Social work leaders have called for a debate over the impact of covid-19 restrictions in care homes on the lives of vulnerable residents.

Kathryn Lindsay, convener of Social Work Scotland, told healthandcare.scot we need a “more open conversation” with the public about the different risks and unintended consequences of the response to the virus.

Ms Lindsay, who is chief social work officer at Angus council, said there had been an “understandable focus” on the clinical aspects of keeping people physically safe from covid-19.

But she added: “In our approach to protecting residents from the virus we are at risk of causing harm, or of missing other harms.”

Care homes across Scotland have seen visits from family members and communal activities curtailed.

Last month a petition was launched calling for visits for care homes to be resumed over concerns a lack of contact with loved ones was causing severe mental distress for residents.

The changes can be particularly difficult for older people with dementia, who might struggle to understand the reasons for staff wearing masks and daily routines disappearing.

Scottish Care chief executive Donald Macaskill tweeted that he was “immensely disappointed” that there was no mention of care home visits in announcements today about the reopening of shops.

Social Work Scotland, the professional body for social work and social care leaders, published an open letter stating the Scottish Government’s commitment on older people’s rights could be being “undermined” because of a lack of focus on wellbeing.

The letter to the Scottish Government’s chief social work advisor Iona Colvin, which relayed the concerns of chief social workers across the country, warned a “narrow focus on protection” could lead to a “heavy handed, paternalistic approach”.

The intervention came after the Scottish Human Rights Commission said the treatment of care home residents could constitute breaches of international human rights law.

Speaking to healthandcare.scot, Ms Lindsay voiced concerns that the “lack of attention to people’s wider well-being…might be a breach of their human rights, in terms of rights to family life.”

Ms Lindsay said it was still vital that decisions about treatment are made with older people’s input or, in cases of diminished capacity, with legal guardians.

“We are aware that in a move to make sure people are safe and protected from covid, there is also a risk that people may overlook the need to make sure people have capacity to consent, so we’re very keen to make sure that that’s uppermost in people’s minds,” she said.

“We can’t just do things because of clinical efficacy, [the letter] was really making sure those points don’t get forgotten about, in the rush to keep people safe from infection from coronavirus.”

“We felt it was necessary for us to make very clear we can’t rush to a clinical solution alone, that we are talking about people’s homes.

“Care homes are homes, that’s the nature of the service that they are providing.”

The Scottish Government has said a resurgence in virus cases could lead to restrictions across the country being re-imposed.

“We need to have a conversation as a country about our tolerance and what we want to see going forward, particularly bearing in mind that we are not out of the woods in terms of the pandemic,” Ms Lindsay said.

“It is entirely possible that there be another phase of the virus and we may need to take more stringent steps, so if we have that conversation sooner rather than later and base it on human rights then I think that that will stand us in good stead for any future measures that we need to take.”

 

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