The latest Common Weal paper by leading care expert Nick Kempe, ‘Lessons Learned?’, examines data from the Care Inspectorate, the body responsible for monitoring social care standards in Scotland, about the state of play in care homes five months after the pandemic crisis began. Kempe’s paper is the first to compare the inspection grades to those pre-crisis to find out whether care homes have improved. The paper also examines where data is missing on care homes since the crisis, and the speed at which inspections are taking place.
Kempe finds there are reasons to worry, not least because the Care Inspectorate haven’t done anywhere near enough inspecting to know if the situation is improving in care homes across Scotland on the crucial issue of Covid-19 infection control. The CI is currently inspecting at a third of its usual rate, and it will take two years to get around every care home since the pandemic if it continues at its current speed.
Of those which have been inspected, there is a very mixed picture. Care homes graded ‘Weak’ prior to the crisis have seen ten improve and ten stay at the same grade as pre-crisis, while those graded ‘Adequate’ have seen five improve, ten stay the same and seven deteriorate. Of those graded ‘Good’ or ‘very Good’ pre-crisis, three have been downgraded to Weak and four to Adequate. More than one in seven care homes inspected have received a ‘letter of serious concern’. What can’t be said is whether the care homes inspected indicate the general trends in the sector or have been inspected precisely because the CI have fears about quality of care in these homes specifically, because no rationale is presented for inspection selection. Some care homes which had pre-existing issues around infection prevention have not been inspected since the crisis.
Kempe describes the Care Inspectorate as having “scarce resources” which are “insufficient to ensure all care homes have appropriate infection control arrangements in place to prevent a second wave of the virus”, finding that some care homes “may never receive an infection control inspection”.
“Is that really good enough when around 2,000 older people have died in care homes?”
Kempe’s findings come as the Sunday Post yesterday revealed 37 patients who had tested positive for Covid-19 between 1 March and 21 April were transferred into care homes, across five health boards. Meanwhile, the trade union GMB Scotland has published a study with social care workers, finding almost half feel they are “never valued” or “often undervalued” by their employer, 60 per cent have considered leaving the industry due to the stress of the job, while nearly three-quarters believe they don’t have enough time with service users to deliver compassionate care, with four in five reporting under-staffing in their workplace. The union described the combination of factors negatively affecting social care workers as “chronic exploitation”.
“Covid-19 has shifted social care from a crisis to a catastrophe,” the union concluded.
Whether it is an under-resourced Care Inspectorate or hyper-exploited social care staff, ‘is this really good enough?’ is the question all of us should be asking. With 46 per cent of all deaths from Covid-19 in Scotland coming in care homes, we shouldn’t take our eyes off the social care scandal.
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