Last Updated on October 20, 2026

Module 6 of the UK Covid-19 Inquiry has been published, examining the impact of the pandemic on the adult social care sector. The Chair of the UK Covid-19 Inquiry, Baroness Hallett, concluded that, in the early stages of the pandemic, not enough was done to protect people in care settings and that the adult social care sector appeared to be 'something of an afterthought'. There were more than 43,000 recorded deaths involving Covid-19 in care homes between March 2020 and July 2022.

In summary, the Module 6 report found that a lack of proper planning, plus failures to implement lessons from earlier pandemic planning exercises, meant Government and devolved administrations took critical decisions in the early weeks without the information they needed. In addition, action to protect carers and care users came too late.

Module 6, the sixth of the Inquiry's 10 investigations, examined the impact of the pandemic on the publicly and privately funded adult social care sector in England, Scotland, Wales and Northern Ireland, including infection prevention, visiting restrictions, the experiences of the care workforce and decisions on discharge from hospitals.

According to the report, while Government and devolved administrations knew, prior to the pandemic, of the extreme vulnerability of care home residents to respiratory viruses, care homes received insufficient protection at the time they most needed it. Significantly, the report stated that the claim that 'a protective ring' had been put in place around care homes 'right from the start' of the Covid-19 outbreak was unfounded.

Furthermore, the report found that not enough was done to protect people in care settings between March and mid-April 2020. The decision to speed up the discharge of patients from hospitals into care homes was necessary to free up hospital beds. But the decision to do so was taken in March 2020 when there was not enough testing capacity to know patients' Covid-19 status.

At the time, isolating discharged patients inside care settings was one of the few effective protections available. Yet, in March 2020, England, Wales and Northern Ireland did not initially advise this, a failure the Inquiry called 'a significant omission'.

The report also shows how, as the virus spread, care home residents were left feeling isolated, abandoned and alone as visiting restrictions cut them off from loved ones, in some cases for months. Some people were not allowed to be with dying friends or relatives in their final moments, leaving bereaved people grief-stricken. They could not help their loved ones with daily tasks such as eating, drinking and washing, support which can be vital for some residents. As a result, Baroness Hallett concluded, 'Many remain wracked by a guilt that they do not deserve to carry.'

Visiting restrictions did not begin to ease until the summer of 2020. The report concluded that the severity and duration of these restrictions caused 'profound and enduring effects' inside care homes, particularly for residents with complex cognitive conditions such as dementia.

According to the report, the Covid-19 pandemic also exposed and exacerbated the underlying fragility of the adult social care workforce. Severe shortages of personal protective equipment (PPE) meant that some care workers were left having to wear waterproof ponchos from festivals, painters’ overalls, or home-made PPE made from fabric, bin bags and bed linen. The report described this as 'wholly unacceptable', finding that care workers were left 'without the protection they needed'. It concluded that while PPE shortages were a global problem, better planning could have ensured a much better supply from the outset.

The UK's 5.8 million unpaid carers were also heavily relied upon, providing complex care for longer hours with little or no respite. The Inquiry concluded that support for unpaid carers came too late and that for too long the adult social care sector as a whole has been undervalued and under-recognised.

The Inquiry's latest report also examined concerns about the use of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions, echoing concerns raised in its Module 3 report that some decisions were made inappropriately or without proper consultation, based on a person's age, health condition or learning disability. While finding no evidence of national policy encouraging blanket use of DNACPRs, the report recommended mandatory end-of-life care training for health and social care workers, who often lacked the skills to have these conversations thoughtfully and compassionately.

Ultimately, the report found that these failures and others stemmed from an absence of proper pre-pandemic planning for the adult social care sector. Exercise Cygnus, a pandemic preparedness exercise conducted in October 2016, recommended developing ways to assess social care and surge capacity, but this work had not been completed by the time the Covid-19 pandemic struck. As a result, ministers were left making decisions without the information they needed about the sector.

The Module 6 report made eight key recommendations to ensure the adult social care sector is better protected and better equipped to respond to the next pandemic, including:

• Improving arrangements for pandemic planning to ensure clearer structures, roles and responsibilities.
• Better planning for the safe isolation of care home residents.
• Implementing financial support schemes ready to be rolled out to support adult social care staff to self-isolate or to limit staff movement.
• Publishing guidance on visiting restrictions.
• Maintaining inspection and oversight by developing protocols to enable inspections to continue, including, where possible, on-site inspections.
• Improving the collection of data about deaths in the adult social care sector.
• Establishing mandatory end-of-life care training for relevant health and social care workers.
• Introducing a voluntary register for the social care workforce in England, recognising and supporting a workforce that already benefits from such registers in Scotland, Wales and Northern Ireland.

In total, 57 witnesses gave oral evidence during Module 6 public hearings, held between 30 June and 31 July 2025. The Inquiry heard from care home residents and their families, unpaid carers, care workers and sector representatives, as well as healthcare professionals, policy-makers, regulators and relevant experts, including serving and former senior politicians and civil servants.

Commenting on the report's findings, Baroness Hallett said, 'Many millions of people across the UK receive adult social care. This includes older people, people with dementia and people living with physical and learning disabilities. For them and the people who dedicate themselves to providing their care, the pandemic totally disrupted their daily lives and had a devastating impact.

'At the critical early stages of the pandemic, not enough was done to protect those living and working in care homes. The mantra at the time of "protecting the NHS" sometimes came at the expense of the users and providers of care. The adult social care sector as a whole appeared to be something of an afterthought.

'The profound isolation and sense of abandonment felt by residents as a result of the visiting restrictions resulted in immense emotional harm. Most distressingly, some people were not permitted to be with their dying loved ones. Many remain wracked by a guilt that they do not deserve to carry.

'During the pandemic, the action taken by Government and devolved administrations to try and protect workers and users of adult social care came too late. The failures were the direct result of an absence of proper pandemic planning for the adult social care sector. It underlines why my recommendations in this report must be acted upon now before the next pandemic strikes.'

Cllr Eamonn O’Brien, Chair of the Local Government Association (LGA), said, 'The pandemic was an extraordinarily difficult time for people drawing on care and support, their families and those who care for them. Councils and their partners worked tirelessly to support vulnerable residents and communities in challenging circumstances. This report is an important opportunity to ensure lessons are learned.

'We're pleased to now be working closely with Government on preparation, should there ever be a future pandemic. Councils, working closely with care providers, the NHS and local partners, have a central role in supporting and protecting vulnerable people. Their experience and expertise must be at the heart of planning for any future pandemic, along with those with lived experience of care. It is essential that the sector is adequately funded and recognised as an equal partner to the NHS.

'It is absolutely vital that nobody is discharged from hospital into residential or other care settings where clinically vulnerable people live, without fail safe testing and isolation regimes, robust guidance, and workforce support.

'We stand with bereaved families in recognising the human cost of the pandemic. We continue to work with Government, our members and partners to ensure that lessons of Covid-19 are acted upon.'

Dr Jane Townson OBE, Chief Executive at the Homecare Association, said, 'Throughout the Inquiry we heard heart breaking testimonies from bereaved families and care professionals. We owe it to those we lost, and those who served to ensure we learn lessons and implement change in a way that is effective and enduring.

'In our evidence we pointed to a hierarchy of invisibility, with people at home supported by both unpaid carers and professional care workers considered only as an afterthought. This must change.

'The adult social care sector entered the pandemic in a fragile state following decades of underfunding, poor commissioning and undervaluing of the workforce. The terms of reference of the UK Covid-19 public inquiry did not permit a focus on wider systemic issues. Baroness Casey of Blackstock has an opportunity to do so as part of the Independent Commission on Adult Social Care.

'We urge the governments of the UK nations to act on the recommendations of the Covid-19 Inquiry and stand ready to support national and local government, the NHS, regulators, care providers and the Casey Commission to implement necessary change. History will judge this moment – not by what went wrong during the pandemic, but by what we chose to do next.'

Caroline, Abrahams CBE, Charity Director at Age UK, said, 'Today's report is, in its own way, quietly devastating. It describes what in truth we already knew: that when Covid-19 took off, people using social care and the staff and unpaid carers providing it were left totally exposed. It makes clear that this was mainly due to a complete absence of pre-planning, leading to the system being overwhelmed when the virus struck.

'It is tremendously important that Government heeds this lesson and that work begins now on actioning those of the Inquiry's recommendations which do not depend on fundamental social care reform, visiting guidance in care homes in the event of another pandemic being one of several examples.

'But fundamental social care reform is also required, and today's report reinforces how important it is that we now actually see it. If a National Care Service had already been in place, underpinned by national standards and with clear accountability to Government, the various disasters that befell social care during the pandemic would have been lessened and some might have been avoided altogether.

'It is for Baroness Casey to work out exactly how a National Care Service should operate, but especially in light of today's report it is also the responsibility of politicians across the spectrum to look firstly towards what they can all agree on, rather than where political advantage may lie.

'We should never forget the hundreds of thousands of individuals and families who saw and experienced things in social care that no one ever should: the loved ones left to die alone or seen only through windows; the care home residents dying with pain that care staff could not alleviate because they didn't have the drugs and because health professionals had been withdrawn.

'If we can come together to implement the Inquiry's recommendations and bring about the reform of social care then we've a good chance of ensuring tragedies like these won't happen again, but until then social care and the people in it remain vulnerable to threats of all kinds.'

Read the full Module 6 report, the in brief summary and other accessible formats on the UK Covid-19 Inquiry website.

In other news, a new policy paper published by the Care Association Alliance (CAA) suggests that careers in care could help to reduce youth unemployment.