The Scottish government lacked expertise on social care and oversaw a ‘search for blame’ on care home deaths, according to its own assessment of how it handled the first six months of the covid-19 pandemic.

The internal review highlights a lack of understanding of social care among senior officials in St Andrew’s House and says ministers created additional anxiety in the way they approached care home deaths.

The shortcomings are included in a ‘lessons identified’ report reviewing feedback and documents, published today by the government’s Population Health Directorate.

In the section on social care, which is one of the more critical parts of the assessment, the authors acknowledge that the government stands accused of double standards in its treatment of the NHS and social care.

More than nine in ten covid-19 care home deaths are under investigation by the Crown Office, healthandcare.scot has reported, compared to one in ten in the health service.

This is despite former Health Secretary Jeane Freeman stating earlier this year that there was “no difference” in how the two sectors were being treated.

The decision to refer care home covid deaths – but not those in hospital or people’s homes – to the prosecution authorities, which was branded as unfair and unjust by care organisations, was raised repeatedly with the review authors:

‘Numerous participants from previous interviews mentioned the Lord Advocate’s decision to enable Police Scotland investigations into deaths in care homes,’ the report says.

‘While acknowledging the need to assess what went wrong, participants expressed that this approach was substantially increasing the very high levels of anxiety being experienced by professional, skilled staff who support and care for the most frail and vulnerable people in our society and there is a perceived and felt search for blame.’

The review team found that there was a ‘negative perception’ demonstrated by the government of the social care sector, stating:

‘Throughout our review, documentation provided highlighted that the social care workforce felt undervalued and under-recognised prior to the pandemic and that there were reports of similar feelings during the early response.’

The 103-page analysis, which the Scottish government says is intended as an illustrative rather than comprehensive examination of the response from March to September of last year, is the first public assessment on behalf of ministers of what worked well and where improvements need to be made.

There are a series of findings around the overall governance arrangements for social care, with the authors concluding the government was ill-prepared for the impact the pandemic would have on social care:

‘One criticism of the internal Scottish government response to the pandemic was a lack of subject matter expertise on social care (in particular for care homes) among key decision-makers within the Scottish government.

‘This led to a perceived overreliance on key members of staff with this knowledge with limited capacity to support all aspects of response.

‘Documents reviewed suggested concerns that this reliance on key individuals will continue to present an issue if there are further waves or future incidents.’

Former health secretary Jeane Freeman raised eyebrows earlier this year when she admitted she did not understand social care well enough when the decision was made to discharge hospital patients into care homes.

The review points to a lack of clarity about accountability and raises concerns that there is no national oversight of workforce planning for social care in Scotland that might tie together the nation’s 1200 different social care employers.

With many care services still suspended and others only now restarting, the review says lessons need to be learnt around how to communicate decisions that are made affecting people’s services:

‘Stakeholders highlighted a perceived lack of information available to their service users about how to access the system but also around withdrawals or changes made to existing packages of care as being key examples of areas where communication should be reviewed for future incidents.’

There is also criticism of the timing of announcements as being ‘unhelpful’, with health and social care partnerships and operators sometimes having to implement guidance on a Monday morning when the guidance itself was only released on the Friday.

 

Read More: Double standards claim over NHS & care home deaths; Prosecutors probe hundreds of covid hospital deaths; Controversial care home discharge report revised; ‘Covid showed ministers should be in charge of care’; NHS left with less than 24hr PPE supply

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