Covid at Home Farm: agency workers were needed following “years of chronic shortages”

Chronic staffing challenges dating “months and years” meant agency carers were travelling to Skye to work at Home Farm nursing home in the weeks leading up to the major Covid-19 outbreak.

Operators HC-One confirmed their use of agency staff as they eventually provided a response to questions the WHFP had submitted a month ago – in the days after the lethal consequences of coronavirus at the nursing home were becoming clear.

The company maintains that at the time of the outbreak it had addressed infection control concerns raised by previous inspections.

The private care home giant also claims it had complied with the guidance over self-isolation, provision of personal protective equipment and training in how to use it.

Workers not tested

HC-One’s response only partially covers some of the other issues raised in the list of 10 questions, sent on the 6th of May.

In the early weeks of lockdown neither itinerant or permanent care workers were being tested, and were instructed to self-isolate if they showed symptoms.

10 residents who tested positive for the virus have died since the outbreak was confirmed at the Portree nursing home in the final days of April.

In total over 60 people – residents and staff – tested positive for Covid-19.

In the wake of the outbreak the Care Inspectorate identified “serious and significant concerns about the quality of care” and launched a court action to remove HC-One’s license to operate Home Farm.

The deaths of three residents are also being investigated by the police.

The Free Press has reported that families had complained – long before coronavirus was known about – that staff shortages were affecting residents’ care at Home Farm.

Competition from tourism

A staff member also blew the whistle on a string of concerns over practices at the home in the weeks running up to the Covid-19 outbreak.

HC-One continue to manage the home, though they have been supported by a team from NHS Highland.

After the initial hearing was deferred – when improvements were noted – a sheriff is due to rule on the Home Farm registration next Wednesday (10th June).

Sir David Behan

In an interview with the BBC in early May HC-One’s executive chairman Sir David Behan conceded it had been difficult to recruit permanent staff on Skye.

He said: “In this particular home we have competition from tourism and other industries.

“We have increased salaries… to try to recruit but we’ve had a large dependency on agency staff because of the difficulty in recruiting staff.”

10 questions from the WHFP

The 10 questions from the Free Press are listed, with the response from HC-One following below:

  1. Can you outline the steps HC-One are taking to care and support residents of home farm, the staff and their families?
  2. Who has taken the lead on this support now that both the Care Inspectorate and the NHS have become involved?
  3. Are relatives able to have any contact with their loved ones inside the home – such as those in the final stages of life?
  4. After Scottish health secretary Jeane Freeman spoke about a need for “direct government action”, would you accept her suggestion that independent care homes had specific problems observing government guidance?
  5. Could the government themselves have done more to support the social care sector?
  6. What are the reasons for the continued problems in recruiting staff for Home Farm?
  7. To what extent does Home Farm depend on staff from outside – either agency workers or staff from other care homes – to ensure the home is adequately staffed?
  8. Between the period that lockdown at Home Farm began (12th March) and the first confirmed Covid-19 case (Monday 27th April) were any staff from outside – either agency or from other homes – brought in to work at Home Farm?
  9. If they were, what steps were taken to ensure they were virus free?
  10. What steps were taken to address the requirements on infection control – as highlighted by the January care inspectorate report – in light of the escalation of the coronavirus pandemic throughout February and early March?

HC-One response

A spokesperson for the home said: “Working with the support of NHS Highland we have already made significant progress and improvements across the home so we can deliver the very best for residents and colleagues at Home Farm.

“Residents and colleagues are also starting to feel better and are on the way to recovering from coronavirus.

“We continue to progress with our robust action plan and remain wholly focused on delivering the best possible care, both now and for the long term.

“This is an unprecedented situation and we are thankful for the support of our local staff team, the NHS and our local authority partners.

“In the months and years before the outbreak, it is known that we have faced chronic recruitment challenges meaning we have struggled to build a consistent and experienced team due to the locality of the home.

“To help to address the staffing challenges, we have been using agency staff at the home.

“Agency staff are booked to complete a block of full-time shifts whilst living on the island.

“Since the outbreak at Home Farm, and with so many local colleagues affected by coronavirus, we had no choice but to immediately relocate colleagues from our other Scottish homes to Home Farm.

“These colleagues have been living on the island since the outbreak, and the home has also benefitted from the support of staff from local NHS services.

“We are grateful for the support of NHS Highland and Highland Council in helping deliver such a strong partnership response to the outbreak at this home, and together we are doing everything we can to contain the virus and ensure those affected receive the care and support they need. 

“The guidance provided to care homes has changed 25 times throughout the coronavirus pandemic in the UK.

“HC-One has complied with the guidance at all times, specifically in relation to self-isolation of those with symptoms and the necessary infection control processes.

“In response to the coronavirus outbreak in the UK, which we have been planning for since February, our colleagues completed additional, specific coronavirus training, infection control training and the correct use of PPE.

“We have ensured that all HC-One Homes, including Home Farm, have consistently had access to the PPE they need. All homes have been issued detailed guidance on using PPE in line with the latest guidance provided by the Scottish Government and Health Protection Scotland.

“We’ve also been completing visual checks on PPE usage at the home using video calling technology.

“We are confident this home had the PPE required, and that Colleagues on site were using it effectively and in line with the applicable guidance.

“We are also confident the issues raised in the previous Care Inspectorate’s 2019 reports were resolved through the additional support we provided to the home at that time.

“We are doing everything we can to support the connection between Residents and their loved ones at this time. Our staff work hard to facilitate regular phone and video calls for Residents.

“We also know the importance to families of being with their loved ones at the end of their lives, and we try to facilitate such visits for as many families as possible.

“These visits are coordinated in accordance with necessary precautions relating to infection control as well as appropriate social distancing.”