Wednesday, 20 May 2020

Care Homes - Thrown Under The Bus



When the time comes to look back on the battle to stop the spread of Covid-19 I suspect the evidence will show that care homes across the UK were 'thrown under the bus'. 

Some of the many challenges have already been widely reported in the media, often with the aim of finding someone to blame, but here are several issues which have jumped out to me so far.
  • Hospitals have discharging patients into care homes without ensuring they are not infected with Covid-19
  • Care home residents and staff in care homes have not been routinely tested for Covid-19 - despite repeated promises
  • The supply of PPE (Personal Protection Equipment) to care homes has been slow and patchy
  • The guidance on the use of PPE in care homes has been poor, for example on the wearing of face masks
  • The absence of a robust TTI (Test, Trace, Isolate) policy has made it more difficult to contain outbreaks of Covid-19   
  • Patients who would normally be transferred to hospitals for treatment have been forced to remain in their care home
  • Doctors have designated care home residents as DNR (Do Not Resuscitate) without consulting residents or their families
  • Staff in the independent sector are being penalised for self-isolating because they do not receive their full pay
  • The Care Inspectorate (which regulates the sector) has been accused of operating with too much of a 'light-touch' after suspending its inspections during the epidemic
My Mum spent her last days in a care home and I know from my own experience that the staff who cared for and looked after her were every bit as committed as the staff in the local hospital (which she visited regularly) and the Home Carers who enabled her to live independently until she needed the extra help and support of a residential care home.  


 


Coronavirus, Care Homes and Testing (16/05/20)



The shocking deaths of 7 residents at the Home Farm care home in Skye has led to the Scottish Government taking the owners (HC-One) to court with a view to removing their licence.

Now I don't know the reasoning behind this decision, but you would imagine the Scottish Government must have a good case for taking such strong action.

But what is odd is that in West Dunbartonshire an even more shocking 16 residents died from Coronavirus after Crosslet House declared itself to be "Covid-19 free".

The Times reported this story on 22 April 2020 with the local MP (Jackie Baillie) and Scotland's health minister (Jeane Freeman) both condemning shameful behaviour which gave the impression that residents were being tested when they were not.

So what action, if any, was taken to safeguard residents at Crosslet House run by West Dunbartonshire council and why should this care home be treated any differently to the Home Farm facility in Portree? 


 


https://www.thetimes.co.uk/edition/scotland/coronavirus-in-scotland-testing-at-care-homes-increased-after-outcry-39r5csbh8

CORONAVIRUS
Coronavirus in Scotland: testing at care homes increased after outcry


22 April 2020

Jeane Freeman, the Scottish health secretary, at Holyrood yesterday. She said that all new residents moving into homes would be tested for Covid-19 and isolated for 14 days - Photo

FRASER BREMNER/GETTY IMAGES

By Helen Puttick - The Times

Inspections and coronavirus testing across Scotland’s care homes are being ramped up after ministers bowed to concerns about the number of residents falling ill.

Jeane Freeman, the Scottish health secretary, said that care homes “should not have seen the level of transmission” experienced if all the guidance on social distancing was being followed.

She announced a “considerable increase in intervention and oversight” with NHS public health directors told to report back on how nursing homes were coping, whether they were following the rules and had the necessary protective equipment.

In a significant change of policy, she also said all new residents moving into homes would be tested for Covid-19 and isolated for 14 days. Less than a week ago Nicola Sturgeon rejected calls to test potential care home residents, arguing that this could undermine other infection control measures.

Yesterday’s figures showed that the number of patients admitted to intensive care with the virus in Scotland was reducing. The death toll of confirmed cases was 985, up 70 from Monday.

Yesterday Jackie Baillie, the deputy leader of Scottish Labour, highlighted that Crosslet House care home, which is run by West Dunbartonshire council, had registered 16 deaths despite managers’ claims that it was “Covid-19 free”.

Ms Baillie accused the council of “a shameful piece of spin” and giving the impression that residents were being tested. Ms Freeman described the episode as “utterly shameful and completely unacceptable” and said the NHS’s regional director of public health would investigate.

The health secretary also promised that she would not leave the office last night until an issue was resolved of personal assistants who care for frail people in the community being unable to contact a helpline for supplies of personal protective equipment. Ms Freeman said: “There is no reason at this point why they cannot access PPE.”

Donald Macaskill, the chief executive of Scottish Care, which represents care home and home care providers, welcomed the new measures to support the sector. “This will support a very stretched sector to deal with the most vicious disease many of us have ever known in our lifetime,” he said.

During her statement in the chamber yesterday Ms Freeman made it clear that testing would be available for all care home staff and residents. She added: “We are also building the testing structure we need as we move to the next phase, our capacity to test, trace and isolate will be critical to controlling the virus.”

The Scottish Conservatives said they continued to hear of shortages of personal protective clothing. Jackson Carlaw, the party’s leader, said: “We keep hearing that Scotland has sufficient supplies of PPE for now and the foreseeable future. But still care homes, and carers working in communities, are being left exposed to the huge risks of coronavirus.

“There is clearly still a problem when it comes to getting these provisions to those who need them and we’re now several weeks into this crisis.”

Ms Freeman said there were enough supplies but that efforts were required to continue ensuring this was the case.



Care Homes and Coronavirus (14/05/20)


Incredible though it sounds Scotland's health minister, Jeane Freeman was forced to admit that she had not seen the latest care home guidance issued by the Scottish Government.

Now there is controversy surrounding residential care at the moment with claims that residents have been:

  • denied access to hospital treatment 
  • discharged from hospital without being given the 'all clear' from Coronavirus
  • issued with 'DNR (Do Not Resuscitate) notices by GPs' without their and/or their families knowledge.
And that's without getting into the problems of PPE and whether 'barrier techniques' in care homes have been of a sufficiently high standard.  

So you would think that the Scottish health minister would be familiar with the latest advice being issued by her own government department. 

Read a full report in the link below to The Scotsman.

https://www.scotsman.com/news/politics/freeman-ive-not-seen-guidance-sending-patients-care-homes-no-test-results-2848242


 


Protecting Service Users and Essential Workers (21/04/20)



The BBC reports another incident of multiple deaths due to Coronavirus in a Scottish care home - this time in Crosslet House run by West Dunbartonshire Council.

As with other incidents, the authorities are clearly working hard to safeguard residents and staff, but it does seem to have been a real struggle to get the right kind of Personal Protective Equipment (PPE) to essential workers on the front line, in this case to home carers and carers in residential homes.

 


Coronavirus: '15 dead' after outbreak at care home in DumbartonImage copyright - GETTY IMAGES Image caption - A quarter of Scotland's coronavirus deaths have occurred in care homes

Scottish Labour's deputy leader said 15 residents have died following an outbreak of Covid-19 at a care home in Dumbarton.

Jackie Baillie, who is also the local MSP, described the reports from Crosslet House as "devastating".

West Dunbartonshire Council said it has suspended new admissions to the 70-bed home for the time being but declined to comment on the number of deaths.

The Daily Record reported the cases were highlighted by a whistleblower.

Ms Baillie tweeted: "Devastating to hear 15 people have died at Crosslet House. My thoughts are with the families who have lost loved ones. Serious questions need to be asked as to the handling of this outbreak. Every staff member and resident must be tested for Covid. There must be no new admissions."

Meanwhile, six residents at an Aberdeen care home are believed to have died with suspected coronavirus symptoms.

Bon Accord Care, the operators of the Kingswells home have confirmed there have been a number of deaths there, and said it has "robust infection control in place throughout the home".

There have been a number of suspected Covid-19 outbreaks in recent weeks.

The largest known have occurred at Berelands Care Home, Prestwick; Burlington Court Care Home, Cranhill; Elderslie Nursing Home, Paisley; and Hill View, Clydebank.

Crosslet House is the second Dumbarton home to experience a number of suspected Covid-19 deaths after it emerged eight residents had died in the privately operated Castle View.


Devastating to hear 15 people have died at Crosslet House. My thoughts are with the families who have lost loved ones. Serious questions need to be asked as to the handling of this outbreak. Every staff member and resident must be tested for covid. There must be no new admissions







Last week official figures showed a quarter of Scotland's coronavirus deaths have occurred in care homes.

In response to the outbreak, a West Dunbartonshire Council spokeswoman said: "Our dedicated team of carers at Crosslet House is working round the clock to provide essential care and support to residents and their families during these unprecedented and hugely challenging weeks.

"Testing of staff and residents has already been undertaken in line with guidance and the care home is already closed to new admissions."

The council said its procedures are "thorough" and added: "Morale among our staff remains high and we are hugely grateful for the vital role they are playing in caring for and protecting residents most in need."

A Care Inspectorate spokesman said: "We are aware of the tragic deaths of residents at this care home as a result of suspected cases of Covid-19.

"Our thoughts are with the loved ones of those affected as well as the staff and wider community of the home.

"We have been notified of the circumstances and we are in contact with the care service and the local health and social care partnership during this difficult time."

Face Masks and Essential Workers (19/04/20)



No one else seems to have picked up on The Herald's story about the Scottish Police Federation demanding better face masks for officers who can't observe social distancing in dealing with members of the public.

Now as I said yesterday I don't understand what wrong with the face masks currently supplied to police officers in Scotland, not least because the SPF haven't shred their 'expert evidence'.

But what really surprises me is the special pleading involved because there are lots of other groups of essential workers whose safety needs to be taken into account as well - Home Carers and Residential Care staff being just two obvious examples. 


 



Masks On vs Masks Off (18/04/20)



Here's an odd story from The Herald which reports that the Scottish Police Federation (SPF) are unhappy with the quality of the Personal Protection Equipment (PPE) provided during the Coronavirus pandemic.

What seems odd to me is that the SPF claim that their expert advisers are advising that their PPE supply is 'rubbish' - yet they fail to provide any evidence to back up this claim.

I understand that PPE is now being organised centrally by the Scottish Government which is what you would expect in an emergency situation, otherwise different groups of essential workers would have to compete and scrabble over scarce resources.

But the ordering and distribution system does seem to have real problems because I know that Glasgow's care workers had a real fight on their hands about wearing face masks - and even now the Government and Council policy is that individual workers should be left to decide whether to wear them or not.

 


https://www.heraldscotland.com/news/18387306.coronavirus-scotland-police-body-raises-concerns-face-masks/


Coronavirus in Scotland: Police body raises concerns over face masks


By Alistair Grant - The Herald

Coronavirus in Scotland: Police raise concerns over face masks

POLICE representatives have raised concerns newly announced protective equipment for officers will not provide any "meaningful protection" against coronavirus.

Police Scotland revealed on Thursday staff will be given surgical face masks to wear when working where it is not possible to adhere to social distancing measures.

But the Scottish Police Federation claimed the scientific case for the personal protective equipment (PPE), known as type two masks, had not been made.

Nicola Sturgeon has pledged to listen and respond to concerns being raised over equipment.

David Hamilton, chairman of the SPF, said: "The demand for PPE amongst our members is understandably high and whilst we note the service is now able to issue type two surgical masks, these will not provide any meaningful protection to officers.

"The advice of our expert panel means that the Scottish Police Federation cannot endorse their use as PPE.

"Our panel is unanimous in its views that the primary aim of the surgical mask is to prevent the wearer from infecting anyone else; and that they offer little effective barrier to the wearer from contracting the virus.

"In short the scientific case that these masks can be used as PPE against Covid-19 has yet to be made."

Police Scotland has secured "initial stocks" of type two fluid resistant surgical masks and is distributing them in response to advice from HealthProtection Scotland, Public Health England and the UK Government.

Officers and staff will be able to use the PPE in low risk situations where they are unable to maintain a two-metre distance from their colleagues or members of the public.

A total of 4,000 of the police workforce have been supplied with the FFP3 mask, which offers an enhanced level of protection through a face-fitted respirator.

Ms Sturgeon was asked about the concerns raised by the SPF during the Scottish Government's daily coronavirus briefing.

She said Police Scotland was using the masks on the basis of scientific evidence from Health Protection Scotland and others.

She said: "We work closely with, not just health and care – although primarily with health and care – but with other parts of the public sector to make sure we have the right supplies, but also that the quality of what is being used is sufficient.

"We will continue to listen to and try to respond to any concerns that are being raised by staff groups, and in this case obviously by the Scottish Police Federation."

Deputy Chief Constable Malcolm Graham said: "We are committed to doing everything we can to protect the public and limit the spread of the virus, and to protect our own people as they carry out their duties.

"We recognise that every day our officers and staff are putting themselves in harm's way and we want them to have the right protection to do their job.

"In line with scientific advice, these surgical masks will be available for use as a precaution for officers and staff dealing with incidents where social distancing measures are not possible."