A survey this week revealed widespread concerns among care home managers about NHS oversight visits introduced during the pandemic.

Complaints included a determination to ’find fault’ and a heavy-handed approach that ‘battered’ already-fragile staff morale.

Scottish Care, which produced the report, is now calling for a review of the oversight structures in place.

In Fife the experience has been different - and far more positive.

Alyson Vale, business and operations director at Abbotsford Care, told healthandcare.scot the close working relationship with the health board had made a "huge difference" during the pandemic.

Ms Vale said NHS Fife “really prioritised getting to know people and not just walking in and expecting to be the experts, which I know is not the experience of other people in different localities...[they] really came to the table with an openness and willingness to recognise expertise of the people already doing the work.

“We’ve definitely got a relationship and that's made a huge, huge difference for us in the last 18 months...We’ve had the opportunity to call on people to ask for specific training and support…that really helps provide a bit of security".

“From my perspective, in relation to what [Scottish Care’s] report is saying about the critical approach, we were very close in Fife to it turning into that. But everybody was willing to potentially put their egos to the side and work together in a really collaborative way.”

An April 2020 article in a local newspaper that included a quote about supporting care homes with “fundamental nursing care” provoked a strong reaction among residential care staff.

“My colleague who is a nurse was particularly aggrieved by that message because she felt, ‘we know what we're doing and we know we're nurses’, said Ms Vale.

“It really has taken individuals within NHS Fife who has been really supportive of us as a sector …We've actually seen integration move forward in a way that's ever happened before.”

Scottish Care’s report raised questions about how the Care Inspectorate’s responsibilities fit into the new assurance landscape.

Ms Vale says the regulator has been “a bit more hands off” and “hasn’t been very forthcoming with support”.

“When they have come in for inspection, it's been very critical. And that level of scrutiny and criticism has not been as supportive as it could have been, as we've seen from our NHS visits, which are very much being geared towards support…But I suppose from their perspective, if we've got all these NHS assurance visits, what's the role of the Care Inspectorate moving forward?”

Read more: Government review admits care home ‘search for blame’; Double standards claim over NHS & care home deaths; Lack of home care deaths investigations ‘unjust’

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