Notifications of deaths of residents related to COVID-19 in adult care homes: 1 March to 20 November 2020

In order to improve the timely availability of data on deaths in care homes caused by the coronavirus (COVID-19), the Welsh Government and Care Inspectorate Wales (CIW) have agreed to publish provisional counts of deaths in care homes, based on statutory notifications by care home providers to CIW. This information helps to monitor the impact of COVID-19 and contributes to Wales and UK wide monitoring and decision-making.

Main results

• Care Inspectorate Wales (CIW) have been notified of 5,562 deaths in adult care home residents since the 1 March 2020. This covers deaths from all causes, not just COVID-19.
• This is 41% higher than deaths reported for the same time period last year, and 35% higher than for the same period in 2018.
• 68% of total deaths since 1 March 2020 were for residents receiving care with nursing.
• CIW has been notified of 934 care home resident deaths with suspected or confirmed COVID-19. This makes up 17% of all adult care home residents reported deaths since 1 March 2020.

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Notifications of deaths of residents received from adult care homes, includes deaths from all causes (7 day rolling average), 7 January to 20 November 2020 (MS Excel)

Source: Notifications of Service User Deaths received by Care Inspectorate Wales (CIW)

During 2019, care home services were undergoing re-registration with CIW due to new legislation, which introduced a new method of notifying CIW of deaths of care home residents. This may have resulted in some disruptions to notifications being submitted.

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Deaths notified to Care Inspectorate Wales of care home residents by cause of death and day of notification (7 day rolling average), 1 March to 20 November 2020 (MS Excel)

COVID-19 related deaths included in the chart include both confirmed and suspected COVID-19. The care home testing policy was expanded on 16 May to include testing being offered to all symptomatic and asymptomatic staff and residents who have never tested positive for COVID-19 even where the home has not reported possible or confirmed cases. More widespread testing may have resulted in some deaths being recorded as non COVID-19 deaths when previously they may have been notified as suspected COVID-19 deaths.

Between 1 March to 20 November 2020:

• CIW has been notified of 934 care home resident deaths with suspected or confirmed COVID-19. This makes up 17% of all reported deaths
• 509 of these were reported as confirmed COVID-19 and 425 suspected COVID-19
• the first suspected COVID-19 death notified to CIW was on the 16 March, which occurred in a hospital setting
• since October, the number of COVID-19 related deaths notified to CIW has been increasing

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Notifications of deaths of adult care home residents with confirmed or suspected COVID-19 by location of death and day of notification (7 day rolling average), 7 March to 20 November 2020 (MS Excel)

Source: Notifications of Service User Deaths received by Care Inspectorate Wales (CIW)

Between 1 March to 20 November 2020:

• 68% of suspected and confirmed COVID-19 deaths were located in the care home
• 29% of suspected and confirmed COVID-19 deaths were located in hospital

The data presented here are based on the Notifications of Service User Deaths received by Care Inspectorate Wales (CIW) from adult care homes which relate to their residents. The location of death may be in the care home, in hospital or another location. 

We are publishing these data to ensure access to the CIW data is transparent and to provide a timely indication of trends for all deaths to care home residents in Wales, from COVID-19 or otherwise. However, CIW are reliant on providers notifying them and being able to provide an indication that they are COVID-19 related deaths. The data published by the Office for National Statistics (ONS), which includes all deaths where COVID-19 was a factor according to the death certificate, report higher numbers of deaths related to COVID-19 in care homes in Wales. We will continue to work with CIW and ONS to explore the quality of these data.

The data in this release is based on the date of the notification rather than the date of death. CIW notifications of cause of death is reported by the care home provider. They are not based on laboratory confirmed tests, and are therefore not directly comparable with Public Health Wales (PHW) data. In their rapid surveillance dashboard, PHW include some notifications received from care homes with a positive laboratory confirmed test for COVID-19. Therefore these data cannot be added together. We will be working with PHW and CIW to understand this overlap and seek to quantify how many of these deaths are included in PHW estimates.

Data included in this release is correct at 23:59 20 November 2020.

Context

In order to improve the timely availability of data on deaths in care homes caused by the coronavirus (COVID-19), the Welsh Government and Care Inspectorate Wales (CIW) have agreed to publish provisional counts of deaths in care homes, based on statutory notifications by care home providers to CIW. This information helps to monitor the impact of COVID-19 and contributes to Wales and UK wide monitoring and decision-making.

Relevance

As the independent regulator for care home providers in Wales, providers are statutorily required to notify CIW of deaths to residents. In addition, these statistics are used daily for a number of other purposes:

• to understand the impact of the pandemic on care homes
• to support evidence-based advice on future decisions around reviews of lockdown arrangements
• contributions to Wales and UK wide monitoring and decision-making

Accuracy

Data is collected on a daily basis via an online form developed and maintained by Care Inspectorate Wales. The data is validated against previous returns and any significant changes are queried.

Data includes all notifications up to midnight each day.

The data collection covers residents of adult care homes.

Care homes are required to notify CIW of the location of death and cause of death. Prior to 29 April 2020 this was via a free text box and CIW have used manual searches on the data to produce summaries by category. From 29 April 2020 the form has been amended to include mandatory tick box categories for COVID-19 Confirmed or Suspected and location (hospital, care home, hospice, ambulance, other). Therefore there is a change to the methodology used to produce these figures from 29 April 2020.

In terms of ‘Confirmed’ COVID-19, from 29 April onwards, this has been provided to CIW by the care home provider by means of an answer to the question: ‘Was the death a result of confirmed COVID-19?’.

Prior to this date, the care home provider wasn’t asked this question and so ‘Confirmed’ for these is where CIW’s inspectors have reviewed the free text data provided by the care home provider (on the questions ‘cause of the person’s death, if known and confirmed by a medical practitioner’ and ‘summary of the circumstances leading up to the persons death and all contributing factors’) and determined that it relates to a confirmed case.

In both scenarios CIW are reliant on the care home provider to inform them appropriately of a confirmed case.

Timeliness and punctuality

The data in this release provides data from the 1 March 2020 and onwards, and the same time period two years prior.

Accessibility and clarity

This statistical release has been pre-announced and then published on the Statistics and Research section of our website. It is accompanied by an Open Document Spreadsheet to allow users to have direct access to the data that underlies the charts in this release.

Comparability

Data for England was first published on 28 April 2020.

The Chief Statistician has produced a blog of the different sources of data on Coronavirus (COVID-19) related deaths in Wales.

National Statistics status

These statistics are not National Statistics. However, as far as has been practicable, they have been collected and validated in accordance with the pillars and principles within the Code of Practice for Statistics. We continue to develop the data collection and quality assurance process to improve the data.

These statistics have been produced quickly in response to developing world events.

Well-being of Future Generations Act

The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators ('national indicators') that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before the National Assembly. The 46 national indicators were laid in March 2016.

Information on the indicators, along with narratives for each of the well-being goals and associated technical information is available in the Well-being of Wales report.

Further information on the Well-being of Future Generations (Wales) Act 2015.

The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local well-being assessments and local wellbeing plans.

Next update

The next release will be at 9.30am Tuesday 8 December.

We want your feedback

We welcome any feedback on any aspect of these statistics which can be provided by email to kas.covid19@gov.wales.

Statistician: Alex Fitzpatrick
Telephone: 0300 025 9016
Email: kas.covid19@gov.wales

Media: 0300 025 8099

SFR 213/2020