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Panorama 2020 E29
Transcript
00:00Joel, it's all right, me and Herbert are here.
00:04More than 22,000 residents of UK care homes
00:08have died with coronavirus.
00:10It would be an absolutely devastating loss of life,
00:13going to have to live with remembering for a long time.
00:16Panorama has filmed at the height of the pandemic,
00:20following staff, residents and families in two care homes.
00:25Are you doing grand?
00:27Ooh, tickled it a bit there.
00:30As they struggle to get the help they need.
00:33Well, we've been waiting for Murphy over three hours now.
00:37He needs something. It's really urgent.
00:40Suffer agonising loss.
00:43He's never spoken a complete sentence.
00:47But that night, he managed to say,
00:50I can't breathe, I'm drowning.
00:53It's hard to know that he suffered as much as he did
00:56and he didn't have to.
00:58And witnessed remarkable survival.
01:01There's a lot of them worse than me,
01:04but I'm much better than I was.
01:07Nasty.
01:09This is the reality of life on the front line of care.
01:13I've got this overwhelming sense of failure,
01:16that we failed them because we couldn't help them.
01:26Normally, the doors would be open.
01:30So people are not getting to a door and then going,
01:33I can't get through it, bang, bang, bang, bang.
01:37But we're experiencing some of that in a minute
01:40because we are having to keep the households closed.
01:49This is each step in Blakeley,
01:51on the outside of the care home,
01:53This is each step in Blakeley, on the outskirts of Manchester,
01:59home to nearly 60 people with dementia
02:02who live in five interconnecting households.
02:0712 people can live on a household.
02:09We have three dementia residential households
02:12and two dementia nursing households.
02:16Coronavirus has created confusing new barriers for residents.
02:22Staff need to limit movement around the home.
02:25Hello.
02:27Ellen, for instance, has some really difficult times.
02:35She becomes quite distressed and suspicious.
02:40Those times she can feel really tormented.
02:44by what's happening in her mind.
02:46It's all shut that way. It's closed.
02:49It's been a real challenge for Ellen.
02:52She's felt really trapped.
02:56Ellen.
02:58Come on. Let's go this way.
03:01It's all locked.
03:03I don't need anything. I don't need to be moved.
03:06You've been singing this morning, haven't you? Come on.
03:09You can touch me if you want. Of course you can.
03:14Can I touch you?
03:16Are you getting upset?
03:18Come on. Come with me. Come with me.
03:21Let's go for a walk.
03:23Come on. Come on. Let's go.
03:25You're all upset. Why are you upset? Come on.
03:32We're going to do a bank job here.
03:35Hi, Dad. Hi, darling.
03:38Michelle Phillips is the manager.
03:40Her father, Michael, is one of the residents.
03:43You're not cold, are you? Yeah.
03:45This is a place that Michelle helped design
03:48around the needs of people with dementia.
03:51It's a passion.
03:53It's consumed in everything I do, really.
03:56I wanted to try and bring about a change
04:01and some innovation and some difference to dementia.
04:05Sing a good song to the merry old sky.
04:10Where did you live before you came here?
04:14It's cos you're getting on a bit, what more do you want?
04:18Well, we all are, aren't we, really?
04:20How old are you? 21.
04:23You jumped up. You was 19 yesterday.
04:26You're 19, you're right, yeah.
04:29I think people speak of care,
04:33I think people speak of care homes
04:36along the lines of God's waiting room.
04:41Well, this place is really not like that.
04:45It's fun and lively places
04:48where people can live well with dementia
04:51and not sat in chairs...
04:57..dying of boredom.
05:00You broke my heart
05:03But still my love
05:07Is only for you
05:10Rudy Mancini, you know it
05:15Panorama filmed with the support of the residents' families.
05:19Until recently, they could come to parties here.
05:23The home welcomed the community in.
05:30But coronavirus has changed everything.
05:38In February and early March, as coronavirus begins to spread,
05:43care homes are desperate for guidance.
05:46Official advice from Westminster at this point
05:49says transmission in care homes is very unlikely
05:52and they should carry on as normal.
05:55Mark Adams heads the charity that runs Each Step Blakely.
05:59Community Integrated Care has 18 homes for older people across the UK.
06:04Most residents are publicly funded.
06:08In early March, we were seeing what was happening in Italy and Spain
06:13and in parts of America which were terrifying,
06:16including care homes where many people died
06:19in two or three significant outbreaks.
06:22And the writing was absolutely on the wall.
06:26Listen, what are the care homes saying?
06:28No official guidance on it yet,
06:30but many are restricting visitors
06:32or asking families to minimise their visits.
06:38We have not had advice or guidance about what we should do.
06:43We set up our own war room.
06:45We made our own decisions about what we could do to protect the people.
06:50On 13 March, the official guidance changes
06:54to say no-one with suspected COVID-19
06:57or who's unwell should visit care homes.
07:00It's not enough for the charity that runs Blakely.
07:03It locks down all its homes.
07:09A loader!
07:11Now, Mark makes his way to the care home.
07:15A loader!
07:17Now, Mark McGinty can only celebrate his mum's birthday outside.
07:22How are you?
07:28You look great.
07:30Happy birthday.
07:33I've missed you.
07:38You look like the Queen.
07:41She's safe. I'm just glad she's safe.
07:44I wish I could come in and see you.
07:47All we can do is just listen to the advice we're given
07:51and hopefully things will pass
07:54and we can start seeing our loved ones again.
08:05Phil Benson, a nurse and dementia specialist,
08:08is put on standby in case of an outbreak in one of the charity's homes.
08:15Upon the first case of coronavirus,
08:17there was a team of us that were ready to dispatch in.
08:20If the time comes and the call comes,
08:23there's two stories my son can tell when I'm older,
08:26and that is that my dad was a nurse and he helped,
08:29or my dad was a nurse and he stayed at home,
08:31because I want my son to be proud of me when I'm older.
08:34And it's the right thing to do anyway.
08:39BBC Radio Manchester.
08:41It's Monday 23rd March.
08:44From this evening, people must stay at home.
08:50By the time the whole country locks down, in England alone,
08:54there have been nearly 300 coronavirus outbreaks in care homes.
09:01A week later, Phil gets a phone call.
09:04It's from Blakely.
09:06I was looking after my son,
09:09and I had to call my wife home from work.
09:12She asked why, and I said,
09:14I'm having to go in.
09:16There's been a first confirmed case.
09:20Goodness, this is it.
09:22That's kind of...
09:24..that pit of your stomach dread.
09:28The first confirmed case was 78-year-old Doreen Tierney,
09:32who'd gone into hospital with breathing problems.
09:37Before she was discharged back to the home,
09:39she tested positive for coronavirus.
09:42It was scary,
09:44because obviously we didn't know much about Covid at that point.
09:47We didn't know how she was going to be when she came back.
09:51And it was scary for all the staff.
09:56Debra Fielding has worked at the home since it opened eight years ago.
10:03She was isolated in her room.
10:05She did come in through the back way,
10:07straight into her end bedroom.
10:10No residence was near her.
10:12The only certain staff were going in.
10:16They had to wear special PPE when they was going in,
10:18as in visors, goggles, aprons, gloves, masks.
10:23We just cared for her until the end of life.
10:29Even before Doreen returned from hospital,
10:32other residents had symptoms.
10:36MUSIC PLAYS
10:40Three days later, she is the first to die with Covid-19.
10:48And I've just checked your temperature.
10:50OK, that's lovely.
10:52Staff now monitor residents' temperatures, oxygen levels
10:56and blood pressure four times a day.
11:00It only takes one minor slip, like, to get Covid into the next room
11:04or for someone to have contact.
11:06You guys are really good at PPE
11:08and really good at making sure you're hand-washing properly.
11:14Despite all they're doing, the virus is spreading rapidly.
11:20Erm...
11:22I've had a weird day today, really.
11:25I get notification overnight
11:27that two people have become really poorly, very quickly.
11:30That were fine yesterday, like, stable.
11:34And, you know, now they're palliative, they're dying.
11:39Erm, and it's just so frustrating
11:42that we don't...we're not able to see or predict this at all.
11:4984-year-old Joan Day is one of their liveliest residents.
11:54She moved in last year.
11:57Until lockdown, her daughter saw her almost every day.
12:02Always friendly to everybody, always had a smile and said hello.
12:05And when she went in each step, whether it was the dementia,
12:09she was singing all the time.
12:12I felt great about it because I thought, well, she's happy.
12:18Erm, Joan Day?
12:19Temperature 36 and her oxygen levels are 89 and...
12:23Are you OK to talk to her?
12:25Oh, yeah, she's communicating,
12:27but she wasn't eating and drinking properly yesterday either.
12:31Early in the pandemic, few tests are available to care homes,
12:35but staff assume she has the virus.
12:39The risk of infection means they should limit time in her room.
12:45Just done a really brief assessment.
12:48Other than Emily, I'd go in and, you know, I'd have a look.
12:52I'd do some much closer stuff, but with the coronavirus,
12:55you want to try and keep the interactions minimal.
13:02Hi, Joan.
13:06Overnight, Joan begins to deteriorate quickly.
13:10Oh, hello. Can you hear me, Joan?
13:15Michelle Heavens is the senior carer.
13:18Joan, we're just going to reposition you and just check you're OK.
13:22OK, Joan.
13:25Through the night, the team gently move Joan to keep her comfortable.
13:31Hands are cold.
13:33Joan, are you in any pain?
13:36All right, Joan.
13:38Her oxygen levels have dropped suddenly
13:41and the carers check her every 15 minutes.
13:45She's struggling to breathe, so Herbert, the duty nurse, is called.
13:53Joan, it's all right. I'm here.
13:56Me and Herbert are here.
14:00Only trained nurses can administer the morphine prescribed to help ease pain.
14:07We've assessed her.
14:09She's still struggling a little bit in breathing.
14:12But her facial expression now is not showing a lot of pain.
14:22Normally, Joan's family would be there,
14:25but now carers are the only link they have to her.
14:30By 7am, it's clear she's not improving,
14:33so Michelle calls Joan's daughter.
14:35And, you know, there's not much else I can say apart from, you know,
14:40she's not going to come back from it.
14:49Every morning, I was awake from, like, five o'clock, couldn't sleep anyway.
14:55When Michelle called that morning,
14:58she said, you know, I'm going to be OK.
15:01When Michelle called that morning,
15:04she was explaining to me that, you know, things weren't good.
15:08She was lovely about it, really.
15:10And she was upset herself.
15:14And she said, Yvonne,
15:17I don't think she'll be here when I come back tonight.
15:21Just before her shift ends, Michelle goes back in to see Joan.
15:26OK.
15:27You've got to make sure that the skin doesn't break down
15:30and that Joan's comfortable.
15:33I sat down and held her hand cos I couldn't imagine not doing that
15:37just cos she's got COVID-19.
15:40You know, it's summer, I can't just walk away from it.
15:43Another day of going home in all sleep
15:45cos you're worrying about your residents and the families.
15:58Deborah now takes over Joan's care.
16:02Today, she's a nurse.
16:05She's a nurse.
16:07She's a nurse.
16:09She's a nurse.
16:12Today, she has five residents with COVID-19 in her charge.
16:18Yeah. OK.
16:20She seems comfortable, though. Oh, I do.
16:22This pressure area's OK? Absolutely fine.
16:25I'll come and check again a little bit later.
16:35Joan dies that afternoon.
16:42Deborah has to tell her daughter.
16:47She's got no words.
16:48We've checked on her 15 minutes ago and she was breathing there
16:53and we've just gone back in and sat cos she's passed.
16:57And she just went to sleep.
17:01I'm so sorry.
17:06Just sorry.
17:09I just put the phone down.
17:11I couldn't have a conversation with them or anything.
17:16I was devastated.
17:28The doctor confirms she died with COVID-19.
17:32It's just horrendous to know that she had the COVID, the virus.
17:38And not know what she was like, what condition she was in.
17:43Was she in pain? Was she really, you know, suffering?
17:47Was she asking for us?
17:52It's the worst feeling in the world.
18:00Downstairs, staff line up to pay their respects as Joan is taken away.
18:08It's one last act of care.
18:16Day 24.
18:20Shit one.
18:25Properly shit.
18:27I hope it stops soon.
18:29It feels like it's hard to be a nurse at the moment
18:31and I had to be proactive in managing the situation.
18:36Be proactive in managing people's health and keeping people safe and well.
18:41I don't feel like I'm able to do that properly or well.
18:50From the early days of the pandemic, the government's message is clear.
18:56Stay home.
18:58Protect the NHS frontline staff working to save lives.
19:05Despite the vulnerability of older and disabled people,
19:08care homes aren't even discussed
19:10at the first 11 meetings of the government's scientific advisers.
19:16And for nearly six weeks, daily briefings only reflect deaths in hospitals,
19:21not in care homes.
19:23Care providers felt they were an afterthought.
19:29Social care has been so dismissed for so long
19:34that I don't think anybody felt that it was a surprise
19:38where the government's priority was protect the NHS.
19:42In mid-March, as coronavirus takes hold, NHS England needs to free up hospital beds.
19:48Over a month, 25,000 people are discharged into care homes
19:53with no requirement for testing.
19:56Panorama has gathered data that shows three quarters of the patients
20:00discharged from 39 hospital trusts between early March and mid-April
20:04had not been tested.
20:08Community integrated care wouldn't take new residents from hospitals at that point.
20:14You've got the system saying, we need your help,
20:17we need to free hospital beds for people that might otherwise, you know,
20:21pass away when they could be saved.
20:23There was immense pressure in some parts of the country
20:26and almost the inference that you were going to fail your community
20:30if you didn't do your bit.
20:32I think in hindsight, everyone realises it was a really stupid thing to do.
20:37The virus will have gotten to care homes in other ways too.
20:40Sometimes infected staff will have taken it in.
20:43But scientists advising government now say that hospital visits and discharges
20:49may have been an important cause of the spread.
20:52NHS England says it's never supported pressure being placed on care homes
20:56to accept admissions.
21:02In Scotland, Wales and Northern Ireland, the care systems work differently.
21:06But there too, patients were discharged to care homes without testing.
21:16Nearly 300 miles away from Blakely,
21:19is Pelham House in Folkestone.
21:23It's a small, privately owned home.
21:26They look after 20 people, mostly with dementia.
21:31Nice cup of tea.
21:33Most of the residents here pay for their own care, like Doreen.
21:37Doreen Amos, Amos.
21:39A-M-O-S-M-O-M-O-S-M-O-T-S-M-O-T.
21:43You know Latin?
21:45Studied Latin.
21:47Very nice, Doreen. Thank you. Nice fish pie.
21:50Lovely, it looks gorgeous.
21:52Doreen has dementia, but she is aware of the risks of the virus.
21:58Coronavirus is something that, if you've got it, must stay isolated.
22:03It's a bit frightening.
22:08This is BBC Radio Kent.
22:10Care home staff in Kent say they're frightened to go to work
22:13Care home staff in Kent say they're frightened to go to work
22:16without adequate personal protective equipment
22:18and no testing available,
22:20even though some residents they're looking after have died from COVID-19.
22:25Hello, Cynthia. Hello.
22:27Don't forget your mask.
22:31Pelham House is owned by Roger Walubie, a former NHS manager.
22:37His team has had to struggle
22:39to get protective equipment, tests and even food.
22:45Our regular food supplier,
22:47who'd been supplying food to the home for ten years,
22:50stopped because their services were overwhelmed.
22:53I would have liked us as a care home to have been prioritised.
22:58As a small provider, we've been left alone and set adrift, if I'm honest.
23:03We would have hoped for more support around testing.
23:07That didn't materialise either.
23:11Good morning.
23:14After 19 years working here, Karen left in February,
23:18but because of coronavirus, she's now back to help.
23:23Get some breakfast.
23:26We're meticulous about PPE and things like that,
23:29We're meticulous about PPE and things like that,
23:32the temperature taking every morning, the staff, the residents.
23:37We were bobbing along, we were so pleased with ourselves
23:40because we hadn't got one single case.
23:44Then one resident, 96-year-old Francis Chapman,
23:47starts showing signs of what could be the virus.
23:52It was at the weekend, so we had to call the 111 service.
23:55We were describing his symptoms,
23:57which could have been anything from a heart attack to sepsis.
24:03They sent out a team.
24:05They said, well, anything could be COVID, but he was very unwell
24:10and his oxygen levels were very low.
24:14The paramedics say he should go to hospital.
24:18The next day, the phone rings.
24:21We got a call first thing in the morning, around nine o'clock,
24:25saying he needed to come home, he needed to be discharged.
24:31The home is told there's no clinical reason to keep him in.
24:35The hospital has tested him for COVID-19,
24:38but don't have the results yet.
24:41We said we'd prefer it, obviously, if he did have his COVID test results
24:45before we could consider him coming back.
24:48Unlike Blakely, they don't have nurses based in the home,
24:52and Francis is very ill.
24:55You know, we're a care home, we can't do anything.
24:58We have no oxygen, we have no, you know, medication to help him.
25:02We had nothing.
25:05So the calls escalated.
25:07Escalated, yeah, to the consultant in A&E being on the phone
25:12and really...
25:16..really requesting and stating that Francis had to come home on that day.
25:22Did you feel bullied into taking him back?
25:25We did, yes, yes.
25:27And on the Monday, we got a phone call
25:30telling us that his results were positive.
25:35The following week, Francis dies.
25:39The hospital says it's likely he already had coronavirus
25:42when they saw him.
25:45And the home was then given advice and training on infection control.
25:50Now Pelham House must fight the spread of the virus.
25:54It was a very scary moment,
25:56because there was not a lot we could do to prevent what was coming,
26:00and it was inevitable.
26:02We knew people were going to go.
26:11By the second week in April,
26:13there have been over 2,500 outbreaks
26:16in residential and nursing homes in England.
26:20So I'm just going now to decontaminate with this aerosol,
26:24and then after 72 hours, we'll go back and do a deep clean.
26:29At Blakely, they are doing what they can
26:32to stop the spread of the infection.
26:35Phil needs to disinfect and seal Joan's room after her death.
26:47Ready?
26:51Good morning.
26:52Deep cleaning like this is more often seen
26:55when hospitals have infection outbreaks,
26:58a costly extra measure that not all homes can afford.
27:02We're here today because they've got some live cases of COVID-19,
27:06so we come in to do a high-level decontamination of the air
27:10and all surfaces within the building
27:12to try and protect the rest of the residents.
27:17Five people have now died,
27:20and 14 residents are showing symptoms of the virus.
27:33So the nursing floor is on the second.
27:37Hi, I was wondering if you could help me.
27:39Chelsea Mills has worked as a carer since she left school 10 years ago.
27:43Here on the nursing floor, people need help with everything
27:46from dressing to going to the toilet.
27:51It's very demanding.
27:53You don't know what to expect each minute, to be fair.
27:56Anything could happen, but you've just got to keep it cool
27:59and see a trigger and try and defuse it before it escalates.
28:05Cup of tea.
28:06Tea?
28:07Yeah.
28:08What kind of tea?
28:09Tea.
28:10Tea?
28:11You taught me.
28:12Yes.
28:13How to make a good cup of tea.
28:15Yes, make a good cup of tea.
28:18Today, she and Lee are looking after three people with symptoms.
28:23Definitely don't come into this job for no money.
28:26Came into it by chance.
28:29I met a girl online who was disabled.
28:32We got married, became her carer.
28:35After she passed away, I decided I wanted to change my full career,
28:39and I absolutely love it.
28:41Just making a difference in someone's life.
28:4773-year-old Jane has been living with dementia for seven years.
28:52Keeping residents like her socially distanced is a challenge.
28:59We are trying to keep them in the bedrooms,
29:01but with dementia patients,
29:03some we are unable to keep in their bedrooms due to distress.
29:08With somebody like Jane, it's impossible.
29:11She will not stay in her room,
29:13and to keep her in there, you'd have to forcefully do it,
29:17or use medication,
29:19which, obviously, it's not something that you'd want to do to anyone.
29:24Sit down, darling.
29:26You want to walk again?
29:30In this part of the home,
29:32they're used to supporting residents at the end of their lives,
29:35but nothing has prepared them for the speed and intensity
29:39of what they're dealing with now.
29:44The latest resident to fall sick is 85-year-old Brian McHugh.
29:50Stats were quite low. He was coughing quite a bit.
29:53It just went from good to bad very quickly with Brian.
29:57I love that one.
29:58Where he's in garden, both with the wellies on.
30:01Probably been doing a bit of gardening.
30:04He was a gentle giant. He was just lovely.
30:07He'd do anything for anybody.
30:09Nothing was ever too much trouble.
30:13Since lockdown, Susan has only been able to see her dad on video calls.
30:20Then, on April 15th, the home tells her Brian is unwell.
30:26And I said to her, do you think it's Covid?
30:28And she said, well, we're not sure, Sue,
30:31but it looks as though he's got those symptoms.
30:38The following day, Brian deteriorates and is in pain.
30:42The next 24 hours are the most traumatic
30:45the staff involved have experienced.
30:48A GP recommends Brian's taken to hospital,
30:51but with health services under huge pressure,
30:54it takes more than two hours for the ambulance to arrive.
30:57I remember receiving another call back from a paramedic.
31:01I remember me saying to him, I need someone here now.
31:05This man is in bad shape.
31:07I was very, very angry.
31:11While they wait, Brian isn't prescribed the strong pain relief he needs.
31:17I was in his room with Chelsea for more than three hours,
31:20with him, right by his side, trying to keep him comfortable,
31:23trying to reposition him, trying to move him around the bed.
31:26Trying to find somewhere where he'd be most comfortable,
31:29where we could help him with his breathing.
31:32To watch someone in pain is absolutely horrendous
31:36when you feel helpless.
31:38You know, if I could have took it away, I could have took it away.
31:42It was extremely hard.
31:48In the early evening, the paramedics arrive
31:51and there's a discussion about what's best for Brian.
31:54Our job is to help provide the best picture
31:58of what's happening with someone to the paramedics,
32:01to the GPs, to the medical team in the hospital
32:03for a medical decision to be made.
32:05And then our direction then is to then implement
32:08the direction from those medical staff.
32:14The family has been told he's dying and the hospital can't save him.
32:18It's agreed that he will stay in the home,
32:21surrounded by people he knows.
32:25We wanted him to go on palliative care as soon as possible.
32:29We thought he'd suffered enough with his dementia and everything else.
32:35Susan asks the carers to give her dad a message.
32:41Just tell him that there's Covid outside
32:44and we've got to be isolated in our own homes
32:47and that's why we can't come to you either.
32:49And just tell him that we love him.
32:53Herbert Mumbamaro arrives shortly after the ambulance has turned up.
32:58He'll be the nurse on duty overnight.
33:02When I came here, emergency services said we can't take him,
33:05there is nothing we can do, and they left.
33:11It means Herbert is the only medically trained person there
33:14through the night.
33:16Morphine has now been prescribed for Brian,
33:19but it isn't relieving his pain.
33:23All the medications that he had been prescribed,
33:26that usually works like magic, did not work on Brian.
33:31Brian, over the last 10 to 12 months,
33:35has never spoken a complete sentence.
33:39But that night, he managed to say,
33:43I can't breathe, I'm drowning.
33:45Words I didn't know he can speak.
33:49That explains the extent of the trauma he was experiencing.
33:58That was the worst I've ever seen.
34:01I don't think I would want to ever experience that again.
34:13In hospital, a doctor might have been able to up the dose
34:17or try other drugs.
34:19But in the early hours of the morning,
34:21that wasn't an option for Herbert,
34:23who was desperately trying to ease Brian's breathing.
34:27I was going on YouTube, on NICE guidelines,
34:35I was trying to find all better ways
34:41to help someone enduring end of life,
34:45a traumatic end of life.
34:48And I implied everything that I picked from those.
34:53Unfortunately, it comes back to the same.
34:56It didn't help me that much.
35:05I wouldn't have thought the best place for Brian
35:09would have been the hospital,
35:11where there is people sharing ideas.
35:18The next morning, Brian's more comfortable,
35:21but the impact on the team has been huge.
35:24And last night, it was horrendous.
35:26It was absolutely horrific.
35:28Yeah, it was one of the worst.
35:34That night, Brian dies.
35:40It's hard to know that he suffered as much as he did,
35:43and he didn't have to.
35:46That's going to be hard for my mum.
35:50What would you want to say to them?
35:53Yeah.
35:57I would like to say...
36:00I'm very sorry for your loss.
36:04It wasn't comfortable for him,
36:07and we tried all the best we could,
36:11but unfortunately, it wasn't good enough.
36:17And for that, I'm truly sorry.
36:20I know they were very busy in the hospitals,
36:23but they should have had someone to be there
36:28in the homes to help them,
36:30even if it's only to go and give them advice.
36:33I feel as though I've let my dad down,
36:36not being there at the end.
36:38Because he relied on me.
36:40He used to say he always wanted me there,
36:42if he was poorer.
36:44And to know what he was going through
36:47and not being able to be there and hold his hand
36:50was just horrendous.
36:52And that will never, never leave me.
36:59The NHS says care homes have had comprehensive support.
37:04Herbert believes there are still lessons to learn.
37:09We would benefit from having a team of specialists
37:15specifically on standby to respond to extreme cases of Covid.
37:21They could give advice on what best to do.
37:24We're not defying death.
37:27But what we are trying to do is our mission statement,
37:32to make it comfortable.
37:37The week Brian died, deaths of care home residents reached their peak.
37:42More than 3,300 died with the virus in England and Wales.
37:48At its worst, 540 passed away in a single day.
37:54Does it make you angry?
37:56Of course it makes me angry.
37:58Nobody really thought about the challenge
38:02that care organisations were going to face
38:05until, if I'm being brutal, the body count became so high
38:09that they couldn't ignore it.
38:12That week, the Health and Social Care Secretary
38:15finally sets out his plan to support care homes in England.
38:20Today we've strengthened the rules
38:22so that all care home residents
38:24who are discharged from hospital will be tested
38:27before being admitted into their care home.
38:31He also announces testing for all care staff and residents with symptoms.
38:36It's now known untested staff played a role
38:39in bringing the virus into care homes.
38:41But a shortage of tests has meant NHS workers have been prioritised.
38:47Lakeleys manager Michelle has symptoms and has been self-isolating.
38:53Now she can be swabbed at the main testing centre for the region.
39:01I expected it to be busier than this.
39:05There's loads of bays stretching all the way down with nobody there.
39:10Two days later, she gets the result.
39:13I was really pleased that I tested negative
39:16because it means I can return to work quickly.
39:23But Michelle's dad, Michael, is sick with the virus.
39:27He has other medical conditions and he's been admitted to hospital.
39:31He was poorly when he left.
39:34She last saw him as he was being taken to the waiting ambulance.
39:38When he spotted me in reception,
39:40he waved to me and shouted after me that he loved me.
39:44So... But then that just made me cry.
39:47When he got to hospital, they tested him
39:50and he pretty much went straight to an infectious disease ward.
39:55And he's been there since.
40:01And up your nose now, relax.
40:03It's all right, darling. You're doing grand.
40:06Oh!
40:09Every few days, someone new is developing symptoms, like Pat.
40:15It's taken three days for her to be tested
40:18and will take another two days to get the result.
40:22It's over half the home now.
40:24I feel like we're doing everything possible
40:26within our powers and gift that we've got here.
40:30And sadly, that's not enough all the time.
40:34Vera is the latest resident to show symptoms.
40:38She's 91 years old and came to the home last autumn.
40:42We call Vera the Queen of Charlestown.
40:44She is our eldest on Charlestown,
40:46so she does kind of look after everybody, mother everybody.
40:51She whizzes everywhere with her little zimmer.
40:54And she chats non-stop, so that's what we like.
40:59Vera has spiked her temperature this morning.
41:02Has she?
41:04What was her temp?
41:0537.3, but it's higher than what it has been.
41:09She's saying she doesn't feel well.
41:11Phil has to call Public Health England again
41:14to request tests for Vera and others who now have symptoms.
41:20But that doesn't help him identify people who have the virus
41:23without showing any signs.
41:29I remember begging and saying,
41:30please, can one of these people go and just test?
41:33Can we not have everyone tested? Why not?
41:36Like, surely, there's such a severe outbreak
41:39here, it's in everyone's interest to be tested.
41:42And now the policy is clear,
41:45we only test people who have got symptoms of coronavirus.
41:50Nearly two months after the country lockdown,
41:53Matt Hancock announces all staff and residents can now be tested,
41:58even if they don't have symptoms.
42:01As far as you can go, but don't cause yourself too much pressure
42:04and wiggle it to cool your nose for ten seconds.
42:07Each home will also have a named doctor,
42:09part of an infection control plan
42:11with £600m ring fence for social care in England.
42:16From the start, we've worked incredibly hard
42:18to throw that protective ring around our care homes.
42:21What protective ring? I haven't seen...
42:25I haven't seen a protective ring. I mean...
42:29We don't understand what the protective ring could have been or was.
42:35At Pelham House, two more residents are showing signs of the virus.
42:41It's just to get rid of this nasty virus.
42:43Oh, I see. Yes.
42:45Stick. Uh-huh.
42:47All 20 residents and 17 members of staff are now tested.
42:51Do you remember?
42:53We've had to do it too. It's horrible, isn't it?
42:55It is, isn't it? It chokes you, doesn't it?
42:58Two days later, the virus has spread to the entire country.
43:03Two days later, when the results come back, they are shocking.
43:09I was upstairs, the manager called me down
43:11and was just sat there with his mouth open
43:13and just pointed at the screen and it was horrific.
43:16You know, every resident apart from two was positive
43:19and a lot of the staff, 80% of the staff.
43:24They had to down tools and go.
43:26And, you know, that left us in a very vulnerable position,
43:30particularly when the cook has to suddenly stop her cooking and go home
43:34and you've got to address the food needs for everyone.
43:38We had cleaners who didn't want to come back to the care home.
43:44Are you ready to carry it? Let me put some gloves on.
43:49As with many care homes, infection control became difficult.
43:53A handful of staff were caring for some very sick residents.
43:58There's three or four of us who have been on the front line as such
44:03and continually tested negative and we could keep going, basically.
44:11In two weeks, nearly half of the home's residents die with coronavirus.
44:17We normally have three deaths on average a year.
44:20We've had nine in the space of ten days
44:24and it's a shock.
44:27We're not used to death at this scale.
44:29Emotionally, it's very challenging having to say goodbye to so many people so quickly.
44:37When they all start going back into the lounge and they all start mixing together again,
44:41they will realise that over half the residents that they've been with for years are not here anymore.
44:48So I think that's when it will really hit home.
44:53Karen has just returned from a resident's funeral.
44:56Peter had no family, he was nearly 76 and had learning difficulties.
45:04Basically, he just went to sleep and was just asleep for two or three days,
45:11probably two days, and then just gently passed away.
45:17He'd always trusted us to look after him and we didn't, we couldn't.
45:26And he always kept saying, I love you girls, I love you girls, I'm so happy here.
45:32It was just overwhelming at the funeral yesterday that he was 76 and we just let him die.
45:39And with his learning difficulties, he wouldn't have understood, you know, he just...
45:45Sorry, can you just give me a cup?
45:54What did you have for breakfast?
45:56I didn't.
45:57Didn't you? Don't you ever have breakfast?
45:59Doreen and Cynthia had both tested positive for COVID-19.
46:03Several rounds of testing have helped the home track the virus.
46:07But at the end of June, they're told they can't have any more.
46:13It's now two weeks since we haven't done testing.
46:15So we've spent the last 10 days or so pretty much pleading, if I'm honest, for more test kits.
46:23Right, let's get on with this phone call then.
46:26I don't want to shoot the messenger, but do you know why?
46:28Because obviously we're in a desperate situation here with residents who are poorly.
46:34So testing is the way we navigate our way out of it.
46:40And we're not going to just let it go, because it's not going to get better.
46:44We're going to have to do something about it.
46:46So we're going to have to do something about it.
46:49So testing is the way we navigate our way out of it.
46:54And just being told there's no way of doing more testing really leaves us in a very vulnerable position, you see.
47:04The government has now announced regular testing for care homes.
47:12At Blakely, there is finally some good news.
47:15This time staff are lining up to welcome Michelle's father, Michael, back from hospital.
47:22Her mother's waiting to greet him on the phone.
47:27Have you got your hearing aid in?
47:31No.
47:32After two weeks in hospital, he's fought off the virus.
47:36So we're just about to welcome Michael home, the first person back from hospital recovered from coronavirus.
47:46After such a difficult, bleak time, this is a moment of relief.
47:51Give her a wave, give her a wave.
47:54Yay, she's waving back.
48:00There you are.
48:03Are you all right now, is that better?
48:05I can't believe you.
48:08Hi.
48:09How are you?
48:10I'm doing all right, how are you?
48:12You've still got a moustache.
48:16Oh, it's good to see you.
48:18Let's get you in your room.
48:21Really happy, it's a feeling I've not had for a little while.
48:24Vera has also made a full recovery.
48:27You know you had the test, didn't you?
48:30Did I have it?
48:32Yeah.
48:33And it came back positive, didn't it?
48:36Well, it's funny because it didn't affect me.
48:41You feeling fighting fit then?
48:43Not fighting fit, but I haven't felt fighting fit for days and days.
48:49Right.
48:50But I'm much better than I was.
48:53Oh, that's brilliant.
48:54Nasty.
48:56There's a lot worse than me.
49:06Hello.
49:07Hello.
49:08Good.
49:14At Pelham House, as lockdown eases, they're now virus free.
49:26But the sad loss of half the residents here means the home has also lost half its income.
49:33It's been a really challenging time.
49:35I think, you know, obviously the relationships have had to change.
49:37The government has given councils more than £3.7bn to help with extra COVID costs,
49:44including support for care homes.
49:46So Roger's asking his local authority for help.
49:50I'm just giving you a reflection of our own audit against a document that says the support we should be getting
49:57and that does include councils use funding where necessary to provide immediate support to providers who need help with COVID-19.
50:05The government money has to be shared between different council services, which are all under pressure.
50:15So far, the homes received about £40,000 of council help.
50:22But Roger says they would need another £100,000 for the home to survive for a year.
50:29We're a very, very healthy and viable business.
50:32Now our future is in the balance and the outlook is not good.
50:39What does that mean for Pelham House?
50:41It means that we can't continue to exist in six to eight weeks' time.
50:48If Pelham shuts, that would mean residents like Cynthia and Doreen would lose their home.
50:54I do like living here and it's very comfortable and there's lots of nice people
50:59and lots of nice, you know, visitors and one thing and the other.
51:04It's a very nice place to be, yes.
51:08If I had to leave, I think I'd miss a heck of a lot of it.
51:17I can walk around the grounds, I can, you know, on the grass and people come and go, which is lovely, you know.
51:24So I'm hoping I can stay here, you see.
51:29I will not get to the point where I've got two hours to go and I've run out of cash or I can't care for people anymore.
51:36I will not leave it till the eleventh hour.
51:40The impact for the residents is even more significant because they do grow to understand this as being their home.
51:48The last few months have changed lives beyond recognition at Pelham and at Blakely.
51:56Over six weeks, half of the 55 residents are thought to have been infected with the virus. Nine have died.
52:04But with no new cases, Phil's work is finished. He's leaving to oversee outbreaks in other homes.
52:11We've got to come out of this the other side and be able to look ourselves in the mirror and say that we did our best.
52:16But even being able to look yourself in the mirror and say you've done your best is still going to be an absolutely devastating loss of life.
52:23And one we're going to have to, you know, live with remembering for a long time.
52:29And that's a scary thought, really.
52:34So, that's me.
52:42It's my job to support everybody else, but it's difficult.
52:49We've got to get back to normal. This was a busy, fun-filled community hub where people lived, where people live.
53:00We've got to get back to that.
53:02The first step is families being able to see each other again.
53:07We were well off then, because I had a fur coat.
53:12I don't think it would score them.
53:18And me, I'm not going to lie, I'm not going to lie.
53:24I'm not going to lie.
53:27I'm not going to lie.
53:30It's me and Roy and Carol, my daughter.
53:36She's 64 now. I haven't seen her for weeks.
53:40Three months it's been.
53:43Vera's family have just missed her 92nd birthday, but now they can see her at a distance.
53:51Hi!
53:52Hiya!
53:53How are you doing?
53:56It's me daughter.
53:59How are you?
54:01Yeah, well I'm sorry we couldn't be here. We'll make up for it on your next birthday.
54:07When things get back to normal.
54:10She's brought you some pictures of the children.
54:13Shall we go and have a look?
54:15Yeah, yeah.
54:17In the past four months, 22,000 care home residents have died with coronavirus in the UK.
54:25In England alone, it's about 19,000. Half of them had dementia.
54:32It's been a tough year for all of us.
54:36It's been a tough year for all of us.
54:39In England alone, it's about 19,000. Half of them had dementia.
54:51The Secretary of State for Health and Social Care declined an interview.
54:56In a statement, his department says,
54:58it's completely wrong to suggest care homes were an afterthought.
55:02Throughout the pandemic, we've been working closely with the sector
55:06and public health experts to put in place guidance and support for adult social care.
55:13We first published guidance in February and have since announced a raft of measures.
55:20Our help has meant almost 60% of England's care homes have had no outbreak at all.
55:27The government has promised it will put forward plans for the reform of the care system in the near future.
55:36When we look back, we will see this as one of the most mismanaged national challenges that we've ever faced.
55:44You can't have a disconnected health and social care system.
55:48It has to change. It cannot be left to local authorities whose budgets are being cut
55:54and they then have to think about who gets care and who doesn't,
55:58and they haven't got the money to pay what it takes.
56:01We have to decide how important our elderly and our vulnerable people are.
56:11No government will get everything right in the extreme situation of a pandemic,
56:16but the country will be judged on how it protects the most vulnerable.
56:21For many, the devastating number of deaths in care homes is a mark of shame
56:26and has provided the strongest argument for reform of a system that has been neglected for too long.
56:35It makes me feel angry because they should have protected us.
56:38They should have, you know, from day one, the NHS rightly gets protected,
56:46but so should all the care homes, every care home.
56:50I think people need to understand how much of yourself you give when you're a carer.
57:03And it's not, for most of us, it isn't just a job.
57:10It's a vocation, it's a commitment you're making.
57:20And there should be greater respect and value given.
57:32If I give my heart to you, will you handle it with care?
57:41Will you always treat me tenderly and in every way be fair?
57:51If I give my heart to you, will you give me all your love?