The RCN has described the COVID-19 Inquiry's Module 6 report as a "damning assessment" of the failures that left social care services, staff and those receiving care exposed during the pandemic.

The report examines the impact of COVID-19 on adult social care across England, Scotland, Wales and Northern Ireland. It says protecting the adult social care sector appeared to be “something of an afterthought”. This came at the expense of vulnerable people using, and staff providing, care services. The report also found the following. 

• Governments failed to adequately consider or plan for the impact of a pandemic on adult social care. 
• Adult social care entered a pandemic already under severe pressure and with widespread staff shortages. 
• Patients were discharged from hospitals to care homes without knowing whether they had COVID-19, owing to a lack of available testing or understanding about how the disease was spreading. 
• Severe shortages of PPE meant care workers often had to work with unsuitable or poor-quality equipment, or without PPE at all. 
• Governments focused on "protecting the NHS", with action to protect the adult social care sector coming too late. 
• Official guidance initially failed to recommend isolating residents returning to care homes from hospital, which the inquiry described as a significant oversight.
• Financial support to enable care workers to stay away from work when infected should have been in place from the start of the pandemic. 
• Restrictions on visiting care homes caused enormous harm to residents and their loved ones, often leading to a decline in residents’ health and wellbeing.  

Professor Nicola Ranger, RCN General Secretary and Chief Executive, said: “This report provides a damning assessment of how social care was so badly failed.  

“Nursing staff in social care were the 24/7 presence, many giving up their family lives to keep people safe and be with those who would otherwise die alone. Vulnerable people, their families and staff were left to make sense of visiting restrictions which caused so much heartbreak.

"Ultimately, the scale of death was unprecedented and left significant numbers of staff exhibiting PTSD. So many paid the ultimate price and must never be forgotten, nor should this be allowed to happen again.” 

We believe the hospital discharge policies combined with a lack of support and protection for staff and residents demonstrated how those in the sector were treated as "second-class citizens" during the pandemic.  

Nicola added: “Our profession raised concerns from the outset, with care homes lacking the staff, or safe capacity to absorb more people at the speed ordered. While nursing staff faced huge risk, at the heart of government and within key agencies, there was a palpable lack of understanding as to how the sector operated. That cost lives.”  

Today, adult social care still faces significant challenges. Nursing workforce shortages continue, along with poor pay, terms and conditions. 

The inquiry’s recommendation to better integrate adult social care into pandemic planning must begin now. We also need joined up thinking across governments to make the sector a more attractive place to work, with a fully-funded action plan to boost workforce numbers.  

Nicola concluded: “The clearest sign the sector would fail the test of another pandemic is in the thousands unable to be discharged from hospitals every day. The legacy of this inquiry must be that we are better prepared, with new investment in workforce and services coming now, not when it’s too late." 

Many people who had COVID-19 continue to suffer from debilitating symptoms well after their initial illness, and nursing staff are disproportionately affected. Read more about support for nursing staff affected by Long COVID. 

Module 6 of the COVID-19 Inquiry opened in December 2023 and the RCN presented evidence as a core participant.