As part of the 2020 adult social care winter plan, the government has called on local authorities and care providers to establish “stand-alone units” – so-called “hot homes” – that would be able to receive and treat Covid hospital patients while they recover from the disease – Samuel Lovett in the Independent 28 October 2020
There is something not right about this seemingly plausible and practical aspect of the winter plan. Think about it and there are actually a few things very wrong.
First this is not the purpose of a care home. These are places where people live, their address and both their private and family space. What is being proposed is not a home and should not be called one. It is at best a convalescence or recovery facility, an isolation centre and at worst a transit camp.
Who will be channelled to these facilities? If those fit for hospital discharge but testing positive are deemed not fit to go home – including a care home – then they remain patients of the NHS. The response should be shaped accordingly. Either they can be cared for safely at home or not. This is not a local authority responsibility or the purpose of regulated care homes. It is Continuing Health Care. If people’s need for long term health care are not best met in acute hospitals then the NHS should commission resources that are.
Purportedly for recovery it is a small step to include the untreatable and those facing the end of their life. A test may be positive but that is no justification to deny people a home life and death.
Some of the thinking behind the “hot homes” idea reveals that the powers that be and their advisers do not really regard care homes as people’s home. They are just a resource to be commandeered by the state at a moment of crisis. One that was entirely predictable.
Care home providers should put the residents of the home first and resist financial incentives. They should insist on dialogue about how they can respond to NHS demand as social entrepreneurs.
Ideally there are facilities that can be re-purposed. Staff recruited or redeployed and trained. What is being proposed is a new category of registered service. One that cannot and should not be aligned with existing categories.
Residential care, particularly for older people, is already seen by many as “warehousing”. This proposal is more like the low-cost self-storage units that are springing up everywhere. Useful for something you want to keep but not in the house.