To ask the Scottish Government what protocols it has put in place for care homes in response to the COVID-19 outbreak; what action it is taking to ensure that the homes (a) are providing appropriate palliative care and (b) have sufficient protective equipment, oxygen and other essential supplies, and how it is supporting them with the recruitment of additional staff where required.
There is considerable work underway way nationally and locally to ensure Scotland’s care homes are fully supported to respond to the COVID-19 outbreak.
The Scottish Government has set out set out a series of steps to provide direct clinical leadership, reporting and assurance for care homes to ensure the wellbeing of staff and residents. This includes: clinical and public health oversight of care homes from NHS Directors of Public Health and other partners; equipping Care Inspectorate for an e ced role of assurance; increasing access to PPE and establishment of a national rapid action group to monitor progress and activate any local action as well as coordinate wider package of support to the sector.
On 13 March, the Scottish Government issued clinical and practice guidance for care homes that set out the risks and the resultant clinical and practical steps to be taken, including the ending of communal activities, communal dining and unrestricted visiting. That guidance was updated on 26 March and again on 15 May. Each iteration is a reflection of the growing understanding of the virus and the situation on the ground in care homes.
As global supply chains for personal protective equipment (PPE) became increasingly challenged and the normal private supply routes to the care home sector were disrupted, the NHS National Services Scotland (NSS) social care triage helpline was launched on 19 March, so that, at national level, steps could be taken to respond to urgent requests for PPE from social care providers, including care homes. NSS order volumes were increased to ensure that we could cope with the additional demand from the social care sector and primary care and pharmacy, as well as the additional demand from acute care.
To make sure that the right PPE was delivered to the right people, direct distribution routes were created, including local PPE hubs for social care providers—which covered care homes—and direct distribution, where that was needed.
Care homes provide an important role at the end of life and we are clear that they should to be supported to provide person centred clinical care which best meets the needs of individuals. Primary care teams continue to be critical in supporting care home residents including for end of life and palliative care support alongside other in-reach services including from palliative care teams.
National Services Scotland (NSS) has arrangements to obtain and supply supportive or palliative care oxygen which can be requested and delivered to any care home where required. Arrangements have been made with health board oxygen leads to ensure that access to additional supplies can be ordered by other appropriate healthcare professionals working within the community to ensure that oxygen is available when required. All medical devices and pharmaceuticals for patients on care homes continue to be delivered by a range of home delivery companies that are contracted by NSS.
The Scottish Government has been working to get students and social care retirees and returners into the system as quickly as possible, and working with partners to support care homes to recruit additional staff. Employers now have direct access to the NHS Education Scotland and the Scottish Social Services Council recruitment portal enabling quick and effective redeployment of care workers. A number of staff have already been matched for work in care homes or care at home under the new portal and more will be joining them in the coming weeks. In addition NHS Boards and Local Authorities who have local oversight of care homes are providing staffing support for example in-reach support from community nursing teams or deploying staff directly to work in care homes.
From 18 May, new arrangements for ensuring appropriate clinical and professional oversight for care homes have been put in place. As part of this multi-disciplinary teams comprising key clinical leads from NHS Boards and Local Authorities including Chief Social Work Officers are providing oversight of local care homes. This approach builds on recent actions and existing local arrangements in helping to keep residents safe.