A UK public inquiry has found that government failures during the Covid-19 pandemic led to the virus spreading rapidly among care home residents, with more than 43,000 deaths recorded between March 2020 and July 2022. The report, chaired by Baroness Heather Hallett, concludes that the adult social care sector was treated as an “afterthought” and received “insufficient protection” during the period when it was most vulnerable.
The inquiry specifically challenges claims made by then-Health Secretary Matt Hancock, who stated in May 2020 that a “protective ring” had been thrown around care homes from the start of the crisis. Baroness Hallett described this assertion as “unfounded” and said the opposite was true. Families of bereaved care home residents have strongly condemned Hancock’s statement, calling it a “cruel lie.” Hancock has declined to comment on the report’s findings.
Central to the failures was the government’s policy to discharge tens of thousands of hospital patients into care homes without mandatory Covid-19 testing before mid-April 2020. This decision was aimed at freeing up hospital beds but was widely criticized for facilitating virus transmission among vulnerable elderly populations. Hancock told the inquiry that the measure was the “least worst decision to a terrible problem,” but inquiry findings highlight the absence of guidance for isolating discharged patients as a “significant omission.”
Care home staff also faced severe challenges, including widespread shortages of personal protective equipment (PPE). The report details how workers resorted to makeshift solutions such as festival waterproof ponchos, painters’ overalls, and homemade masks fashioned from bin bags and bed linen. This lack of adequate PPE was described as “wholly unacceptable” and compounded the risk of infection within care settings.
Visiting restrictions in care homes, implemented to limit virus spread, had profound emotional and health impacts on residents and their families. Many residents experienced isolation and decline, especially those with dementia, as restrictions sometimes prevented relatives from being present in final moments. The inquiry characterizes care homes during lockdown periods as “prisons” and notes the enduring guilt felt by relatives unable to be with loved ones.
The report also addresses concerns over the use of “Do Not Attempt Cardiopulmonary Resuscitation” (DNACPR) orders, finding that some were applied inappropriately, sometimes based solely on age, disability, or health condition, without proper consultation or consideration of individuals’ wishes.
Baroness Hallett attributes many failings to the absence of adequate pandemic planning for the adult social care sector despite prior knowledge of its vulnerability, such as warnings from the 2016 Exercise Cygnus simulation. She calls for better preparation in future, including improved capacity for isolation within care homes, financial support to allow staff to self-isolate, and mandated end-of-life care training. The report includes eight key recommendations aimed at safeguarding care home residents and staff in any future health emergencies.
Prime Minister Andy Burnham responded by affirming the government’s commitment to learning from the inquiry’s findings and developing an action plan to better protect vulnerable populations moving forward. Meanwhile, groups representing bereaved families expressed disappointment that the report did not go far enough in certain areas and vowed to push for stronger measures to prevent similar failures in the future.
The UK Covid-19 Inquiry, established in 2022 and costing over £200 million to date, is expected to publish its final comprehensive report in mid-2027. The recent publication is the sixth of ten planned modules, focusing specifically on the impact and management of the pandemic within adult social care and residential homes.