Blanket 'do not resuscitate' orders imposed on English care homes, finds CQC

Blanket orders not to resuscitate some care home residents at the start of the Covid pandemic have been identified in a report by England’s care regulator.

A report published by the Care Quality Commission (CQC) found disturbing variations in people’s experiences of do not attempt cardiopulmonary resuscitation (DNACPR) decisions during the pandemic.

Best practice is for proper discussions to be held with the person involved and/or their relatives. While examples of good practice were identified, some people were not properly involved in decisions or were unaware that such an important decision about their care had been made. Poor record-keeping, and a lack of oversight and scrutiny of the decisions being made, was identified.

The report, 'Protect, respect, connect – decisions about living and dying well during Covid-19', calls for a ministerial oversight group – working with partners in health and social care, local government and the voluntary sector – to take responsibility for delivering improvements in this area.

The report surveyed a range of individuals and organisations, including care providers and members of the public, and identified:

• Serious concerns about breaches of some individuals’ human rights.
• Significant increase in DNACPRs put in place in care homes at the beginning of the pandemic, from 16,876 to 26,555.
• 119 adult social care providers felt they had been subjected to blanket DNACPR decisions since the start of the pandemic.
• A GP sent DNACPR letters to care homes asking them to put blanket DNACPRs in place.
• In one care home a blanket DNACPR was applied to everyone over 80 with dementia.

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Source: The Guardian. 18 March 2021