Vulnerable children in care are catching the novel coronavirus, with at least one residential home reporting all of its children falling ill, and several staff in other homes going into self-isolation.
Fears over children’s care homes in Britain harbouring some of the worst cases of communal infection have been sparked, after a report shared with this site outlined a number of cases in several care homes where children and staff appear to have contracted the virus.
The report, which was published on Monday by the Independent Children’s Homes Association (ICHA), includes information circulated among over 400 care homes.
One care home, which could not be contacted for further information, confirmed in the report that all twelve of its children had become ill. At least two homes said two of their carers had tested positive for COVID-19, with three members of staff requiring hospital admission. Other care home managers said they had isolated staff with “quite severe symptoms”.
It is likely that the current ICHA report outlining COVID-19 outbreaks within these settings are conservative, with many more children infected with the virus. The report also only incorporates independent care home contributions, and does not include care homes run by local authorities in England and Wales.
The Department of Education and the Department of Health and Social Care’s hands-off approach towards children in care during the outbreak may partially be down to ongoing myths about how the novel Coronavirus affects children.
Once thought to be largely immune from the disease, new research is confirming the worst – that children can catch the virus, and die from the infection. Newborns, and children with underlying health conditions, many of whom are represented within the care system, are especially at risk, making it more important than ever for the government to act urgently.
While the government has focused its attention on care homes looking after the elderly during the pandemic, it has routinely ignored children in residential settings, who are by definition also vulnerable.
Edward Nixon, the founder of Every Child Leaving Care Matters, said, “I’m pleased Matt Hancock is looking at issues within care homes, but it seems that his comments do not apply to children’s home settings and are exclusive to the Older People sector, which is partly understandable but he misses the point about many children who are ‘in care’ and vulnerable because of serious physical health conditions, others who are vulnerable due to acute mental health challenges, and who will really struggle in terms of their emotional well-being in the current lockdown.”
A significant number of children in care homes have health conditions which make them susceptible to infection. As many as 62% of children in residential care homes live with a serious mental health condition which could be aggravated by the outbreak, and a lack of government guidance to ensure that the spread of the virus in these homes is stopped.
Staff are required to notify the placing authority of any children infected with the virus, but it is not clear whether care homes are doing so. Birth parents who have court ordered contact in place or who continue to retain parental responsibility have been kept in the dark about their children’s health during the outbreak.
The Office for National Statistics does not carry information about the number of children’s care homes affected by COVID-19 as standalone data.
As the child protection sector continues to operate during the outbreak, new children who could potentially be infected with the disease are being introduced into care homes, increasing the risk of further and recurring infections among children and staff.
While some care homes are isolating newly admitted children for 7-14 days, not all care homes are employing this strategy, leaving children open to infection, and staff confused about what needs to be done to protect children in these homes. Some staff also raised concerns in the report that their homes had not been inspected in over two years.
Elizabeth Cooper, the deputy CEO of the ICHA said that although Personal Protective Equipment (PPE) could provide a barrier to infection in care homes, it posed other problems:
“Children need physical contact and affection. Looked after children have as great, if not more of a need for this to help them heal. They already often feel alienated and ‘different’ and adding a physical barrier to this contact compounds this.”
Mandatory testing for the virus could be a way forward, but while it has been made available to front line workers looking after children in care, vulnerable children are still not eligible for these tests, making it impossible to know the full extent of infection spread within children’s homes.
The testing kits too, are problematic. A booking form produced by Wakefield NHS for health and social care staff requesting a test, highlights concerns about the accuracy of the kits.
The test used in their programme is called PCR, which NHS Wakefield says has a high number of false negative results, and that, “Research studies have suggested that false negatives may be as high as 30% in ‘real world’ testing situations.”
The form goes on to explain that, “Out of 10 people who have COVID-19, seven will test positive for the virus but three will test as negative when they are actually positive.”
NHS Wakefield outline the local public health advice for these tests, which it says requires a key worker with COVID-19 symptoms to isolate for the full 7 days before returning to work, even if the PCR test result is negative.
The guidance then tells organisations to use their discretion as to whether or not to follow the advice.
For vulnerable children in care and at-risk adult carers, the test’s 30% failure rate, a lack of compulsory COVID-related duties on councils and care homes, and incomplete government guidance on how to support children in care during the outbreak could be fatal.
Ms Cooper said she would welcome detailed guidance from the government;
“There are guidelines for care homes that don’t really apply to our sector, but are all we have. Clarity from the government and the Department for Education would make a positive difference.”