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Data on death notifications involving COVID-19

Data on death notifications involving COVID-19 received from individual adult care homes in Wales between 1 Jan 2020 and 30 June 2021.

We have published data showing the number of notifications of deaths of people involving COVID-19 received from individual adult care homes in Wales between 1 January 2020 and 30 June 2021. The data is based on notifications to us by adult care home providers about deaths of residents involving COVID-19 both confirmed and suspected.

It is important to note the number of death notifications involving COVID-19 is not in itself an indicator of the quality of care provided. There are many factors which affect the number of deaths in a care home. These include but are not limited to: rates of community transmission, the size and layout of the care home, the age, ethnicity and health and care needs of the people living in the home.  

World Health Organisation evidence shows once COVID-19 is present in a care home “it is difficult to control, in part due to the number of people living closely together in facilities designed for communal living and the fact personal care requires close proximity.” 

The data reflects deaths of residents involving COVID-19 which were notified to CIW, regardless of where the person contracted COVID-19 or where the death occurred. For example, a resident may have been admitted from a care home to hospital with a non-COVID related illness, contracted COVID-19 while in hospital, and subsequently died before returning to the care home. The provider must notify CIW of the death of the resident and that this involved COVID-19 irrespective of where the death occurred. This notification is not confirmation there was COVID-19 present in the care home.

The data is based on notifications to CIW by adult care home providers about deaths of adult care home residents involving COVID-19 both confirmed and suspected. These notifications were based on the care home providers information, which may or may not correspond to a medical diagnosis or test result. Therefore a notification to CIW is not confirmation that COVID-19 has been noted on the death certification. This is primarily because there were limitations on access to testing for COVID-19 prior to 16 May 2020. 

As this data is based on notifications to CIW, it is not possible to deduce whether COVID-19 was the primary cause of death in each case. There will be some people who sadly died with COVID-19 and others who died from COVID-19. This data does not quantify how many people are in each category.

Why we are publishing now

Regulations require service providers to notify the regulator of specific events, including outbreak of infectious disease and deaths of people using their services (care homes). 

From 12 March 2020, we asked all providers to tell us about each case of suspected or confirmed COVID-19 in people using the service or staff.  From 29 April 2020, we have asked providers to tell us whether deaths involved suspected or confirmed COVID-19.

We collated this information and made it available to provide the public with transparent data about the national position in relation to COVID-19 outbreaks and its impact on the care sector.  From 5 May 2020, notifications to CIW of deaths involving COVID-19 in care homes have been published at local authority level.  This data includes notifications of deaths of care home residents involving COVID-19, regardless of where the death occurred.  

We are now publishing data showing the number of death notifications involving COVID-19 we have received from 1 Jan 2020 to 30 June 2021 for each care home registered with us.

The data reflects deaths of residents involving COVID-19 which were notified to CIW, regardless of where the person contracted COVID-19 or where the death occurred.  Therefore the data will include deaths of people who lived in care homes where the death occurred in the care home, in a hospital, in an ambulance or any other setting.

We have not published this data at an individual care home level before.  This is because we believed releasing the data at the height of the pandemic could have had a serious impact on continuity of care.  We were concerned people could use it to make decisions that inadvertently put people at wider risk if they were considering the data as a single indicator of quality and safety. 

We now believe that changing factors in the pandemic have reduced the risks around publication e.g. successful take-up of the COVID-19 vaccine across the country. In publishing this data we aim to provide a more comprehensive picture of the impact of COVID-19 on care homes, the people living in them, their families and the staff who cared for them.

Death notifications alone are not an indicator of quality or safety

The data is based on notifications to CIW about deaths of adult care home residents involving COVID-19 both suspected and confirmed in Wales.  

The number of death notifications alone is not an indicator of quality or safety in individual care homes. There are many factors which affect the number of deaths in a care home.  These include but are not limited to rates of community transmission, the size and layout of the care home, the age, ethnicity and health and care needs of the people living in the home.  

CIW uses a range of information and intelligence about services to assess risks and make decisions about where to inspect, taking action to protect people where necessary. This includes information we receive through safeguarding referrals, whistleblowing and concerns from people using the service, people’s relatives/friends, staff members, professionals, other regulators and members of public. These and other indicators, such as previous regulatory history, absence of a registered manager, and other notifications are more likely than death notifications alone to indicate where there is a risk of poorer quality care.

How we have used this data

Regulations require service providers to notify the regulator of specific events, including outbreak of infectious disease and deaths of people using their services (care homes). The information is used, alongside other intelligence to inform our inspections and prompt action where we have concerns. During 2020-21 we designated a team working across inspection and information management to review the notifications related to COVID-19 outbreaks and deaths and produce regular daily and weekly reports. 

We shared these reports with relevant organisations to inform local and national planning and responses to outbreaks of infection and to promote oversight and support for services locally. 

From 5 May 2020, notifications to CIW of deaths involving COVID-19 in care homes have been published at local authority level.  From 8 December 2020 data related to notifications to CIW of cases of COVID-19 in care homes was published.  The data was released to provide the public with transparent data about the national position in relation to COVID-19 outbreaks and impact on the care sector. 

Throughout the period we have carried out assurance activity through our inspections, check-in and monitoring calls in all care homes in Wales. This does not include informal support inspectors will have given to providers throughout the pandemic.

Most care providers we have undertaken assurance activity with have demonstrated good practice. However, where we found failures in services that impacted or posed a risk to people’s well-being outcomes we issued priority action notices. These are the first stage of our securing improvement and enforcement pathway and set out the regulatory failings for the service provider and the action they are required to take to improve the service. These services are prioritised for a follow-up inspection within six months to check the required actions have been taken.  Where services failed to take action to improve we took further enforcement action including issuing statutory improvement notices, restricting a service’s operation or, in cases where there is no safe alternative, taking action which would lead to the closure of a service.

Notes about the data

It is important to note the following about the death notification data:

  • Providers have a legal duty to notify us of deaths of people under their care. This data is based on the notifications care home providers have sent to us.
  • The data reflects deaths of residents involving COVID-19 which were notified to CIW, regardless of where the person contracted COVID-19 or where the death occurred. For example, a resident may have been admitted from a care home to hospital with a non-COVID related illness, contracted COVID-19 while in hospital, and subsequently died before returning to the care home. The provider must notify CIW of the death of the resident and that this involved COVID-19 irrespective of where the death occurred.  This notification is not confirmation there was COVID-19 present in the care home.
  • The data is based on notifications to CIW by adult care home providers about deaths of adult care home residents involving COVID-19 both confirmed and suspected.
  • These notifications were based on the care home provider’s information which may or may not correspond to a medical diagnosis or test result.  Therefore a notification to CIW is not confirmation COVID-19 has been noted on the death certification.  This is primarily because there were limitations on access to testing for COVID-19 prior to May 16 2020.
  • As this data is based on notifications to CIW, it is not possible to deduce whether COVID-19 was the primary cause of death in each case.  There will be some people who sadly died with COVID-19 and others who died from COVID-19.  This data does not quantify how many people are in each category.
  • It is important to note the number of death notifications involving COVID-19 is not in of itself an indicator of the quality of care provided. There are many factors which affect the number of deaths in a care home.  These include but are not limited to: rates of community transmission, the size and layout of the care home, the age, ethnicity and health and care needs of the people living in the home.
  • The data is based on the date notifications were submitted to CIW which may differ from the actual date of a person’s death.
  • The ONS publish data on deaths in care homes in Wales. CIW’s figures on notifications of deaths involving COVID-19 may not tally with the ONS data. This is because ONS data is based on death registrations and the date of death, whereas CIW data is based on data supplied by care providers alerting us to a death potentially involving COVID-19.  

Support for people who have been affected

Every notification of a death to CIW represents a life lost and families and friends grieving for their loved one. Their sadness was often compounded by COVID-19 restrictions preventing them from being with their loved one as often, or for as long as they would have wanted in their final days.  
Staff who had cared for and developed relationships with them were also grieving and deeply affected by the loss of the residents in their care.  

We offer our deepest sympathies to all those who have lost a family member or friend as a result of the COVID-19 virus.  We ask for compassion and respect to be shown to people living in care homes, to families, and to the staff who worked tirelessly and selflessly to protect people, care for them and tackle the many challenges they faced. 

It is understandable people living in care homes, their families and staff will continue to be anxious about the risks presented by COVID-19. This is likely to be felt even more acutely where people have died after contracting the virus.

If people have concerns about the quality of care they or their loved one receives, we would encourage them to discuss this with their care provider.

They can also tell us about it in the following ways:
Using our online form 
By email: CIW@gov.wales
By telephoning: 0300 7900 126

For those who have been bereaved, there is support available at charities such as Cruse Bereavement Care (External link).

If staff who work in social care need support during this difficult time we would encourage them to seek support from their line manager.  (SCW) Social Care Wales (External link) has launched a new employee assistance programme that offers well-being support to those employed in the social care workforce in Wales. Posters and information about the service have been sent to workplaces. Social care staff should speak to their manager or employer to find out how to access it. Or, if you have any queries, call Care first's 24/7 number – 0333 2129 212.

In addition, Samaritans (External link) has launched a new confidential support line for NHS and social care workers in Wales (External link).

Click the link below to access the data

Data on death notifications involving COVID-19 (External link)

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