Coronavirus in Scotland: Serious issues with infection control and PPE still being found in Scots care homes, as expert warns of risk with more indoor gatherings and possible second wave

Serious issues with infection control and PPE use are still being identified in some Scots care homes, as one expert warned of the ongoing risk linked to more indoor gatherings and a possible second wave of the virus in winter.

The latest Care Inspectorate Parliamentary report rated seven out of 22 care homes visited as "weak" or "unsatisfactory" or needing further improvements in the categories of either infection prevention and control and staffing, with letters of serious concern issued in several cases.

Professor Rowland Kao, epidemiologist at the University of Edinburgh, warned of the ongoing risk to care homes as gatherings increase elsewhere in society. For instance, he refers to more people meeting indoors as the weather changes, students - including from outside of Scotland - returning to universities, workplaces reopening and the recent evidence of outbreaks linked to schools.

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Prof Kao says people coming in and out of care homes, from staff and visiting families to people doing deliveries, means "there will always be a risk."

The latest round of inspections identified a number of concerns with infection prevention and control at various Scots care homes/ Professor Rowland Kao (right) warns of the ongoing risk with more social gatherings and the risk of a virus resurgence.

He says it will be vital for care homes to receive full supplies of PPE, ensure everything is dealt with hygienically and that residents and staff are regularly tested - including antibody testing - given the possibility of a virus resurgence.

But he warns another issue will be maintaining staffing levels in care homes with the winter months bringing other viruses like flu, which could mean periods of self-isolation for staff and cover issues in a sector which is already stretched financially.

'Serious concerns'

The latest fortnightly Care Inspectorate report to the Scottish Parliament published its inspection findings on August 19.

Ashwood House care home, in Callander near Stirling, was visited by inspectors four times in a month but is still failing to meet requirements in infection prevention and control - and earlier in August it received a notice of proposal to cancel registration.

Following visits on July 7 and 10, inspectors reported the home had an "unacceptable" level of cleanliness and hygiene with "numerous pieces" of equipment used to support residents either not clean or in good working order, and they also expressed concerns about the safety of a gas appliance and fire doors and exits.

The report said staff did not have full access to PPE and there has been "no staff training in relation to Covid-19" and people were not being encouraged to stick to social distancing guidance.

A letter of serious concern was issued after the first visit on July 7.

A third visit on July 30 found "minimal improvement" and a notice of proposal to cancel registration was issued on August 5. A fourth visit on August 11 found requirements for improved infection prevention and control and environment safety and cleanliness - and regarding leadership and quality assurance - had not been met.

A spokesperson for care home provider, Mauricare, said staff and management continue to work very hard to ensure the safety and wellbeing of residents, and stressed the 21-bed home has been Covid free.

The spokesperson said they are thankful to the authorities for their support, especially Stirling Council, and remain committed to meet and maintain the requirements.

'Unsatisfactory'

Inspectors also gave a rating of "unsatisfactory" for infection prevention and control practices in Newton House care home in Newton Mearns, Glasgow. This facility was also served a letter of serious concern.

The report said the standard of cleanliness for some equipment, including some bed mattresses, was a "concern."

It also said clothes were not being washed properly at the correct temperature to minimise spread of infection and that there was a lack of training for staff on infection prevention and control practice and highlighted concerns about the use of face masks and compliance with social distancing.

The report said there was no significant improvement when they visited the service for a second time on August 11.

But a spokesperson for care provider Hamberley Care stressed the safety and wellbeing of their residents is their "highest priority," adding: "We immediately implemented our action plan to remedy these issues and we are preparing further evidence to demonstrate the infection control measures, and requisite training, which predated this inspection.

"We can also confirm that the home continues to have an adequate supply of appropriate Personal Protective Equipment (PPE) and that we continue to apply our infection control protocols on a daily basis to ensure our residents and colleagues stay safe and well.

"We have also provided evidence that proves infection control training compliance was at a very high level – over 98% for all staff. This is to correct the factual inaccuracy in the Parliamentary report."

Following the initial inspection the care home purchased replacement mattresses where required and instructed an independent infection control audit to be conducted of the home immediately.

Inspectors did find that residents in this home were "well cared for and supported to remain active" and that staff responded to people's needs in a "kind and compassionate manner" and that residents were supported to keep contact with families.

Other inspection findings in the latest Care Inspectorate report can be found here>»

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