Government failures caused Covid-19 to spread “like wildfire” among vulnerable and elderly people, and Matt Hancock’s “protective ring” around care homes did not exist, a public inquiry has found.

Heather Hallett, who is leading the Covid-19 inquiry, said the care sector was an “afterthought” and rejected the former health secretary’s long-held claim that he threw a “protective ring” around care homes from the start of the pandemic, saying it was “unfounded” and the “opposite was true”.

She described the government’s failure to advise that patients discharged from hospitals into care homes should be isolated was a “significant omission”, which led the virus to spread rapidly among residents and staff.

Lady Hallett also said preventing visits to care homes led to “immense emotional harm” for residents and left them with “profound isolation and a sense of abandonment”.

“The adult social care sector as a whole appeared to be something of an afterthought, where the mantra of ‘protecting the NHS’ sometimes came at the expense of the users and providers of care,” she said.

“Care homes received insufficient protection at the time they most needed it. These failures created environments in care settings in which the virus could spread like wildfire.

“Most distressingly, some people were not permitted to be with their dying loved ones. Many remain racked by a guilt that they do not deserve to carry.”

Covid-19 Bereaved Families for Justice UK said Hancock’s claim about a protective ring had been a “cruel lie”.

Speaking on behalf of the group, Jean Adamson – the daughter of the Windrush pioneer Aldrick Adamson, who died in a care home after contracting Covid – said the report was “a devastating account of one of the darkest episodes in our country’s history”.

“It shows that the government knew the care sector was extremely vulnerable to a pandemic and yet did nothing – failing to act until it was too late,” she said.

“The most at-risk people in our society, the sick, elderly – many of whom had a full and long life ahead of them – were failed by a government who abandoned them and left them to die.”

Related: ‘Superficial damp squib’: Covid inquiry recommendations fail to impress bereaved families

But Adamson said the report “doesn’t go far enough” in its recommendations and the group felt “really let down in several places”.

“We’re going to look at them in more detail, and aim to strengthen them, make them more robust. Because we don’t want to be standing in this place in 10 years’ time, trying to learn the same lessons all over again,” she said.

More than 43,000 people died from Covid-19 in UK care homes between March 2020 and July 2022.

Hallett’s report, published on Tuesday, focuses specifically on adult social care and residential homes and is the sixth of 10 to be published by the inquiry.

It is the most expensive public inquiry in the country’s history, costing more than £200m, and has so far made 55 recommendations on how the country can better prepare for pandemics.

Hancock was called to give evidence in which he took responsibility for the government decision to discharge about 25,000 hospital patients into care homes to free up NHS bed space before mandatory testing was introduced on 15 April 2020. The policy was later ruled unlawful by the high court.

Hancock told the inquiry it was the “least worst decision to a terrible problem”. Hallett said the policy was necessary to free up hospital beds, but she criticised the government for not advising care homes to isolate discharged patients.

The inquiry’s chair said it was “wholly unacceptable” that care staff were left without adequate personal protective equipment, describing how people resorted to using “festival waterproof ponchos, painters’ overalls and gloves purchased from DIY shops”, as well as making their own from fabric, bin bags and bed linen.

She noted the emotional toll on staff, saying: “The scale of death and suffering witnessed by social care staff … was unlike anything they had seen before.” Hallett said this led to post-traumatic stress and suicidal thoughts, and that several care workers killed themselves.

Hallett made eight key recommendations in the report, which included better pandemic planning, financial support to help social care staff to self-isolate, and guidance on visiting restrictions based on the principle that residents have the “right to in-person visitors, except in the most grave or exceptional of circumstances”.

She also said there should be mandatory end-of-life care training for health and social care professionals, including on the use of do not resuscitate orders, after concerns that blanket policies based on age or disability were introduced during the pandemic.

“The action taken by the UK government and devolved administrations to try to protect workers and users of adult social care came too late. My recommendations must be acted upon now before the next pandemic strikes,” she said.

The prime minister, Andy Burnham, said the government was “committed to learning the lessons” from the report and pledged to use the findings to develop a plan for any future pandemic.

Caroline Abrahams, the charity director of Age UK, said the report was “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,” she said.

She said the report reinforced the need for “fundamental social care reform” but that many of its recommendations could be implemented before the conclusion of Louise Casey’s review into the creation of a National Care Service.

“It is tremendously important that government heeds this lesson and that work begins now,” she said.