For grieving daughter Lisa Hovell, the coronavirus crisis in care homes seems far from over.

%image(15245380, type="article-full", alt="Dennis Ely, who died in hospital after contracting coronavirus Picture: SUPPLIED BY FAMILY")

Over the past six weeks, amid a slowing number of deaths and cases, she has been fighting for answers over her 82-year-old father’s death from Covid-19.

Like many others, Mrs Hovell has raised questions over whether staff treating her dad wore PPE – and if he caught the virus from people admitted back into his care home from hospital.

A further 17 deaths in Suffolk’s care homes reported this week has brought the total death toll to 152, according to provisional Care Quality Commission data.

That’s compared with 110 in Norfolk, and 107 in Cambridgeshire, both of which have bigger populations.

Data out this week reveals 71% of Ipswich and 70% of Mid Suffolk care homes have battled outbreaks during the pandemic.

They are two of the highest percentages in the country.

Suffolk also recently received a £9m share of the Infection Control fund, launched to reduce coronavirus spread in care homes.

But why has the county had so many outbreaks and deaths?

Beds ‘block booked’ in care homes

At the beginning of the coronavirus outbreak, Suffolk’s clinical commissioning groups and county council block purchased 182 beds in care homes so that hospital patients could be moved into them.

It is feared that these patients, who were not tested for Covid-19, brought coronavirus into care homes.

The ‘block booking’ happened after NHS boss Simon Stevens, sent a letter to all hospitals on March 17 urging them to “urgently discharge” all hospital in-patients who were medically fit to leave.

%image(14549107, type="article-full", alt="Councillor Helen Armitage, Labour spokeswoman for health at Suffolk County Council, said care homes needed clarity. Picture: SARAH LUCY BROWN")

It was not until a month later, on April 15, that hospitals and care homes were told these patients needed to be tested for coronavirus before being discharged.

The number of beds set aside for hospital patients in Suffolk is among the highest in the country, and cost £4.5million to secure for an initial period of April 1-July 31 and beyond.

Helen Armitage, Labour’s health spokeswoman at Suffolk County Council (SCC), said when the authority was asked why Suffolk had a higher death toll its adult social care boss said she “did not know”.

“What we now know is 182 care home beds in Suffolk were reserved in order to discharge hospital patients,” she said.

“We also know these patients were not routinely tested until mid-April.

“It is reasonable to believe this was a major factor in causing the virus to spread in our care homes.”

%image(14551862, type="article-full", alt="Penny Otton, leader of the Liberal Democrat, Independent and Green group, branded the move "irresponsible" beyond belief Picture: SARAH LUCY BROWN")

Penny Otton, leader of the Liberal Democrat, Green and Independent Group at Suffolk County Council, added: “Failing to test patients being discharged from hospital, and then placing these patients into care homes, is irresponsible beyond belief.

“We are very concerned that this occurred in Suffolk, and that this seems to account for the much higher proportion of Suffolk care homes with outbreaks compared to Norfolk and Cambridgeshire.”

The CCGs and SCC said the additional 182 beds have helped them cope with additional demand.

Hospital chiefs, meanwhile, said they were following national guidance when they discharged patients.

On Wednesday, Boris Johnson told senior MPs there had never been a “concerted effort to move people out of NHS beds into care homes”.

‘I can’t move on’

%image(15245381, type="article-full", alt="Dennis Ely lived in Ipswich all his life Picture: SUPPLIED BY FAMILY")

Five people, one of whom later tested positive for coronavirus, were discharged from Ipswich Hospital into Asterbury Place between March 19 and April 6.

Bosses at Care UK, which runs the home, said that to the best of their knowledge, none of the five had Covid-19 on arrival - but because there was no testing, they cannot be sure. All were asked to self-isolate in their rooms.

But one, who was admitted to hospital in early April with a health condition that did not suggest coronavirus, took a test which gave a positive result.

Mrs Hovell is adamant this was how the virus got into her father’s care home – and questioned why people were not being tested before they were discharged.

Mr Ely died on April 10, and the five further deaths happened over a three-week period between that date and April 28.

“Why did they admit people in from the hospital, from other outside organisations?” Mrs Hovell said.

%image(14549428, type="article-full", alt="Six deaths linked to the coronavirus have now been reported at Asterbury Place Picture: ARCHANT")

MORE: Is full testing of staff and residents being offered to Suffolk care homes?

Care home chiefs also confirmed that in line with national PPE guidance, protective equipment was not being used until April 11, when they first discovered Covid-19 was in the home – even though they had full stocks from the outset.

“(Staff at the home) knew PPE was there, but the management said, ‘it’s not time yet’,” Mrs Hovell added.

“I can’t move on myself until I’ve got some answers about what happened.”

Despite attempts to contact head office by phone and email, the family say they are yet to receive answers over Mr Ely’s death – but they had received a final bill for his care.

However, since this newspaper contacted owners Care UK, they said a full response has been sent updating the family on the results of their investigation. Mrs Hovell said she is yet to receive this.

%image(15245382, type="article-full", alt="Dennis Ely in his younger years Picture: SUPPLIED BY FAMILY")

A Care UK spokeswoman said they were very sorry for the delay, adding that an initial reply was sent within three working days of the first email.

“Since then, all the facts have been gathered and a detailed response has now been sent to the family,” the spokesman said.

“We do acknowledge that we should have updated the family on our progress with the investigation.”

PPE and testing ‘very hit and miss’

David Finch, who heads up Suffolk’s association of independent care home providers, said various other factors also need to be considered.

In Suffolk, there are a higher number of nursing beds than in Norfolk and Cambridgeshire with people choosing to spend their final moments in homes rather than in hospital.

Also, some of Suffolk’s care home buildings are older, and less able to establish isolation areas.

National issues such as PPE and testing were “key problems” early on, Mr Finch said, with PPE supplies very “hit and miss” at the beginning of the crisis.

“I remember early in April going into Ipswich Hospital for a routine appointment, which was still going ahead,” Mr Finch recalls.

“You could see all the staff with PPE – goggles, masks, aprons, gloves, visors – and at that point there were still care workers without aprons and gloves.

“PPE supply has been very hit and miss from what I understand, early on, they didn’t know what was turning up, when it was turning up. Over the last six weeks it has been so much better. Suffolk County Council (SCC) has given out something like 9,000 masks per day.”

Early in the crisis Nicola Rowland, who runs Park Manor Care Home in Ipswich, said she had “lost sleep” and spent hours searching for PPE – while SCC said it had “lobbied the government” for more supplies.

%image(14549133, type="article-full", alt="David Finch, chairman of the Suffolk Association for Independent Care Providers, said testing was crucial for beating the virus in Suffolk care homes. Picture: CEPHAS CARE")

A PPE cell was quickly established, with Mr Finch saying his organisation “has ongoing confidence” in stock levels.

Suffolk County Council’s adult social care team said a testing system had been in place locally since the end of April and start of May where all staff and residents in a care home would be offered testing, if one person displayed symptoms and their test came back positive.

SCC bosses say this has meant they have been able to confirm Covid-19 causes of death, perhaps earlier than other regions.

Matt Hancock responds

It’s still near impossible to tell the true scale of deaths and cases, Mr Finch said, due to testing issues.

Had national guidance on PPE and testing been better, some deaths would “most certainly” have been prevented, Mr Finch added.

%image(14619172, type="article-full", alt="Health secretary Matt Hancock said millions of pounds had been given to Suffolk to help beat the virus Picture: Pippa Fowles/10 Downing Street/Crown Copyright/PA Wire")

Health secretary and West Suffolk MP Matt Hancock said the government had spent an extra £380m in Suffolk to tackle Covid-19.

“I have been completely open about the scale and the difficulties of this PPE challenge,” he said.

“I launched a new PPE plan to ensure the right pieces of equipment get to the right people at the right time in our Suffolk hospitals and care homes over the coming months.

“Our testing programme has been running very successfully. I will continue to carefully monitor the impact of outbreaks on care homes to ensure providers get all the support they need.”

‘Scores of people still dying’

UNISON eastern’s head of local government Sam Leigh called on health, council and care leaders to work with unions to establish “what’s gone wrong” in Suffolk.

“It’s shameful that scores of people in Suffolk care homes are still dying of Covid-19 every week,” he said.

“Health, council and care leaders need to work with unions to find out what’s gone wrong in Suffolk.”

But Beccy Hopfensperger, adult social care boss at Suffolk County Council, said: “I believe people can feel confident that their loved ones are being properly looked after in care homes throughout Suffolk.

“While it is deeply upsetting that we are losing loved ones to this virus, it is a reflection on the high quality of our care homes in Suffolk that they are able to provide a comfortable environment for people.”

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%image(14551199, type="article-full", alt="Union leaders called for health and council leaders to work with them to establish what went wrong Picture: ANDREW MATTHEWS/PA WIRE")

%image(14549192, type="article-full", alt="Councillor Rebecca Hopfensperger, Conservative cabinet member for adult care, said full care home testing had been in place for a number of weeks. Picture: SCC/SIMON LEE PHOTOGRAPHY")