Coronavirus: What went wrong in Scotland’s care homes?

By Mark Daly, of BBC Scotland

During the coronavirus pandemic more people died with the virus in Scotland’s care homes than in its hospitals. The latest figures show almost 1,900 deaths in care homes where Covid-19 is on the death certificate. A BBC Disclosure programme, The Care Home Scandal, looked at what went wrong. In the initial programme on care homes, reporter Mark Daly came to Dumbarton, where a remarkable number of residents died after contracting coronavirus.

Scandal of how Scotland’s care homes were neglected during the pandemic

At the height of the pandemic, 39 staff members at Whitehills care home in East Kilbride were off work.

In April, the BBC understands, the home had issued a red staffing alert – meaning it did not have enough staff to properly care for its residents.

Figures released to the BBC under Freedom of Information suggest absence rates like this were not unusual.

During lockdown, the Care Inspectorate received 30 red warnings that homes did not have enough staff to properly care for their residents, and 149 amber warnings that staffing was stretched.

Louise McKechnie believes the high level of absence at Whitehills affected her grandmother’s care.

Bridget Snakenburg had been at Whitehills for four years when she contracted Covid, then had a stroke.

Louise – who herself works in the care sector – got into the home and was shocked by what she saw.

She said she found Bridget soiled and wet, in a dirty room, with an open bag of used PPE in her bathroom.

“That’s how bad it was,” Louise said.

“It was meant to be discarded right away, to prevent any more infection getting about.

“She’d been in her bed for a long time, and her room hadn’t been touched for a long time. The debris had built up. I’ve never seen a room like that.

“There weren’t enough staff to care for their needs.”

Four days after her stroke, Louise decided to clean her gran’s mouth and found what appeared to be old food inside.

“I had to break it off of her cheek.”

Bridget died later that day. At the time, the BBC understands, the home was on an amber staffing alert.

“She should not have been left in the first place to die like that,” Louise said. “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, which has praised our high standards of hygiene.”

An investigation by South Lanarkshire Council found “no significant issues that would pose a risk to care home residents”.

In May, Rodger Laing was moved from hospital into a care home. Twenty-two days later he was dead. He had caught Covid-19.

Rodger was one of more than 1,300 patients discharged into homes in Scotland to free up hospital beds for coronavirus patients.

The 80-year-old had dementia and had been in Midlothian Community Hospital for about seven months.

In December, before the pandemic, Rodger’s family had agreed on a move to a care home – one of several considered was Drummond Grange in Edinburgh.

But when social workers wanted to move him there, coronavirus was already in the home.

Rodger’s story was first reported in the Edinburgh Evening News. His son, Rodney Laing, was interviewed for BBC Scotland’s Disclosure.

He said: “I said to the social work department ‘you cannot take a human being out of an environment that he’s healthy in, and put him in an environment that is riddled with Covid. There’s elderly people in there dying. You’re sending my dad to the gallows’.”

Rodney was worried about the risk from the virus and said he felt under pressure to agree to move his father.

Rodger was tested when he left hospital. The test was negative; he didn’t have Covid when he moved to Drummond Grange.

But within three weeks, the family’s worst fears were realised when he contracted the virus.

Rodney said: “The people that were in the hospital ward with my dad are still alive. And our dad’s not.

“He was just a file with a name on it, and they wanted that file off their desk, so they thought, get him into that nursing home, then I can move on to my next case.”

Morag Barrow, from Midlothian Health and Social Care Partnership, said they had been working closely with the Laing family since December 2019.

She said: “Mr Laing’s son was given power of attorney to make the decisions affecting his father’s care.

“Decisions affecting a patient cannot be made without the permission of the patient themselves or in cases where that is not possible, their power of attorney.”

The day after Rodger died, the Care Inspectorate carried out an unannounced inspection of Drummond Grange.

It found serious concerns about availability and use of PPE, infection prevention and control practices and staff knowledge of residents’ status relating to Covid-19.

The home was issued with a letter of serious concern and at the next visit improvements were found.

Barchester, the company that owns Drummond Grange, said it had significant concerns about the Care Inspectorate report.

It told the BBC: “The home had full PPE stocks and the staff are all trained and experienced in infection control.

“In addition, the home increased staffing levels to address the fact that not all residents have capacity, and many are not able to socially distance.”

Care home residents could not get into hospital

Gerry Gallagher battled to get his mother Rose admitted to hospital from Kyle Court care home in Paisley.

The 90-year-old had suspected Covid symptoms. The home’s GP said the most important thing was for her to be kept comfortable in familiar surroundings.

“I disagreed with that,” Gerry said. “I said: ‘The most important thing is to have a chance of life’.”

A care home nurse told Gerry he might have difficulty getting Rose admitted to hospital because she had already been put onto end of life care.

“I was stunned by that, and I am angry still about the fact that the GP put mum on end of life medications without any notification or agreement with me,” he said.

Gerry said Rose had been written off, but he insisted she was taken to hospital. She was admitted three days after she fell ill. She died a week later, with Covid.

Her son believes if she had been taken into hospital earlier, she may have had a better chance.

“We shouldn’t be treating care home residents as anything less than full citizens,” he said.

“Yeah, they are elderly, they’re dependent on us. But they deserve the same treatment, and the same chance as other people.”

A spokesperson for care home operator HC-One denied Mrs Gallagher had been “written off” and said Kyle Court staff “strongly believe they did everything possible to provide the best care and support” for her.

They added: “The care home has no control over the prescribing decisions made by GPs.”

The Greenlaw GP Practice in Paisley said its clinical decisions were made “in the best interest of the patient” and it “followed the national and clinical guidance on Covid-19 at all times”.

At the time, the Scottish government guidance said: “It is not advised that residents in long-term care are admitted to hospital for ongoing management but are managed within their current setting.”

This guidance is no longer available on the government website.

The Scottish government told the BBC “it has never been advised” that care home residents should not be transferred to hospital “when it is clinically assessed to be in their best interests”.

Donald Macaskill, chief executive of Scottish Care, which represents the private care home sector, believes a “root and branch review” is required to decide how much the public purse should provide to the sector.

Most care is delivered by private and charitable organisations on behalf of the state, he points out, with staff pay pegged to the minimum wage and the Scottish living wage.

Just how much do we value care? At the moment you can get more money by walking a dog in Edinburgh than you can for caring for a human being.” said Donald Macaskill, of Scottish Care

Less than 16% of Scotland’s care homes are owned by the ‘big five’ chains – which include wealthy equity firms – with the vast majority owned by private family-owned businesses, Mr Macaskill adds.

“The vast majority deliver excellent care. This isn’t an issue of individuals seeking profit; it’s an issue of the failure to value care.”

Commenting on BBC Scotland Disclosure programme, Scottish Liberal Democrat leader Willie Rennie said:

“This programme has once again exposed the mistakes that were made in the handling of Scotland’s care homes and the dreadful toll that this has taken on far too many vulnerable people.

“Its disappointing that the First Minister and Health Secretary refused to be interviewed. [It’s not Willie, it is scandalous- Ed.]

“With the prospect of a second wave of the virus very real, the Scottish Government should announce a rapid inquiry to learn lessons and help us to plan for what is ahead. It is not enough to leave this to inquisitive journalists when so many Scots have already died.”

Disclosure: The Care Home Scandal will be shown on BBC One Scotland on Tuesday 28 July at 22:45, and afterwards on the BBC iPlayer. Look out for another expose about care homes on Panorama later this week.

One comment

  1. Let’s maybe go back a bit to the bigger picture.

    Coronavirus was known about back in early January.. The outbreak in China was well underway and as January moved to February the outbreaks in Italy, Spain and elsewhere were well known. Concomitantly the need for and introduction of lockdown was well known.

    But lockdown did not come to the UK. Rather the UK government issued public notices to advise that government and the NHS were well prepared for the virus and that the best thing people could do was sneeze into tissues and wash their hands. Accordingly, and despite medical warnings no restrictions what so ever were placed on mass gatherings like Cheltenham Race Festival, pop concerts and rugby football. The dictum of Dominic Cummings of ‘ it’s all about herd immunity, protect the economy and too bad if a few pensioners die ‘ was all to grimly the policy.

    And so with the virus deliberately spread, and then the modelling revealing maybe 500,000 deaths if there was no check on spread ( eg lockdown ) the rest all became history.

    Yes there may have been inadequacies in the care home sector. And yes there needs to be a recognition of this. But the policy of letting the virus spread, and too bad if a few pensioners die should be the real focus of attention.

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