Two north-east care homes where 27 people died and more than 150 others caught Covid-19 have been slammed by health inspectors.
The Care Inspectorate paid visits to Inchmarlo House near Banchory and Deeside Care Home in Cults amid outbreaks of the virus last month.
Both have been given a “weak” rating – equivalent to two points out of six – for their level of care and support amid the pandemic.
And this morning the Procurator Fiscal confirmed it received reports in connection with 12 deaths at Inchmarlo and 15 at Deeside.
Inchmarlo House
‘Lack of engagement’
The Care Inspectorate made a number of recommendations for management at Inchmarlo House, which is operated by Skene Enterprises.
Residents were left isolating in their bedrooms, going long periods without any “meaningful” activities or regular interactions.
Two residents claimed they did not have any way of contacting staff if they were in distress or had fallen.
Concerns were also raised that some were not being given help to eat and drink, and “did not always” receive support if they had extra dietary requirements.
The Care Inspectorate report said: “Although staff understood the importance of social distancing, there were challenges in implementing guidance.
“Staff were not always successful in reducing anxiety about isolation.
“There was also a lack of social engagement and people were left for lengthy periods without emotional support.
“Most support was provided in relation to the delivery of personal care.”
Infection control
Inspectors highlighted some issues regarding infection control at the 52-bed Inchmarlo House, but said staff had good general knowledge of cleaning systems.
However, it reported their understanding of PPE practices was “limited”, with some wearing the same clothes while travelling to and from work.
The report said: “Some staff were wearing clothes that could prevent good hand-washing and increase the risk of cross-infection.
“Staff were unclear about the management of uniforms and other clothing which increased risks when travelling between home and the service or the community.”
While all permanent staff were given training on infection control, PPE and Covid-19, the Care Inspectorate was “not confident” all had retained the information.
It said language barriers prevented some employees from confirming they had understood the training, noting there were no alternative materials to support their learning.
“There was a lack of leadership and poor understanding around roles and responsibilities, specifically regarding the delivery of person-centred care,” the report said.
“Consequently, people were not experiencing well co-ordinated, consistent care and support.”
The Care Inspectorate issued three requirements for the home – including that residents are safe and their anxiety is managed, and that infection control procedures are followed with continuing training.
Deeside Care Home
Furnishings ‘visibly dirty’
At Deeside Care Home, inspectors found furnishings and shared equipment which were “visibly dirty” and in a “poor” state of repair.
They acknowledged, however, that a deep cleaning operation took place “immediately” when the issues were brought to the attention of management.
Elsewhere they found bins “overfull” with PPE waste – which raised the risk of infection.
And while there were healthy reserves of protective equipment on offer, inspectors said: “Stocks in some of the stations were visibly low and we suggested that this be reviewed to ensure they were fully always stocked.
“Not all staff were following good practice in the use of PPE.
“In particular, storing face masks in their pockets and wearing aprons used for personal care alongside those for catering.
“This has the potential to compromise good infection control practice.”
The facility was given until December 31 to conduct a deep clean and audit of all equipment, ensure PPE bins are of a suitable size and implement an effective system to supervise staff PPE use.
Poor communication
Both care homes were criticised by the Care Inspectorate for poor communication during the outbreaks of Covid-19.
Cases of the disease at Inchmarlo were first reported on December 16, with 12 deaths now being investigated.
Deeside Care Home closed to new admissions and visitors on December 8. The Procurator Fiscal is investigating 15 deaths there.
During the last update 107 positive coronavirus tests had been recorded among residents and staff at Inchmarlo, and 76 at Deeside.
Inspectors were told by the family of one Inchmarlo resident: “There is difficulty with people answering the phone and passing on messages.”
They found relatives were “frequently” having to initiate contact with the care home to find out what was happening regarding the outbreak.
Similarly, inspectors noted delays in passing information at Deeside.
“This had resulted in some people being concerned about their relative’s wellbeing,” they said.
“We were able to establish that increased management support was being put in place to help support improved communication.”
A spokesman for the Crown Office And Procurator Fiscal Service said: “The investigation into the deaths is ongoing and the families will continue to be kept updated in relation to any significant developments.”
Report reaction
Homes committed to high standards
An Inchmarlo House spokeswoman said staff are “committed” to providing a high standard of care, and thanked the other agencies which offered support during the outbreak.
She added: “The recent Covid-19 inspection by the Care Inspectorate and the requirements set out in their report are a vital part of the healing process, and many of the recommendations identified have already been implemented or are in progress.
“We remain committed to providing the high standard of care and friendly atmosphere which has been nurtured over more than three decades, always focusing first and foremost on all those who call Inchmarlo House Care Home their home and their workplace.”
Iain Ramsay, the chief social work officer for Aberdeenshire, said: “We will continue to monitor the care provided to residents at Inchmarlo Care Home through the work of the Aberdeenshire Care Home Oversight Group, including regular assurance and support visits to the care home.”
Meanwhile a spokesman for Deeside Care Home said all of the points addressed by inspectors were met by the December 31 deadline.
“In addition, we have implemented a number of extra measures to further improve overall standards at the home,” he added.
“These include increasing the home’s management team to enable staff to carry out a comprehensive review of individual care plans and provide regular updates to residents and their families on how we are tackling Covid-19.
“We pay tribute to our loyal, hard-working employees for continuing to support our residents at this difficult time and we remain committed to ensuring the home delivers the high-quality care our residents expect and deserve.”
A spokesman for Aberdeen City Health And Social Care Partnership said the body is working closely with Deeside Care Home’s operator “to fully meet the requirements and areas for improvement detailed by the Care Inspectorate.”
Home ‘didn’t have capability’ to handle crisis
By Kieran Beattie
The son of a Deeside Care Home resident who died after contracting Covid-19 has said it “just didn’t quite have the capability” to cope with the crisis.
But the man, who did not wish to be named, did have praise for the overall care his dad received.
He said: “The care that my father had, and he stayed there for nearly a year, was excellent.
“The quality of the staff and general ambiance was generally of a very high standard.
“Although it would appear as if, once they got into a tricky situation, they didn’t quite have the capability or capacity to deal with it.
“The thing for me was the communication with relatives and next of kin.
“During the pandemic phase, the communication with families was almost negligible.”
The man was “surprised” at the grade it was awarded by the Care Inspectorate, adding: “We visited seven homes before my father went into a home, and Deeside was miles better than anything else we saw.
“We read the Care Inspectorate reports prior to him going in a year ago, and they were also excellent.
“It appears that when this situation came upon them, either they were very unlucky -because other care homes didn’t have this issue but some did – or they just didn’t have the capacity to deal with the crisis situation.”