Warnings from stretched Scottish care homes revealed

An investigation into the care of the elderly in Scotland’s residential homes during the pandemic has revealed a huge number of warnings were issued to the Care Inspectorate over staffing shortages as the homes battled to prevent the spread of coronavirus.

BBC investigative programme Disclosure has found that at the height of the pandemic - between 3 April and 17 June when care homes were obliged to report on staff shortages to the Care Inspectorate – 179 red and amber notifications were issued.

The 30 red warnings indicated there were an insufficient number of staff to properly meet residents’ needs while the 149 amber alerts issued indicated resources were stretched and that the staffing levels were close to impacting on the quality of care.

As a result, the programme has found that many elderly residents were left without sufficient care, while at the same time homes felt “pressured” by the government into receiving more residents from hospitals, who were not tested for 
Covid. The revelations, which will be broadcast tonight, come as demands also increased for the Scottish Government to end the secrecy over the exact location of coronavirus deaths in care homes.

A staff member speaks to a care home resident

The majority of care providers in Scotland, including council-run homes, have refused to release information about the numbers of deaths, while the Care Inspectorate has said it won’t reveal the information for “commercial” reasons.

Care homes have accounted for more than half of all coronavirus deaths in Scotland since the start of the pandemic, but a lack of detailed information has made it impossible to map all the deaths to specific care homes or care providers.

In the four months since lockdown, there were also around 2,400 more deaths in care homes than would normally be expected for that period. Covid-19 was the underlying cause in 79 per cent of the excess deaths.

Scottish Labour’s health and social care Monica Lennon has now challenged Health Secretary Jeane Freeman to publish the data on how many deaths were in each home, and also said her own attempts to obtain more detailed data on local breakdowns from National Records of Scotland and the Care Inspectorate had been blocked.

First Minister Nicola Sturgeon. Picture: Andrew Milligan/PA Wire

She said: “The continued refusal to provide details on the level of the virus and the number of deaths at a care provider and care home level means that families continue to be left in the dark.

“The enforced separation from their family members in recent months has been heart-breaking, and many people have told me of their anguish about a lack of clear information regarding what is happening to their relatives.

“The least that should be provided is clear information about the prevalence of the virus and the suspected death rates in each care home. Withholding this information across the board as a blanket policy is completely unacceptable, and it should be made public.

“Fears over this secrecy only highlights the wider concerns about accountability in care and the need for a national care service.

“The Health Secretary could end the secrecy today by releasing the data on care home deaths. The Scottish Government must do the right thing and publish the data, out of respect for grieving families and to avoid repeating decisions that risk lives.”

The Care Inspectorate said it would not disclose the data via a freedom of information request, as infections and death numbers “may not necessarily be related to a service’s quality of care, hygiene standards, and use of PPE.”

However a Scottish Government spokesperson said that it was not confident that the information was robust enough to publish. “To meet our obligation under statistical guidelines we need to be confident that data is accurate and robust, within legal guidelines and protecting people’s right to confidentiality.

“Care homes must be allowed to focus on providing sufficient standards of care for their residents, especially at a time when those services are under increased pressure as a result of the coronavirus outbreak.”

The pressure felt by care homes is also revealed in the BBC programme as it spoke to carers, relatives and experts about the Scottish Government’s decisions and the provision of care for the elderly 
as thousands of residents died at the height of the Covid-19 crisis.

Dr Donald Macaskill, chief executive of Scottish Care which represents the independent care sector, said: ‘I know of dozens of care homes, who are convinced, whose staff are convinced, that it was as a result of a discharge from a hospital or an admission from a hospital that they introduced Covid into the care home.”

He added that there was a “degree of pressure” put on care homes “to make themselves available to relieve the NHS at a point at which there was a risk.”

The programme says that by 1 May, more than half of all Scottish care homes had coronavirus within them and hundreds of residents were dead or dying. It was at this point that mass testing for residents and staff was announced.

Relatives of elderly residents at care homes which were affected by the crisis, have also spoken out, with reports that at the height of the pandemic, 39 staff members at Whitehills care home in East Kilbride were off work.

Louise McKechnie believes the high absence rate at Whitehills affected the care of her grandmother Bridget Snakenburg, who had been at Whitehills for four years when she contracted Covid, then took a stroke. Ms McKechnie said she was shocked by what she saw in the home, finding her grandmother soiled and wet, in a dirty room, with an open bag of used PPE in her bathroom.

She said: “She should not have been left in the first place to die like that. Nobody should be left like that.’

A spokesperson for Whitehills said: ‘We have apologised to Mrs Snakenburg’s family for failing to quickly remove used PPE from her room during the Covid crisis. Our infection control procedures have since been fully reviewed and endorsed by the Care Inspectorate.”

In a statement to Disclosure the Scottish Government said: “The impact on care homes around the world has been profound. It is right and proper that decisions taken during this process face scrutiny in the fullness of time but we are committed to protecting life and protecting people from this virus, and all our efforts are going towards doing everything we can to mitigate the impact of Covid-19 in Scotland.”