party leader Keir Starmer calling the failure to protect care homes “a national shame.”

Prime Minister Boris Johnson said last month that he took “full responsibility for what has happened,” but argued that the government had done all it could at the time. He said that the situation in the care sector was exacerbated by the fact that “nobody knew early on during this pandemic… that the virus was being passed asymptomatically from person to person.”

So what are “care homes” in the UK and who runs them?

Care homes are similar to what are known as Adult Living Facilities (ALFs) in the United States, and include what used to be knows as Old People’s Homes in the UK.

In a detailed article Wired explains that he care homes sector is worth around £15.9 billion a year in the UK, with around 410,000 residents. They calculated that there are around 5,500 different providers in the UK operating 11,300 care homes mainly for the elderly, but also including other groups who are unable to live independently without some help.

The coronavirus pandemic has thrust the UK’s care homes into the spotlight as the worst hit by chronic understaffing and lack of testing for vulnerable residents.

In England alone, a third (29.1 per cent) of the more than 15,000 care homes are currently experiencing a coronavirus outbreak, and have reported 4,343 deaths within a fortnight from April 10. Care homes around the country have become the new front line of the pandemic — and deaths are piling up.

The rising cost of PPE and extra staffing to cover for self-isolating workers, combined with continuously falling occupancy rates, are pushing the sector into deep financial hardship.

A third of care providers in the UK are at risk of going out of business in the next three years and could be leaving thousands of elderly people and those with disabilities without much needed care.But Covid-19 does not have to kill thousands of vulnerable people to be the straw that breaks the social care sector’s back.

The sector, which includes domiciliary care workers who visit people with learning difficulties, mental health problems and physical disabilities in their own homes, was in trouble long before the coronavirus crisis hit.When caring for the elderly and vulnerable became big business in the 1980s, hedge funds and private equity firms – dazzled by the promise of a steady stream of income from an ageing population – piled into the sector and built, bought out or leased chains of care homes across the UK.

At the other end of the spectrum are family-run homes and a small number of charitable and council services. Local councils pay care home operators the bare minimum to house people without the means to pay for themselves, so operators charge people who can fund their own care at least 30 per cent more, an average £672 per week, to compensate for their running costs.

Besides the lack of funding, offshore owners and investors can cash out with short-term profits, which has pushed many care homes to the brink of financial collapse. A report published in November 2019 by the Centre for Health and Public Interest (CHPI), an independent think tank in London, revealed that the 26 largest providers of care home services in the UK – including HC-One, Four Seasons Health Care, Barchester Healthcare and Care UK – pocket around £1.5bn from an annual revenue of £15bn for lease agreements, dividends and debt repayments.

These businesses need profit margins of at least 12 per cent to be able to repay their debt, before reinvesting in staffing and the running of their homes, and if there isn’t enough income to pay the debt, then the quality of care provided comes under pressure.

[This article contains information first published on RT.com]