Care leaders, unions and MPs have rounded on Boris Johnson after he accused care homes of failing to follow proper procedures amid the coronavirus crisis, saying the prime minister appeared to be shifting the blame for the high death toll. With nearly 20,000 care home residents confirmed to have died with Covid-19, and estimates that the true toll is much greater, there has been widespread criticism about a lack of personal protective equipment (PPE), testing and clear guidelines for the sector. On Monday, the total UK coronavirus death toll rose to 44,236, up 16 on the day before. The Guardian has previously revealed how public health officials proposed a radical lockdown of care homes at the height of the pandemic, but they were overruled by the government. Agency staff were found to have spread the virus between homes, but a health department plan, published in April, mentioned nothing about restricting staff movements. Around 25,000 patients were discharged into care homes without being tested for coronavirus, an official report said. Speaking during a visit to Goole in Yorkshire, Johnson said the pandemic had shown the need to “make sure we look after people better who are in social care”. He went on: “We discovered too many care homes didn’t really follow the procedures in the way that they could have but we’re learning lessons the whole time. Most important is to fund them properly ... but we will also be looking at ways to make sure the care sector long term is properly organised and supported.” The comments followed fears that ministers – mindful of a likely future inquiry into how the UK came to have the highest coronavirus death toll in Europe, with the proportion of care home deaths 13 times higher than in Germany – could be seeking to lay some of the responsibility on outside bodies, including Public Health England (PHE). A No 10 spokesman insisted Johnson was not blaming care homes, saying they “have done a brilliant job under very difficult circumstances”. He added: “The PM was pointing out that nobody knew what the correct procedures were because the extent of asymptomatic transmission was not known at the time.” But Nadra Ahmed, chair of the National Care Association, which represents smaller and medium-sized care providers, said Johnson’s comments were “a huge slap in the face for a sector that looks after a million vulnerable people, employs 1.6 million care workers and puts £45bn into the economy every year”. She added: “Despite the fact PPE was diverted, despite the fact we didn’t have testing in our services, despite the fact they’ve not put any money into our sector, it has worked its socks off, and it’s a huge disappointment to hear the leader of our country say what he’d said.” A spokesman for the Association of Directors of Adult Social Services said Johnson was correct to say the sector needed reform and more funding. But he added: “Social care has been hit hard by Covid-19 and it feels unfair to blame care homes for the initial response to the pandemic as they did not feel prioritised from the outset.” Caroline Abrahams, charity director of Age UK, said: “It would be unfair for anyone to suggest that care staff have been authors of their own misfortune: on the contrary, in a neglected and cash-strapped system they have been magnificent throughout the pandemic – arguably far better than we as a country deserved.” Rehana Azam, national officer for public services at the GMB union, which has many members in the social care sector, said: “Johnson is complaining about the arrangements that he and his government have established and failed to change. There is no point the prime minister passing the buck on this one.” The criticism was echoed by opposition politicians, with Liz Kendall, Labour’s shadow social care minister, saying: “Staff who have gone the extra mile to care for elderly people, and experienced things the rest of us can only imagine, will be appalled to hear the prime minister’s comments. Boris Johnson should be taking responsibility for his actions and fixing the crisis in social care, not blaming care homes for this government’s mistakes.” Ed Davey, the Lib Dems’ interim leader, said Johnson was “trying to shift the blame to those who risked their lives caring for our loved ones”. Nick Forbes, leader of Newcastle city council, said that at the start of the crisis the local authority had 147 requests for emergency PPE from care homes because they only had enough stock to last 24 hours. He said: “The prime minister is either woefully uninformed or wilfully misleading with those comments and it will anger people right across the sector.” While the government said it had “thrown a protective ring around care homes”, studies and reports from the sector have painted a different picture. One PHE study found that temporary care workers transmitted Covid-19 between care homes as cases surged. During flu pandemic planning in 2018, a report from social care directors warned ministers that frontline care workers would need advice on “controlling cross-infection”. But the health department’s social care plan, published on 16 April, mentions nothing about restricting staff movements between homes. The Guardian also learned that while public health officials proposed an 11-point plan to protect care homes in April, including a radical lockdown, with staff moving in for four weeks while temporary NHS Nightingale hospitals were deployed, it was rejected by the government. The care sector has also complained about a lack of protective equipment for staff, with providers in some cases having to secure their own supplies. Earlier in the outbreak, care home operators accused the government of “a complete system failure” over testing for Covid-19. Care home managers said lives have been put at risk and conditions for dementia sufferers have worsened because of the government’s failure so far to test hundreds of thousands of staff and residents.