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COVID-19 Insight 5: Our data

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Homecare providers – prevalence of COVID-19

Graph showing the highest rate of COVID-19 in Yorkshire and The Humber, the North East and the North West Graph showing England average of 10% of DCAs having at least one case of COVID-19
Percentage of DCAs by COVID-19 submission status: 2 November - 8 November
Source: CQC Domiciliary Care Agency Survey. Homecare providers with at least one case include suspected AND confirmed cases. Numbers in brackets show number of services that are primarily homecare providers in the region. Included in these figures are homecare services currently lying dormant, so completion rates are slightly higher for fully active services than this might suggest. Percentages may not add to 100% due to rounding.

Homecare providers – availability of all PPE

Graph showing the largest percentage of providers without available PPE being in London
Homecare providers - availability of all PPE
Source: CQC Domiciliary Care Agency survey – latest response in period 2-8 November 2020.

Homecare providers – staff absence

Graph showing the highest rates of staff absence in London and the West Midlands
DCA staff who deliver care to people absent due to coronavirus
Source: CQC Domiciliary Care Agency survey – latest response in period 2-8 November 2020. Includes staff who are self-isolating or have care commitments. England average: 4%.

Deaths notified by care homes

Graph showing an increasing number of deaths in the past month after a previous steady decrease since the first wave
Care home COVID-19 deaths: seven day moving average
Source: CQC death notifications submitted 10/04/2020 to 06/11/2020
Map showing the highest rates of COVID deaths in care homes happening in London, the North West and the North East
Number of notifications by care homes of deaths where COVID-19 is reported as suspected or confirmed per 1,000 care homes beds – 10 April to 6 November 2020
Source: CQC death notifications submitted 10 April 2020 to 6 November 2020.

Deaths of people in care homes, by ratings

We have used two methods to examine deaths in care homes, where confirmed or suspected COVID-19 was flagged on the notification form, in relation to ratings. Below we show the percentage of all care home deaths notified to CQC within each rating band, compared with the overall distribution of ratings. For example, 21% of deaths occurred at care homes rated as requires improvement, compared with 16% of care homes that currently hold that rating.

Bar chart showing little difference between the percentage of care homes receiving each rating and the proportion of deaths at those services
Source: CQC ratings, November 2020; notifications of deaths under Statutory Notification 16 to CQC, 10 April to 6 November 2020, where confirmed or suspected COVID-19 was flagged.

The second analysis shows the rate of deaths per 1,000 beds by care home rating, which updates figures previously included in our State of Health and Adult Social Care in England, 2019/20 (page 47).

Both charts reflect a slight skew towards requires improvement, but there is no clear correlation between the number of deaths and overall rating.

Bar chart showing the rate of deaths per 1,000 care home beds for each rating - showing no strong correlation
Source: CQC ratings, November 2020; notifications of deaths under Statutory Notification 16 to CQC, 10 April to 6 November 2020, where confirmed or suspected COVID-19 was flagged; CQC register at 1 April 2020.

Deaths of people detained under the Mental Health Act

All providers registered with CQC must notify us about deaths of people who are detained, or liable to be detained, under the MHA. From 1 March to 6 November 2020, we have been notified of 102 deaths that mental health providers indicated were suspected or confirmed to be related to COVID-19. A further five COVID-19 related deaths of detained patients were reported by other (non-mental health) providers.

People liable to be detained includes detained patients on leave of absence, or absent without leave, from hospital, and conditionally discharged patients. ‘Detained patients’ also includes patients subject to holding powers such as sections 4, 5, 135 or 136, and patients recalled to hospital from community treatment orders. These counts may also include notifications about the deaths of people subject to the MHA who are in the community and not in hospital.

Data on notifications may be updated over time and therefore successive extracts may lead to changes in overall numbers unrelated to new cases.

The chart shows the number of deaths by week of death.

Weekly MHA deaths in England (COVID and non-COVID): 1 March to 6 November 2020

Of the 304 notifications from mental health providers in the 2020 period (covering all causes of death), 240 were from NHS organisations, of which 76 deaths were indicated as being COVID-19-related, and 64 were from independent providers, of which 26 deaths were COVID-19-related.

We have identified 16 detained patients whose deaths have been notified to us from 1 March to 6 November 2020 who had a learning disability and/or were autistic: the majority were not identified as related to confirmed or suspected COVID-19. Of these people, most also had a mental health diagnosis. Please note that these patients were identified both from a specific box being ticked on the notification form and a review of diagnoses in the free text of the form.

Table showing all deaths of detained patients from 1 March to 6 November 2020, by age band and COVID-19 status
Age band 18-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Unknown Total
Suspected or confirmed COVID-19 1 1 4 6 14 20 33 19 9 107
Not COVID-19 8 15 14 26 39 40 29 13 37 221
Total 9 16 18 32 53 60 62 32 46 328
Table showing all deaths of detained patients from 1 March to 6 November 2020, by gender and COVID-19 status
Gender Female Male Unknown or unspecified Total
Suspected or confirmed COVID-19 35 61 11 107
Not COVID-19 70 111 40 221
Total 105 172 51 328
Table showing all deaths of detained patients from 1 March to 6 November 2020, by ethnicity and COVID-19 status
Ethnicity Suspected or confirmed COVID-19 Not COVID-19
Asian 3 4
Black 12 20
Mixed 1 3
Other ethnic groups 0 1
White 65 110
Unknown 23 70
Not stated 3 13
Total 107 221
Table showing all deaths of detained patients from 1 March to 6 November 2020 by place of death and COVID-19 status
Place of death Suspected or confirmed COVID-19 Not COVID-19
Medical ward 62 66
Psychiatric ward 34 65
Hospital grounds 1 6
Patient’s home 0 18
Public place 0 4
Other 1 26
Not stated 9 36
Total 107 221

Deaths of people with a learning disability

In June 2020, we published new data on the number of deaths of people who were receiving care from services that provide support for people with a learning disability and/or autism between 10 April and 15 May 2020. We have now updated this analysis for the period 10 April to 30 September.

We received notifications of the deaths of 970 people with a learning disability or autism from services identified as caring for people with learning disabilities or autism. This is 41% higher than the 687 deaths notified in the comparable period in 2019.

Of the 970 people who have died during the period this year, 263 were as a result of suspected or confirmed COVID-19 as notified by the provider, and 707 were not identified as related to COVID-19.

As we noted in our previous briefing, we know that people with a learning disability are at an increased risk of respiratory illnesses and in November 2020 Public Health England published a report highlighting this issue further in relation to the impact on rates of death with COVID-19 of people with a learning disability. In March 2020, NHS England highlighted how people with a learning disability have higher rates of morbidity and mortality than the general population, and die prematurely. In 2018/19, at least 41% of people with a learning disability who died, died as a result of a respiratory condition. They have a higher prevalence of asthma and diabetes, and of being obese or underweight; all these factors make them more vulnerable to coronavirus. Our figures show that the impact on this group of people is being felt at a younger age range than in the wider population.

Bar chart showing contribution of COVID-19 to higher death rates amongst people with learning disabilities in 2020 compared with 2019
Notifications from providers of services for people with learning disabilities and/or autism spectrum disorder that state the person who died had a learning disability by age and COVID-19 status: 2019 vs 2020
*Denotes bars where data has been suppressed due to low numbers. Source: notifications of deaths under Statutory Notification 16 to CQC, 10 April to 30 September 2020, and comparable period in 2019

Of the 970 people who died, 948 were received from adult social care settings.

Table showing the distribution by COVID-19 status and service type
Type of adult social care setting Confirmed or Suspected Covid Not Covid Total
Community based adult social care services 124 345 469
Residential social care 135 344 479

We only show this breakdown of service types for adult social care. The remaining 22 deaths were of people notified to us by types of service in numbers less than 10; to avoid identifying individuals we have not included them here.

Deaths of people from Black and minority ethnic groups in adult social care settings

In our second COVID-19 insight briefing we published exploratory data on the ethnicity (where known) of people whose death in adult social care settings was notified to us between 10 April and 15 May 2020.

We have now updated this analysis to 30 September 2020. As we noted previously, the ethnic category fields in the notification forms are not mandatory, and for the period in question this information was missing in 12.8% of forms, which was a slight improvement on the 13.8% we observed in the period to 15 May.

Of deaths with a known ethnicity, 96% of those notified during this period were White, with Mixed, Asian and Black all just over 1% each, and ‘Other’ less than 0.5%. Therefore while the vast majority of deaths in these settings were of White people, once again we found that Black people in particular who died were more likely than White people to die with confirmed or suspected COVID-19 flagged on their notification form. The chart shows that 23% of White people who died were flagged as confirmed or suspected COVID-19, compared with 28% of Black people.

Graph showing Black people being more likely to die with COVID-19 than White people
Notifications of deaths in all adult social care settings 10 April to 30 September 2020 by ethnic group and COVID-19 status
Source: notifications of deaths under Statutory Notification 16 to CQC, 10 April to 30 September 2020

If we look only at care homes, this pattern is slightly more distinct. The chart shows that while 25% of White people who died were flagged as confirmed or suspected COVID-19, for Black people who died the figure was 34%. It should be noted that all these figures are somewhat lower than the percentages we reported for the period 10 April to 15 May – this is to be expected because the new time period covers a much longer period after the first wave of COVID-19 subsided.

Chart showing a markedly higher proportion of Black people dying with COVID-19 than White people
Notifications of deaths in care homes 10 April to 30 September 2020 by ethnic group and COVID-19 status
Source: notifications of deaths under Statutory Notification 16 to CQC, 10 April to 30 September 2020

ONS data on all weekly deaths in England (COVID and non-COVID) compared with the average for 2015-2019

Graph showing the number of weekly deaths this year going above the previous years' average in recent weeks
Total weekly deaths in 2020 compared with sum of average weekly deaths in English regions between 2015 and 2019
Source: ONS COVID/non-COVID 2020 death data and 2015-2019 death data. Week 43: week ending 23 October 2020.
Last updated:
18 November 2020