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Overview —

Two thousand deaths later, has infection control in care homes improved?

Credits —

Nick Kempe

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Nick Kempe investigates the Care Inspectorate's attempts to assess the ongoing response in Scottish care homes to the Covid-19 pandemic.

After the previous foreseeable disaster laid out in Kempe's earlier paper for Common Weal, The Predictable Crisis, the Care Inspectorate has been attempting to assess Scottish care homes in light of the pandemic.

Whilst some care homes have improved, Kempe raises serious concerns about the quality of data being gathered and the "slow and seemingly random way" in which care homes are being reassessed. He raises particular concern that five months on from the onset of the pandemic in Scotland, staff in care homes are still not being properly trained in infection control.

Summary

• The Care Inspectorate (which is responsible for monitoring standards in care homes) is currently doing only about a third of its usual checks and at the current rate would take over two years to inspect all care homes to assess Covid control measures.

• This means there simply isn't enough data to provide any confidence that, as a sector, care homes are doing any better than they were five months ago.

• There is no rationale presented by the Care Inspectorate for which care homes are being chosen, nor any reasonable explanation for why those care homes identified as having pre-existing infection prevention problems were not prioritised for inspection

• There should be a mandatory ban on discharge of people to any care home assessed as Weak.

• Of those previously graded Weak, ten have improved (three to the status of Good) but ten have not.

• Of those previously graded as Adequate, five have improved but seven have deteriorated (ten remained the same).

• The Care Inspectorate chose to inspect 17 care homes rated Good or Very Good, of which three are now downgraded to Weak and four to Adequate (the second lowest). Only four remained Good and one Very Good (with five no longer graded as a result of different methodology).

• More than one in seven care homes inspected have received a 'letter of serious concern' from the Care Inspectorate.

• In only one case has the Care Inspectorate used new Covid powers to issue an Improvement Notice with intent to close the care home.

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