The announcement of NHS Highland buying out HC-One’s Home Farm care home in Skye has taken away the focus in much of the media from the Care Inspectorate’s official inspection report at Home Farm from 18 May, which has only just been published by the care regulator now. You can access it here.
It makes absolutely damning reading about the quality of care provided by HC-One across the board. The list of failings include:
- Some residents were left lying in urine and faeces, including occasions when it had been left for so long that it had dried.
- Medications were not always dispensed safely.
- Doors were left open while people received personal care.
- Some residents didn’t receive the right support to eat and drink well, and monitoring of some people’s weight stopped during the covid-19 crisis, with some found to have lost weight.
- Staff had to provide care without accessing care plans for residents.
- Redeployed staff were not given information about residents’ care needs, and voiced concerns about the quality of care at the home to management.
- Staff did not know about residents’ repositioning needs, meaning they were more likely to develop pressure ulcers.
- No proper skin records were being kept, meaning it was difficult to share information between staff on the right support to maintain healthy skin.
- Residents were not being assisted to move safely, including being lifted from bed in unsafe ways.
- Most staff were kind and helpful, but one resident who was upset was described as “attention seeking”.
The report concludes by stating “we were concerned that the provider’s failure to prepare for a potential outbreak, poor quality care planning and a lack of well established safe and person-centred work practices contributed to the poor care people experienced.”
In the section on “leadership” at Home Farm, the report states that HC-One management were “resistant” to support from NHS Highland to improve conditions at Home Farm in 2019 and early 2020, refusing offers to assist with cleaning and disinfecting the home which “placed people at unnecessary risk”.
The report adds: “Senior managers gave assurances on 12 May 2020 that urgent and robust action had and was being taken to make improvements and protect people from harm. When we inspected the service on 13 May we found further evidence of unsatisfactory performance in key areas including cleanliness, infection control and food safety. We were concerned about the provider’s lack of transparency. Our confidence in the provider’s capacity to work with others to make improvements and protect people from risk was significantly reduced.
“We considered there was a real risk of redeployed staff becoming infected, given the unsatisfactory infection control arrangements. Three redeployed HC-One staff chose not to have a covid-19 test despite being requested to do so by public health. This decision unnecessarily increased the risk of infection spreading. This concern was escalated to a senior HC-One manager and testing took place thereafter.”
It was the basis of this report which led the Care Inspectorate to have HC-One’s license temporarily revoked, and NHS Highland take effective management control at the care home. But the court attempt to have it permanently revoked was dropped in August because by then the Care Inspectorate had found significant improvement. Of course, that improvement only came about because NHS Highland was at that point managing the care home. HC-One were given chance after chance to improve the situation at Home Farm, and we can see the sum of their efforts above.
So it leaves a sour taste in the mouth that HC-One has now received £900,000 of taxpayers money in the sale of Home Farm to NHS Highland. Remember, this isn’t a small company – it’s the biggest care home provider in the UK. It still runs many more care homes in Scotland. In responding to the sell-off and the Care Inspectorate report, there was no apology from HC-One, nothing about lessons learnt, they were simply “grateful” for the “collaborative and constructive working relationship” with NHS Highland in recent months, and wished them all the best for what they were sure would be a “bright future ahead of it under NHS Highland’s leadership”.
There is something fundamentally wrong with social care when gross negligence by a private provider is rewarded with a £900,000 golden goodbye. Where is the accountability for repeated failure? For the hurt caused, and lives lost? 30 residents and 29 staff tested positive for covid-19 at Home Farm. Ten people died. If there is no process in place for circumstances like this – where the permanent revocation of a private providers license without compensation is clearly the correct course of action – then that is something the government needs to legislate to change.
Questions about the future of social care and care homes in Scotland, and the role of private providers, must begin with Home Farm – not end there.
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