GMB seeks assurances as care home visiting resumes

Precarious balance between compassion and safety ahead of care home visit re-start, as GMB asks for worker assurances

Speaking ahead of the re-start of indoor visits to care homes across Scotland today (Monday 1 March), Rhea Wolfson of GMB Scotland’s Women’s Campaign Unit said: “The balance between compassion and safety is precarious at this moment. Confidence is fragile among care home workers and there can be no room for complacency.

“That’s why ahead of the return to care home visits GMB has asked the Scottish Government to ensure the delivery of three basic provisions:

  • Safe levels of staffing provision in homes.
  • A whistleblowing facility for worker safety.
  • Stringent enforcement of government safety guidelines.

“Everyone wants to see families reunited but government and employers owe a great debt to these key workers after the last year, and it’s important their voices are now being heard.”

The Scottish Government has published new guidance for care homes on visiting during the pandemic plus tools and resources on visiting and supporting residents in homes with COVID-19.

You can access this here: http://bit.ly/3fY3MFq

The guidance supports adult care home residents to resume meaningful contact with loved ones. This begins with up to two designated visitors, and a total of two visits a week.This will become normal practice in all but exceptional circumstances, such as a COVID-19 outbreak.

It is hoped to gradually increase the frequency and the number of people who can visit.

A tale of two care homes

Lothians MSP Miles Briggs has expressed concern over infection control measures at an Edinburgh nursing home.

The Care Inspectorate carried out an unannounced virtual inspection of Lorimer House Nursing Home, Lanark Road, on 27 January and followed this up with a visit with Healthcare Improvement Scotland on 5 – 8 February.

They reported ‘significant concerns relating to infection protection.’

Cleaning agents did not meet current best practice guidance and there was inadequate staff access to both PPE stations and clinical waste disposal bins.

Several soiled mattresses and mattress covers were found during the inspection and some dining room furniture was contaminated by food waste.

Edinburgh Health & Social Care Partnership has been informed of the findings and a follow up inspection to monitor progress will take place.

Lothian MSP, Miles Briggs, said: “The majority of care home residents have received their first vaccination for Covid-19, but it is still vital that infection prevention control measures are strictly followed.

“Care homes have had months to fully implement proper protocols and there is no excuse for not following guidance to the full.

“These concern from the Care Inspectorate must be immediately addressed to ensure the safety of care home residents at Lorimer House Nursing Home.”

Management at Lorimer House say the report does not tell the full story, however, and they fully expect to be exhonerated on appeal.

Sean Black of Lindemann Healthcare, who operate Lorimer House, responded: “The safety and wellbeing of our residents is our highest priority, and Lorimer House has always received the highest standards during inspections.

“We are appealing against the recent rating from the Care Inspectorate, as we were graded at this level because we were using a different cleaning solution to the one specified.

“Lorimer House has a robust cleaning regime which was previously inspected at the NHS Covid assurance visit, and the detergents used in the home are a suitable alternative to bleach-based solutions, which are registered to British safety standards.

“It is unfortunate and disappointing that this information was released before the appeal process was complete. We strongly believe that our appeal will be successful and hope that the corrected rating will be reflective of our consistent high standards.”

No such issues at Northcare Suites Care Home on Telford Road, however; the care home received a glowing report.

Northcare was inspected between 13 -19 January using virtual technology.

Feedback from residents, families and visiting health professionals was very positive, and essential visits at end of life were both encouraged and supported.

Northcare ranked ‘very good’ across the board: in people’s health and wellbeing, infection prevention and control practices and staffing arrangements.

Concern over conditions in capital care home

Lothians MSP Miles Briggs has expressed concern over a failure to improve conditions at Braid Hills Nursing Centre.

The latest Care Inspectorate report reads:

Braid Hills Nursing Centre is registered to provide care to 95 older people and 24 adults with a physical disability. The provider is BUPA Care Homes (ANS) Limited.

We carried out an initial inspection of the service on 29 September and 1 October, with NHS Lothian. The findings were outlined in the report laid before Parliament on 14 October.

We completed a further visit on 12 November with NHS Lothian to follow up on the improvements required in relation to cleanliness, infection prevention and control, waste management, the use of PPE and staff knowledge. The findings were outlined in the report laid before Parliament on 25 November.

We determined that further progress was still required.

We visited the service again on 29 December. Improvements were not sufficient in respect of the standard of cleanliness, waste management, the use of PPE, staff practice and knowledge. Overall, the management oversight and quality assurance systems were ineffective.

We issued a letter of serious concern to the provider on 29 December which detailed immediate action the home must take.

We returned to the service on 2 January 2021. Although the service had made plans to address our concerns, progress was not sufficient to reassure us that people were being supported safely during the pandemic. We issued the service with an improvement notice on 4 January 2021.

We have informed Edinburgh health and social care partnership of our findings.

We will undertake a further visit to monitor the improvement notice.

This was a follow-up inspection. We did not change the service evaluations.

Lothians MSP Miles Briggs said: “This is extremely concerning that Braid Hills Nursing Centre has failed to make the necessary changes to make the care home safe.

“The care home has repeatedly been told to follow the necessary measures in respect to the standard of cleanliness, waste management, the use of PPE, staff practice and knowledge, but have refused to do so.

“Increased levels of Covid-19 in the community puts elderly care home residents at even greater risk and Braid Hills Nursing Centre’s license must be reviewed if they will not meet the necessary standards to keep residents safe.”

Concern over Edinburgh care home failings

An Edinburgh care home is failing to provide adequate care to residents despite THREE visits in September, according to the latest fortnightly report by the Care Inspectorate to the Scottish Parliament.

Guthrie House Care Home on Lasswade Road, which is operated by Four Seasons Healthcare Group, was first visited by inspectors on 1 September, when a letter of serious concern over failings was issued. This was followed up by a visit two days later with representatives from NHS Lothian.

Inspectors found ‘people did not have sufficient access to fluids and were not supported promptly when in pain or distress. We were concerned about the care of residents, cleanliness of the environment and equipment, compliance with infection prevention and control and staffing levels’.

When inspectors visited Guthrie House again on 23 September they found no improvement in the support offered to indivudals experiencing pain and distress. Medication procedures were weak and there was no improvement to the quality of documentation relating to the support provided.

Commenting on today’s report, Lothian MSP Miles Briggs said: “This is deeply concerning that Guthrie House still hasn’t made the necessary improvements to cleanliness of the home and residents who are in pain are still not being supported promptly.

“Full compliance with PPE guidance is crucial to ensuring that care home residents are safe and there can be no exceptions.

“Guthrie House has been repeatedly warned about cleanliness and following PPE guidance. Strict protocols must be put in place to turn the level of care at the home around.

“There are still a number of care homes in the Edinburgh and Lothian who are not following PPE and social distancing guidance fully and the message of full compliance must be reinforced.”

Cramond Residence scores high with Care Inspectors

DELIGHTED staff at Edinburgh’s most exclusive care home are celebrating being scored highly by care regulators, just 18 months after it was created.

Purpose-built Cramond Residence only opened in October 2018 and was subjected to an unannounced, three-day check by Care Inspectorate experts in March. 

Now the national watchdog has published its report, awarding the home four 5s and a 4 for its performance to date – where 5 is “very good” and 4 is “good”. The highest available score of 6 is considered “excellent”.

Eileen Gray – General Manager at Cramond Residence

Eileen Gray, General Manager at Cramond Residence, said: “These results are great news for our residents and for their friends and family. What comes through repeatedly in the 10-page report is that this is a home where the residents are extremely safe.

“It’s also hugely gratifying that when the Inspectors sought the views of 13 residents and four relatives, the feedback was universally positive. Everyone told them how much they love it here.

“Of course, we aspire to score across-the-board 5s and 6s. In fact, that is the target we set ourselves to achieve after three years of operation.  However, building a team from scratch in the care sector is a huge challenge.

“For us to have scored so highly after just 18 months is a real testament to the entire team. I’m very proud of them and what they have achieved here in such a short space of time.”

Ms Gray, a highly experienced nurse who has worked in the care sector for over 30-years, said she and the rest of the team would now be taking on the Inspectorate’s advice on “areas for improvement” from the report and would be drawing up detailed action plans to implement.

She added: “We will never be complacent. No matter how good a care home is, the inspectors will always find room for improvement. Our team know that we must constantly be developing and improving.”

Cramond Residence can care for up to 74 older people and has a specialist dementia unit to care for those with an advanced stage of dementia. Each resident enjoys a luxury room with en-suite bathroom facilities. It maintains a care staff to resident ratio of at least 1:4 at all times. 

Spread across three floors, it also adopts a small-group living philosophy. That means groups of eight rooms form distinct “houses”, where residents are encouraged to eat and socialise together. This is believed to have played a major role in infection control during the Coronavirus pandemic to date.

Ratings for the residence included a 5 for supporting people’s wellbeing and the report praised the organised events, intergenerational work with local schools, and the ability for residents to move about freely, building rich friendships and relationships.

It said: “We saw that care staff, administrators, ancillary and management teams knew people who lived there, which meant people felt secure and confident with staff who cared for them.”

The residence also scored a 5 for its leadership, noting: “We saw that the management team were settling in well and working well together. People who lived in the service and their relatives were confident that the service was well managed.”

Another 5 was awarded for the residences’ staffing, with the report stating: “It is important that people who use this service have confidence in the staff who care and support them. We saw the level of training, support and supervision most staff received. This showed that they were competent, skilled, and were able to reflect this in their practice, whilst keeping people safe.”

Likewise, the residence was scored a 5 for its purpose-built setting, which includes a cinema, gym, garden lounge, library, hairdressing salon, activity rooms, a physiotherapy room and even a private, fine-dining area for residents to use with friends and relatives.

Inspectors graded the residence a 4 for how well care and support is planned. While acknowledging Cramond Residence’s pioneering and easy-to-access electronic system for individual care plans, it suggested those plans should have a greater focus on measuring outcomes for residents.

However, the report went on: “We found that people who were supported by different organisations worked well together by sharing information, examples of these include physiotherapists, pharmacists, podiatrists and GP’s, which was appropriate, confidential, and respectful. 

“This meant that people who used this service could be confident that they received responsive care and support.”

Cramond Residence provides a combination of luxury accommodation and the highest quality of care. Set in a leafy location, it offers small group-living in nine houses, with all residents enjoying a wide range of amenities and activities, delicious food and bespoke care. 

Places in the care home start from £1850 a week. To find out more, call 0131 341 4037 or visit https://cramondresidence.co.uk/

Care Inspectorate takes legal action over Skye’s Home Farm Care Home

The Care Inspectorate has taken legal action over the running of a private care home on Skye where seven residents have died in a coronavirus outbreak.

The inspectorate has asked the Sheriff Court to cancel the registration of the HC-One-owned Home Farm 40-bed nursing home facility in Portree.

It follows an unannounced inspection of the home on Tuesday.

A spokesperson for the Care Inspectorate said: “An inspection has identified serious and significant concerns about the quality of care experienced by residents at Home Farm Care Home in Skye. 

“We understand this is a difficult and distressing time for residents, their loved ones and staff at the home.

“However, our first priority is always the health and wellbeing of residents.

“We have submitted an application to the sheriff court seeking cancellation of the care home’s registration.

“This could mean new care arrangements will be put in place for residents at Home Farm care home.

“We are working closely with partners including NHS Highland to ensure that residents experience appropriate care during this difficult time.”

In addition to the seven deaths, 30 of the nursing home’s 34 residents and 29 staff have tested positive for Covid-19.

A spokesman for HC- One, who operate 56 homes in Scotland, told the BBC: “We have accepted the shortcomings at Home Farm and apologise to our residents, their families, and the local community. We are fully committed to making significant improvements at the home and determined to put things right.”

On HC-One’s website – their slogan is ‘the kind care company’ – Home Farm is described:

‘The home’s caring team has created a family atmosphere, encouraging everyone to eat and celebrate special occasions together. Residents are invited to decorate their rooms with small items of their own furniture and treasured belongings so that it feels just like home. Daily life is carefully designed to support mind, body and soul.

‘Home Farm’s Home Manager makes sure that all Residents receive the kindest possible care. Our extensively trained team will deliver all the nursing and specialist care and support services that your loved one requires.

‘Personalised care plans consider not only medical, personal and dietary needs, but also the individual’s likes and dislikes, religious preferences, and suggestions from family members that might make their stay with us that little bit more enjoyable’.

On 29 April, HC-One wrote to local authorities seeking additional funds:

As we have done throughout the coronavirus crisis, we firmly believe we have a responsibility to our Residents, our Colleagues and to the wider public to highlight the challenges facing care homes at this unprecedented time.

This is why we have published online each day the total number of coronavirus cases and deaths experienced at our homes, and why we are also publishing in full the letter we have sent to the Local Authorities we work with regarding our request for financial support.

The Government has previously announced £3.2bn of additional funding for Local Authorities in response to the additional costs placed on them and their partners, which include all social care providers, by the coronavirus outbreak. We welcomed this announcement and the priority now is that this money reaches the front line.

As set out in our letter, HC-One has been significantly impacted by coronavirus including most importantly and most sadly the loss of more than 700 Residents and three Colleagues from this terrible virus. Alongside this, admissions have understandably fallen, and costs have significantly increased as we invest in the PPE needed to keep our Residents and Colleagues safe.

As a responsible provider, we entered this year and this crisis in a very strong financial position. In response to the financial impact of coronavirus we have taken a range of measures, including engaging with our lenders and our owners, to make sure we have the balance sheet resilience needed to see us through this challenging time.

These are prudent and responsible steps to take, as is looking at our income in the short term and engaging with the organisations that pay for the Residents living in our homes.

The Local Government Association and the Association of Directors of Adult Social Services, which represents Local Authorities and Social Care Commissioners respectively, have highlighted that care providers experienced a predicted 10% increase in costs linked to their coronavirus response.

Our letter therefore seeks to start a conversation with our Local Authority partners on how we can access some of the additional funding provided by Government to cover these additional costs.

We clearly set out the impact of the virus on our organisation, the statistical modelling we’ve completed that shows the predicted future impact of this deadly virus, the proactive steps we have taken to build financial resilience, and our request to discuss an income guarantee to assist us in the short term.
 
This request aligns with the Government’s COVID-19 Social Care Action Plan, which states Local Authorities must “protect providers’ cashflow”, and reflects the offers we’ve already received from some of our Local Authority partners who recognise the vital role our homes play in communities across the UK.
 
We are fortunate to be in a financially stable position, and to have the support of owners who are invested in the organisation and its mission for the long-term. We are therefore confident we can ‘weather the storm’ caused by coronavirus. Nevertheless, the responsible and prudent action was to engage with our funders, commissioners and lenders to make sure we build the most resilient financial position possible to achieve this.  
 
As we move forward during this public health emergency, HC-One will continue to focus solely on protecting the health and wellbeing of our Residents and Colleagues.

This includes providing the PPE, training and wellbeing support our teams need, but also engaging transparently in conversations with our funding partners about the additional financial support required to support our organisation.

Since the Care Inspectorate’s intervention it has been announced than an eighth resident has died.

Health Secretary Jeane Freeman and Scottish Care CEO Donald Macaskill have wriiten a joint letter to all care home staff in Scotland this morning.

JF_and_DM_-_CARE_HOME_STAFF_letter_-_May_2020

An inspection report will be published in due course.

Care and Carers: A Guide to Keeping in Touch

For people experiencing care, this pandemic may be worrying and confusing.  Alongside other organisations, The Care Inspectorate has produced information to support contact with loved ones during this time.

We have published a guide to keeping in touch, with practical information on using apps and mobile devices so  loved ones can stay in touch when those they care for can’t receive visitors.

The Scottish Council for Learning Disabilities website has published easy read information about the COVID-19.

Alzheimer Scotland have created a suite of resources for people with dementia, their carers and families to use throughout the coronavirus pandemic.

Supporting_people_to_keep_in_touch_when_care_homes_are_not_accepting_visitors

Bereavement Charter for Scotland launched

Scotland’s first Bereavement Charter for Children and Adults has been launched.

https://scottishcare.org/bereavement/

The Charter describes what good bereavement care and support should look like – even more important now with COVID-19.

People who are bereaved may not have been able to be with a person as they approach the end of their life and may be isolated from their usual networks of support.

It has also changed the traditional ways we are able to mark our grief. Traditional bereavement rituals and funerals have changed with many people now unable to attend funerals in the way that they might have in the past.

Many deaths have become sudden with little or no time to prepare.

Every death is unique and that the way we each come to terms with a death is individual. This Charter describes the difference good bereavement support can make.

#becausegriefmatters

Drumbrae Care Home ‘must make ugent improvements’

A care home for older people in Edinburgh must make urgent improvements in the care experienced by residents, inspectors have said.

The Care Inspectorate has served a formal Improvement Notice on council-run Drumbrae Care Home following an inspection which raised serious concerns. Continue reading Drumbrae Care Home ‘must make ugent improvements’