Meeting of the Parliament (Hybrid) 30 September 2020
We were initially alerted to the situation by reports in the national press on what was happening south of the border. That was when we began to investigate what was happening in our care homes. In May, June and July, there were a number of such reports. That is why we commissioned the specific piece of work that Public Health Scotland is undertaking. It is looking at the dates of discharge from hospital into care homes, whether the individuals were infectious at the point at which they were discharged and what the rationale was for the discharge of patients who were infectious.
It is in the context of the global pandemic and its presence in Scotland that we sought to introduce measures to protect those who are most vulnerable to being harmed by it. Among others, those measures included what were undoubtedly severe restrictions on visiting care homes. Those restrictions lasted for a long time, except in the case of essential visits. Since 3 July, we have been steadily trying to ease those restrictions, initially with outdoor visits, and then by increasing the number of outdoor visitors and preparing care homes for the return of indoor visits from early August, with each resident having one designated visitor. Care homes have had to be free from Covid for 28 days and to be participating fully in the staff testing programme. Most recently, we have worked to restore some of the normal communal activities and health and wellbeing services that residents previously had access to. However, none of that is normal when physical distancing remains necessary, staff are wearing additional PPE and enhanced cleaning is in place.
None of those decisions to restrict visiting or then to open it up in a limited way has been taken without strong and clear clinical advice on risk levels and mitigation, particularly from those with considerable experience in older people’s physical, neurological and mental health care. We have worked closely on this and other issues with groups such as the dementia in care homes group and Scottish Care, and we have listened to others and looked at approaches elsewhere.
Of all the decisions that we have had to make this year and all the decisions that I have had to make this year, those have to have been the hardest, because I know so very well their impact and the harms that can be caused as we try to prevent harm.
Listening to those views, I am acutely conscious that what is probably missed the most is time and touch—time with the loved one to talk, have a cup of tea and catch up on news, and the chance to touch, holding their hands and giving them a hug. When I spoke to members of the care home relatives Scotland group a few days ago, that came across very strongly, but as strong were their recognition and understanding of the need to protect their loved ones from the virus.
The work that we now have under way, on which I intend that we will reach a conclusion, in part, very shortly, is to open up visiting to designated visitors so that they can visit more often and for longer, with all the appropriate PPE and other measures being in place, and also eat with their loved ones if they wish, bring in gifts and personal possessions, and have a named back-up visitor for times when they cannot visit.
I want us to reach a better balance in the measures that we take, bearing in mind, of course, that where there are increased numbers of cases in the locality of a care home, the local director of public health has a responsibility to act to increase protective measures if that is what their professional judgment tells them is the right thing to do.
All those steps and the many views and propositions that are on offer about the future of adult social care are well within the scope of the independent review that was announced in the programme for government. The review is well under way and it is on track to produce recommendations in the very early part of next year. It has the expertise and experience of both its chair, Derek Feeley, and its advisory panel, and its work at pace includes listening to unions that represent staff, to providers, to local government, to families, to carers and, most important, to those who receive care.
In adult social care as in the NHS, the most important resource that we have are the staff who work there. Be it in care homes or in care at home, they bring compassion, skill and expertise to the job. In creating a national approach to this vital service, be it a national care service or any other option that this Parliament chooses, there are important decisions to come on valuing those staff and offering jobs that not only are worth while and rewarding in themselves, but offer future progression, training and learning in a coherent and consistent way.
Those will be vital questions for all of us in the coming months, but for the residents of our care homes and their families right now, there is, I am sure, a better balance that we can strike. That work is under way and I intend to be able to update Parliament and, most important, relatives and care home residents shortly on the first steps towards that better balance.
I am pleased to support Ms Lennon’s motion. I move amendment S5M-22860.2, to leave out from “, and further calls” to end and insert:
“; notes that the Scottish Government will soon be setting out winter plans for the NHS and social care to ensure that they are as protected as possible during the winter; welcomes that the independent review of social care is examining how adult social care can be most effectively reformed to deliver a national approach to care and support services, including a National Care Service; recognises that everyone has a part to play in ensuring that transmission of COVID-19 is curtailed in order to protect the most vulnerable people in society, and further recognises that, while some restrictions on care home visiting may be required to prevent the spread of COVID-19 to and within care homes, these should be removed, mitigated and amended as soon as it is clinically safe to do so in order that care home residents can safely see their loved ones.”
15:48Motions, questions or amendments mentioned by their reference code.