In brief:
- At least 6% of English care home residents have died as a result of coronavirus.
- That national average is tragically high. And yet it disguises even higher excess-death rates – of upto 17% – in certain parts of the country.
- Deaths have been greater in areas where homes are poorly rated, larger and receive less funding.
This year, around 27,000 more people have died in English care homes than normal. There are roughly 460,000 care home beds in England, meaning at least 6% of care home residents have died unexpectedly.
That national average is tragically high. And yet it disguises even higher excess-death rates in certain parts of the country. In some local authorities, around 17% of care home residents have died as a direct or indirect result of coronavirus. That is 1 out of every 6 residents.
The areas with most excess care home deaths are in London, where COVID has spread most extensively in the general population. That makes outbreaks in London care homes much more likely. But location is not the only important factor. Care homes in Brent have been 4 times safer than in Hammersmith. Both are London boroughs, so what drives such differences?
Well, our analysis suggests that excess deaths have been greater in areas where homes are poorly rated, larger and receive less funding. Let’s take each of those three factors in turn:
- First, areas with worse rated care homes have seen more death. The Care Quality Commission grade English Care Homes as: “Inadequate”, “Requires Improvement”, “Good” or “Outstanding”. We convert these grades into a rating of 1 to 4. We then find the average rating for each English Local Authority, weighting by the number of beds in each care-home. On this measure Newham and Hammersmith have the worst and fourth-worst rated care homes in England (of 2.15 and 2.29 respective). They also have the worst excess care home death rates in the country.
- Second, areas which spend less per care home resident have seen more death. The NHS publish data on the total spend on over-65 residential care by each English local authority. We divide this by the number of residents at year-end reported in that data to calculate an average spend per resident. To control for the fact that the costs of running a care home across the country, we compare the average spend in each local authority to the average spend for their region. Critically, 8 of the 10 areas with the highest excess death rate spend less than the average for their region. For example Southwark, which is fourth worst, spends less 25% less per resident than the London average.
- Third, areas with larger care homes have seen more deaths. The typical Hammersmith care home has 45 residents, compared to 20 in Brent. This makes an outbreak in a single care home more deadly.
In short, more residents have died in areas with care homes that are less well funded and less resilient. That sounds obvious: but its key to understanding why the UK has seen so many die from coronavirus.
We have only been able to pull together data on care home beds, care home ratings and care home spending for English Local Authorities. And even then our data is not complete: we only cover English Metropolitan Districts, London Boroughs and Unitary Authorities. That gives us a sample of around 150 local authorities.
We’ve attached the code below. As well as a spreadsheet with the final dataset. We welcome comments and invite others to use the data.