Chamber and committees

My answer to S5W-29119 on 17 June 2020 outlines how national guidance recognises the need for additional staffing within care homes to manage the impacts of COVID-19 and support residents. The guidance also recognises that reduced activity among residents decreases muscle mass and functional decline which is heightened in the elderly population. Whilst it is essential all shielding and physical distancing precautions are adhered to, the guidance recommends that residents should be supported to remain active within a reduced space and this is vital for their health and wellbeing.

A safety huddle template and professional judgment template have been developed in conjunction with the care home sector to help care homes identify residents’ care needs and associated staffing requirements. This can also be used to identify where changes to skill mix and additional clinical input is required to support the changing needs or complexity of residents.

To support additional staffing requirements, the Scottish Government has been working to get students and social care retirees and returners into social care 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.

All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx

The national clinical and practice guidance for adult care homes which was first published on 13 March and updated on 26 March and 15 May, recognises the need for additional staffing within care homes to manage the impact of COVID-19. The guidance suggests that additional staff are likely to be required to support measures such as shielding, physical distancing and caring for those being isolated to support and enable compliance with Infection Prevention Control measures including the need for enhanced cleaning schedules to reduce transmission of infection are essential at this time.

Care home providers are responsible for ensuring adequate staffing to care for residents and carry out enhanced cleaning schedules drawing on their contingency plans at this time to meet the needs of individuals. If the Care Inspectorate becomes aware of peoples’ needs not being met by there not being enough staff, it can require the service to act to improve this. The Care Inspectorate retain the discretion to impose conditions about staffing, or any other matter, on any individual care service where that is necessary to ensure people experience high quality care.

To support care homes to identify staffing requirements during COVID, a safety huddle template and professional judgment template have been developed in conjunction with the care home sector and should be used to help care homes identify residents’ care need and associated staffing requirements. This can also be used to identify where changes to skill mix and additional clinical input is required to support the changing needs or complexity of residents. The safety huddle template should be used on a daily basis to enable care homes to identify and escalate concerns. The template is designed to reduce the need to collect multiple sources of information as the information in the template can be used to inform the Care Inspectorate staffing ‘rag status’, Health and Social Care Partnerships and Public Health requirements.

Where there are staffing challenges, care homes will be supported as necessary by local partners such as NHS Boards and Local Authorities. In addition, the Scottish Government has been working to get students and social care retirees and returners into social care as quickly as possible, and working with partners to support care homes to recruit additional staff. Employers now have direct access to a recruitment portal developed by the NHS Education Scotland and the Scottish Social Services Council 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 terms of additional resource, I confirmed on 12 May that an initial £50 million would be provided to help the social care sector deal with the financial implications of the pandemic. This funding will be released by local authorities through local Mobilisation plans and will allow cash to flow to those parts of the social care sector where additional costs, such as staffing costs, have been incurred, particularly in care home and care at home services.

There are people more at risk clinically from Coronavirus, but not such high risk that we ask them to undertake the very difficult job of shielding. This group includes people over 70, women who are pregnant and people who receive the flu jab for medical reasons, regardless of age.

People in this group should strictly follow physical distancing measures, but are able to go out in line with current public health guidance, including the additional easing of lockdown measures covered in the decisions taken on the 28th of May.

If individuals are unable to access the essentials they need, and have no support available to do so, they should contact the national helpline on 0800 111 4000.

During this pandemic the Scottish Government recognises that many older people may experience feelings of loneliness. They may wish to contact the Age Scotland Helpline, which provides information, friendship and advice. The service is helping older people to feel less socially isolated and is helping to tackle loneliness. The Helpline number is 0800 12 44 222.

As we consider options to relax restrictions, fairness, quality of life and the human rights of older people will be important factors in the decision making process.

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.

Since May 2019, Transport Scotland has worked with the rail industry to increase passenger and freight capacity on Scotland’s railway.

These increases have been underpinned by several service enhancements and infrastructure improvements providing passenger benefits that include: 13 electric services per hour between Edinburgh and Glasgow; 8-car trains offering more seats on the main Edinburgh to Glasgow route; and an hourly Inverurie to Montrose service.

Together with the introduction of all 70 Class 385 electric trains, as well as 17 more four carriage High Speed Trains which are gradually replacing three carriage Class 170 units on routes to Inverness and Aberdeen, these efforts have delivered 130,00 additional weekday seats and circa 500 more services since the start of the ScotRail franchise.

Since 2019, freight capacity has been improved through electrification to the Grangemouth terminal, gauge clearance on the Shotts line, a new southern connection at Blackford, a crossover at Aberdeen Craiginches with work ongoing on improvements at Inverness Needlefield yard and Coatbridge.

The Scottish Government is committed to publishing the rail services decarbonisation action plan for Scotland’s railways, this will include its assessment on the use of battery and hydrogen technology powered trains as well as electrification to meet the 2035 traction decarbonisation target. Other infrastructure works may also be required to fully capture the benefits and these will be assessed on each line of route based on current and forecast capacity.

Network Rail is currently developing a Business Case to support the recommendations of the Far North Line review group. Abellio ScotRail has also been involved in discussions to assess the deliverability and affordability of the options for potential implementation during the next eight to ten years.

Early work had, prior to the Covid-19 disruption, started on developing and trialling enhancements to the Radio Electronic Token Block signalling on the line and this will re-commence as soon as it is safe to do so.

The Scottish Government is committed to publishing the rail services decarbonisation action plan for Scotland’s railways, this will include its assessment on the use of battery and hydrogen technology powered trains as well as electrification to meet the 2035 traction decarbonisation target.