Sturgeon and Freeman can’t hide their ducking of Covid care home inquiry

Sturgeon and Freeman can’t hide their ducking of Covid care home inquiry

by Robert Kilgour
article from Monday 18, January, 2021

SINCE THE NEW LOCKDOWN measures came into force there have been murmurs from some MSPs about whether or not it would be wise to put the May Scottish Parliament elections on hold while Scotland gets to grips with both the second and third Coronavirus waves. Certainly with campaigning potentially limited by lockdown, there must be a question mark over the wisdom of proroguing Parliament for weeks on end if the crisis is still raging in the Spring.

Whatever MSPs decide, the SNP will be hoping that it goes ahead as planned in May – and not just because of a significant lead in the polls that makes them clear favourites to win. Weighing on the minds of the First Minister and her Cabinet may also be a desire to face the judgement of voters before key elements of scrutiny of the Scottish Government’s recent time in power are in place. 

We have known for a long time, for example, that a key review of the effectiveness of Scotland’s Curriculum for Excellence by the OECD has been delayed until the Summer, long after the point at which it might persuade voters that the education of their children might be safer in the hands of others. Move the election to the Autumn and suddenly possible criticism of the system that the SNP has been in charge of implementing will come into play.

Similarly, since the start of the pandemic, the Scottish Government has quietly been doing whatever it can to avoid the full glare of scrutiny over Covid deaths in care homes. PPE unavailability, shortcomings in routine testing for staff ­– and perhaps most worrying of all, a policy during the height of the first wave of discharging Covid patients back into care home settings without testing or waiting for test results, have all placed our vulnerable elderly in care homes at a higher risk of infection and have sadly resulted in many deaths. 

Just before Christmas, the independent Equality and Human Rights Commission published a short report flagging up why these and other issues had often compromised the human rights of vulnerable residents and social care staff alike. Its first recommendation was that “The Scottish Government should undertake a public inquiry into the rate of Covid-19 infections and subsequent deaths in care homes as soon as practicable.” 

I and others in the sector have long agreed but predictably the First Minister told journalists in December that to hold a public inquiry now (before the election) would only drag care staff unfairly and unnecessarily away from their work looking after residents during the pandemic. 

As someone who employs around 1,100 staff, caring for some 700 vulnerable elderly in 15 care homes across Scotland, I can assert with confidence that it certainly isn’t pressure on care workers that the First Minister is worried about. That’s because far from shielding the care home sector and its workers from onerous reviews during the pandemic, the Scottish Government has ramped up scrutiny as never before, taking up an unprecedented amount of staff time. This would be less problematic if it wasn’t for the fact that much of the activity seems politically motivated with – you’ve guessed it – the May election in mind. 

Since last May, the Scottish Government has introduced and organised several (and in many cases, new) separate review and scrutiny mechanisms for the care home sector, ranging from Covid-related spot inspections by both the Health and Safety Executive and the Care Inspectorate, to a new system of daily care home information returns being required to be submitted by all care home managers on each care home’s Covid-19 experience and performance.

Spot checks can happen day or night, often unannounced, so staff have to stay on their toes – and rightly so, one might argue. Compared, however, with requirements in England, where Care Quality Commission inspections are conducted on a risk assessed basis – meaning the inspections themselves are focused and full-scale inspections only happen in homes where the CQC have concerns. The experience and regime in Scotland is really quite different and onerous.

Similarly, whereas in Scotland the new daily care home information returns are required to be submitted by all care home managers to the new local joint NHS/local authority teams set up by the Scottish Government, providers in England only have to complete an NHS capacity tracker weekly.  The 15 hours on average of front-line staff time it takes to respond to Police Scotland requirements around Covid-related deaths and suspected deaths can seem hard to reconcile with the needs of service users, especially when you consider that the same approach isn’t happening for deaths in Scottish NHS hospitals or in the general Scottish community.

Of course, these are unprecedented times. Safety comes first, so dedicated care home staff have rarely complained – even if few here in Scotland are aware that elsewhere in the UK public authorities have realised that taking carers away from their jobs to fill in endless forms during a pandemic isn’t the best use of their time.

What is galling though is additional government exercises that seem to betray a more fixed political agenda. When the Care Inspectorate was quietly asked by the Scottish Government in May to commission a ballpark commercial valuation of the entire care sector, independent providers smelt a rat. The same organisation was recently asked to work on producing a document proposing changes to the property requirements for both new build and existing care homes, which seems to threaten the viability of many existing facilities. Trust has been damaged at a crucial time for all.

Then, having commissioned Public Health Scotland largely to exonerate it of responsibility for infections and deaths that resulted from a deliberate policy of hospital discharges of Covid patients into care homes, the Scottish Government launched the Feeley Review Commission. This panel, which has no care home sector representative on it, is expected to make detailed recommendations on the possible creation of a new National Care Service by the end of January, without having input from any public inquiry into what has actually happened during the pandemic. How can its conclusions possibly be relevant?

The answer is simple. They will be relevant insofar as they’re designed to inform the content of the SNP’s own general election manifesto. I would mind less if I thought that such important issues were getting the careful, independent, fact-driven consideration they deserve. They aren’t though, because rigorous scrutiny before 6th May isn’t on the government’s agenda and never has been.

The vaccination programme may be ongoing but it is very likely nonetheless that we will have to live with Coronavirus over the long term and adapt carefully to provide those for whom we care a safe, protective and happy environment in which to live. If the election ends up being delayed by the pandemic – perhaps until the Autumn – then I would urge the government and opposition MSPs to use the extra time to pause and take full stock of what has happened in the social care sector – and why.

And if it goes ahead as planned I would call on the incoming Scottish Government finally to do the right thing well before next Winter – hold a timely public inquiry on the failures of 2020 in the care sector – and learn how to avoid them as part of any future reformed system. Any other approach is a derogation of responsibility to the entire social care sector and the Scottish people it serves.

Robert Kilgour founded Four Seasons Health Care in Fife in Scotland in 1988, opening its first care home in Kirkcaldy in May 1989 and leaving in early 2000 when the company was operating 101 care homes with around 6,500 staff UK wide before making his final financial exit from the company in 2004. He then founded Renaissance Care in 2004 and is currently Executive Chairman of that company, one of the leading Scottish care home operators. Renaissance Care runs 15 homes throughout Scotland looking after 700 vulnerable elderly residents – 70 per cent of whom are local authority clients – employing close to 1,100 staff. 

Image by Udo Voigt from Pixabay

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