Care Quality Commission publishes data showing death notifications involving COVID-19 received from individual care homes

The Care Quality Commission (CQC) is today publishing data showing death notifications involving COVID-19 received from individual care homes between 10 April 2020 and 31 March 2021. This is accompanied by our CQC Insight report which draws from the data to make the key points and provides crucial context for understanding what this data says. We are publishing this data in addition to the data already published on a weekly basis with the Office for National Statistics (ONS) on the total number of care home residents who have died with COVID-19.

The impact of the pandemic on people who draw on and work in adult social care services has been devastating and despite the best efforts of staff, COVID-19 has contributed to a significant increase in the number of deaths in nursing and residential care settings. Throughout the pandemic, CQC has encouraged care providers to be open with people in their care and their loved ones and most providers have ensured that information about the circumstance of people’s deaths is shared appropriately.

It is important to note that death notifications do not in themselves indicate poor quality care, particularly given the potential influence of variable factors, including rates of local community transmission, size of the care home, and the age and health and care needs of the people living there. Moreover, many notifications relate to the deaths of care home residents which occurred in other care settings.

The data on the number of death notifications involving COVID-19 from care homes across all regions published today is presented alongside government data on all COVID-19 deaths. This is because care homes are part of the local community and are impacted when COVID-19 is prevalent in the local area.

The inclusion of a death in the published figures as being involved with COVID-19 is based on the statement of the care home provider, which may or may not correspond to a medical diagnosis or test result or be reflected in the death certification.

The data covers deaths of residents involving COVID-19 under the care of the provider as notified to CQC, regardless of where the virus was contracted or where the death occurred, including in the care home, in hospital, in an ambulance or in any other setting. For example, a resident may have been admitted from a care home to hospital with a fracture, contracted COVID-19 while in hospital, and subsequently died without returning to the care home. The provider must notify CQC of the death of their resident and that this was involving COVID-19, but this would not necessarily indicate that there was COVID-19 present in the care home.

Throughout the pandemic, CQC has used information from individual care homes about deaths involving COVID-19, alongside other information and any concerns received, to assess risks and make decisions about where to inspect, taking action to protect people where necessary.

CQC conducted 5,577 inspections of residential adult social care providers between 10 April 2020 and 31 March 2021. While death notifications are one indicator which might lead to an inspection, other information of concern, including safeguarding referrals, whistleblowing, complaints, previous regulatory history, or absence of a registered manager, are all more likely than death notifications to indicate where there is a risk of poorer quality care.

Kate Terroni, CQC’s Chief Inspector of Adult Social Care, said:

“In considering this data it is important to remember that every number represents a life lost – and families, friends and those who cared for them who are having to face the sadness and consequences of their death.

“We are grateful for the time that families who lost their loved ones during the pandemic have spent meeting with us and the personal experiences they have shared. These discussions have helped us shape our thinking around the highly sensitive issue of publishing information on the numbers of death notifications involving COVID-19 received from individual care homes.

“We have a duty to be transparent and to act in the public interest, and we made a commitment to publish data at this level, but only once we felt able to do so as accurately and safely as possible given the complexity and sensitivity of the data. In doing so, we aim to provide a more comprehensive picture of the impact of COVID-19 on care homes, the people living in them and their families. It is important to be clear, however, that although this data relates to deaths of people who were care home residents, many of them did not die in or contract COVID-19 in a care home.

“As we publish this data, we ask for consideration and respect to be shown to people living in care homes, to families who have been affected, and to the staff who have done everything they could, in incredibly difficult circumstances, to look after those in their care.”

In addition to wider ongoing monitoring of adult social care services, CQC also carried out inspections looking specifically at infection prevention control in care homes between 10 April 2020 to 31 March 2021, so that the public can be assured across eight key criteria that services have an effective approach to infection prevention control.

These inspections looked at areas including whether staff had been properly trained to deal with outbreaks and whether staff and residents had adequate PPE (Personal Protective Equipment), and, while in a small number of cases inspectors took action to protect people, they found generally high levels of assurance.

Across all care settings, staff have gone to great lengths to try to contain the effects of this virus, as our report published today on infection prevention and control in hospitals shows.

Ends

Notes to editor

• Providers have a duty to notify CQC of deaths of people under their care. This data is based on the notifications that care home providers have sent to us. Care providers has been given advanced sight of the data published on their service.

• The notification form asks care homes to tell us whether the death was a result of suspected or confirmed COVID-19. Since it is not clear if the cause of death is COVID-19, throughout this publication release we discuss these figures as ‘deaths involving COVID-19’.

• ONS publishes their own weekly data on deaths in care homes in England. These figures may not completely tally with the deaths published by ONS. This is because ONS data is based on death registrations and the date of death, whereas

• CQC data is based on the date that providers notify us of a death potentially involving COVID-19. These figures will also be different from the data published by the government, which reports deaths that occurred within 28 days of a positive COVID-19 test both by date of death and date reported to Public Health England.

• Given the evolving national uncertainty around COVID-19 and its spread across people and communities, CQC took a decision that releasing the data at the height of the pandemic could have a serious impact on continuity of care, with concerns people could use it to make decisions that inadvertently put people at wider risk if they were considering the data as a single indicator of safety. Our decision was accepted by the Information Commissioner’s Office. CQC has consulted with partners, including the Office of National Statistics (ONS), the Information Commissioner’s Office and the Office of the National Data Guardian to ensure that this data is presented accurately and responsibly.

• Our inspectors use all the data and information we receive about a service to monitor for indications that there is a risk to the quality of care, which may lead to an inspection. Notifications of deaths are only one of these indications, but they are not in themselves a good predictor of poor-quality care, particularly given the potential influence of variable factors, including rates of local community transmission and size of the care home. Other variable factors include the characteristics of people living in the care home, including their age, health, and care needs, and whether they are from Black and minority ethnic groups, for whom the pandemic has had a disproportionate impact.

Throughout the COVID-19 pandemic, the CQC’s regulatory role has not changed. CQC’s core purpose of keeping people safe is always driving decisions about when and where we inspect. As the risks from the pandemic change, we are evolving how we regulate services to reflect what we have learnt during this time. You can read more about our current approach on our website.