I hadn’t planned to spend any time today (14 October) looking more into the care home sector. However, I was ‘stimulated’ to do so by reading Common Weal’s daily Source Direct newsletter this morning (as is my habit still, just!).
In its news review section Source Direct opts to amplify yesterday’s BBC News Scotland website report on the Chair of the Balhousie Care Group and his assertion that the Scottish Government’s revised guidance on care home visiting is ‘ill thought out’. Source Direct’s brief coverage is worse than the BBC’s: the former chooses ONLY to amplify the businessman’s assertion whereas in the BBC’s article at least we learn, on reading through to the end, of those who welcome what the SG has done.
As Tusker and others work to challenge the BBC and corporate media’s lack of balance and absence of context in their reporting of Scottish ‘politics’, it is disappointing to find such examples of ‘new media’ aping BBC-style aggregation and amplification of corporate media headlines without context and without balance, albeit on a much smaller scale.
How do we square away the following?
On the one hand, the Ainslie Manor Care Home in Girvan tells the world – including prospective clients – this:
“At Ainslie Manor we put our residents first and by operating regular, comprehensive internal and external audits we monitor all aspects of residents care, with the audits and day to day documentation freely available to the residents and their families.” And goes on:
“At Ainslie Manor we recognise the benefits to our residents of having a well trained and highly motivated team, we encourage staff with their learning and development through personal development plans and regular supervisions.”
On the other hand:
The Care Inspectorate (CI) tells us this about Ainslie Manor following an inspection conducted on 21 September 2020.
On ‘audits’ – “There was no evidence of any audits of practice relating to COVID-19 taking place.”
And on an area for improvement which had been identified by the CI on 17 September 2019 viz.: “The quality assurance framework should continue to be refined and strengthened to ensure the consistent application of best practice guidance.“ The September 2020 inspection report finds: “There was no evidence of a quality assurance framework being in place. We have made this a requirement”.
So not quite what the company claims on its website in terms of audits and related documentation?
On staff training, the inspectors report: “No training records were available, we were told only a small number of staff had undertaken training. We were not confident staff had the knowledge to implement safe infection prevention and control practices.”
“Staff did not have access to the most current version of Health Protection Scotland COVID-19: Information and guidance for care home settings. Staff were also unaware of the National Infection Prevention and Control Manual; this is considered best practice in all care settings.”
So again not quite what the marketing material tells us? How can this discrepancy be acceptable: how can words on an inspection report that few members of the public will read be sufficient to address such apparently basic and serious deficiencies?
Does the CI have any power to insist that a commercial care home company in its marketing towards prospective clients has to remove factually incorrect or misleading information on e.g. documented audits and documented staff training? I suspect not. Can basic advertising standards even be insisted upon?
If you thought that was worrying enough – read on:
On the question put in the CI report: “How good is our care and support during the COVID-19 pandemic?” – the home scores ‘2’ i.e. ‘weak’. Also, the CI considers this: “Infection control practices support a safe environment for people experiencing care and staff” – the home scores ‘2’, ‘weak’.
The inspection report tells us more:
“Cleaning products must be aligned to current best practice guidance. We could not be confident of this because the products being used did not clearly identify the chlorine concentrate on the labels. We asked the service to check this with their supplier to ensure they meet the minimum requirement of chlorine concentrate.“
“We also found some cleaning products had been decanted into bottles with no labelling available for staff to know what they were using. These aspects increased the risk of harm to both residents and staff.“
“The service had two new residents who were isolating following admission. Staff did not follow best practice guidance and left these isolation rooms without removing their PPE. There was also no signage available outside the isolation rooms to alert staff of the need to take precautions. “
“There were limited clinical waste bins available and as a result the bin in the sluice area had been overfilled and posed a hazard. We also found PPE being disposed of in general waste bins. There were no clinical waste bins available in the rooms where the new residents were isolating.”
“Concerns were identified regarding the laundry system. We saw dirty and contaminated linen being stored on the floor waiting to be washed. This did not follow best practice guidance and posed a risk to residents and staff.”
“The Care Inspectorate has, for the past several years, asked the provider to review and reduce the number of shared rooms. There has been no progress made. The care home continues to have six shared bedrooms. Given the current COVID-19 situation this means there is a risk of cross infection for the people who live in shared rooms.”
“There was no contingency plan to support staff absence as a result of COVID-19. This meant that there was a risk the service could run short of staff “ and “At the time of the inspection, there were no domestic staff available from mid-afternoon onwards. The service had recently identified this as being a risk and was looking to address this. “
Does this match public perceptions?
The Ainslie Manor Care Home is owned/run by Cumloden Nursing Homes Ltd. So the Balhousie Care Group is not alone in having serious deficiencies exposed by the Care Inspectorate. And this point needs to be rammed home: these deficiencies are present EVEN AFTER all that has been experienced and should have been learned and fixed during 2020 to date!
How many more serious failings in this sector might be exposed by aggregating and amplifying the findings of inspection reports? How would the public react if all this was better known? How about it all those BBC Scotland investigative journalists – how about performing a public service? How about challenging the apologists for the commercial care home sector that BBC Scotland seems so keen to give a public platform?
And should what has been revealed by the small sampling of care home sector practices by The Tusker over recent days be anything other that temporary aberrations (and that has to be in serious doubt), then it must be right to re-asses now the powers of the Care Inspectorate coupled to the ability /capacity of the public health authorities to intervene in the interests of vulnerable residents as they did in the care home on Skye earlier in the year.