COVID-19 outbreaks in care homes during the first wave: are Care Quality Commission ratings a good predictor of at-risk homes?

• Published in: The Journal of hospital infection 2021-05, Vol.111, p.96-101
• Main Authors: Tulloch, J.S.P., Green, R., Tunnah, C., Coffey, E., Ashton, M., Ghebrehewet, S.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Care home; Care Quality Commission rating; COVID-19; COVID-19 - epidemiology; Disease Outbreaks - statistics & numerical data; England - epidemiology; Female; Forecasting; Homes for the Aged - statistics & numerical data; Humans; Infection prevention and control; Male; Nursing home; Nursing Homes - statistics & numerical data; Pandemics - statistics & numerical data; Quality of Health Care - statistics & numerical data; SARS-CoV-2
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2020.12.023

COVID-19 placed a significant burden on the care home population during the first wave. Care Quality Commission’s care quality ratings are given to all English care homes and could be used to identify whether care homes are at risk of COVID-19 outbreaks. An audit was performed, April 2020, of Liverpool care homes to identify associations between COVID-19 status and care quality ratings from the Care Quality Commission. Univariable logistic regression was performed to identify whether the Care Quality Commissions ratings were associated with a care home experiencing a COVID-19 outbreak, or a home having asymptomatic cases. Over half of the care homes (53.2%, n=41), had laboratory-confirmed clinical cases and 39 (95.1%) of these were reported as outbreaks. A small number of care homes (10.4%, n=8) had asymptomatic cases and over a third had no clinical or asymptomatic cases (36.4%, n=28). There was no significant difference between the overall Care Quality Commission rating of Liverpool and English care homes (p=0.57). There was no significant association between any of the Care Quality Commission rating domains and the presence of COVID-19 outbreaks and/or asymptomatic cases. During the first wave of the COVID-19 pandemic, Care Quality Commission ratings were not associated with COVID-19 outbreaks or asymptomatic cases in care homes. Infection prevention and control components of Care Quality Commission ratings need to be strengthened to identify care homes at a potential risk of infectious disease outbreaks that may require targeted support. Further large-scale studies will be required to test the findings from this study.