The Scottish Parliament Chamber Business - October 2020, 7 Oct 2020

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From YouTube: Urgent Question - BSL - 7 October 2020

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Urgent Question - BSL

A

The presiding officer has selected an urgent question as a result of that decision, time will be around 6 15 and I call neil finley.

B

Yeah to ask the scottish government what action action is taking in response to the outbreak of covert 19 at the red mill and milford house pair homes in lothian.

A

Cabinet secretary gene freeman.

C

Thank you very much presiding officer. I want to make a number of points in my answer.

C

First of all, I want to express my condolences to the families who've lost loved ones in these two outbreaks and my thoughts too, to those families with loved ones in the homes affected, to residents themselves and to staff who have tested positive and indeed to those staff who are understandably upset and anxious about the residents for whom they care so much.

C

Neither of these homes had previous outbreaks nor had been flagged as either amber or red in either the care inspectorate or the local director of public health assessments.

C

So the care inspectorate will immediately conduct root, cause analysis that I have asked them to do and from that identify any further actions we need to take in terms of our winter preparedness work in the adult social care sector in terms of the specific homes themselves, for each of these homes, milford and milford house and red mill for each of the local care homes. Support teams are in direct contact, together with the local health protection team, to make sure that the homes have all the ppe.

C

They need support with their staffing, where they have staff who are isolating and staff who have tested positive, including the nhs lothian staff bank. All relevant infection prevention and control measures are understood and being implemented and that both homes have the clinical care they need, and that is being provided to the residents affected.

A

B

Their lives and for the families left behind and for the staff who are doing their very best. Over the last two days, I've been contacted by many staff, members and families of residents at the red, mulcair home, and I know colleagues have had similar contact uh with milford house. Both staff and relatives need our 100 support at this extremely difficult time. I spoke to hc1 today in relation to red mill, and they tell me first positive test was on the 25th of september nhs.

B

Scotland were informed on that day, but that the whole home testing regime by nhs, scotland did not take place until six days later. Today, 28 staff are still waiting on results. Six staff are waiting on a test. Some tests couldn't be given, because labels didn't come with kits, plenty of residents are awaiting results.

B

Some people have not held hard results, despite being tested on the 28th of september. Nine days ago, one staff member received three sets of results. One received someone else's results and 20 results were returned negative, but with no information with them as to whom who they belonged to.

B

I really hope the same has not happened at milford house, because staff and residents deserve so much better than what appears to be a shambles with the testing regime. In this case, if this is the way it is operating, then how on earth can we get on top of the virus cabinet secretary?

B

The staff at this home deserves so much better than what they're being provided with in terms of the testing regime, and I have to say in this case this is not the owners of the home, that is responsible staff and the the owners are doing their best. It is the testing regime that is at fault, governor secretary.

C

So I I don't have the benefit of the information mr finley has just provided, but I will absolutely look into that later today and seek to give him a detailed response tomorrow and also to other members who have a direct interest and concern. The information I do have is that from nhs lothian is that all tests that were carried out before the weekend have been returned and are in the test and protect system. Now that is clearly different from what mr finley is telling me. So we need to pursue that in some detail.

C

What I do know is that in red mill we have 37 staff and 18 residents who have tested positive and in milford housed 18 staff and 13 residents who have tested positive. So obviously results have been coming back, but it. But the issues that mr finley is raising are serious issues and we will have taken a note of those as he spoke, but if he would care to send them directly to me, so I'm absolutely sure about the facts of that.

C

As he understands them, then, as I've said, we will investigate that urgently and make sure that if there are those problems, I understand exactly why those problems have occurred and what we are doing to resolve them and to make sure too that, if those problems do exist, as mr finley has described them, that that is not replicated across across the system.

A

B

I would urge the cabinet sector I'm more than happy to provide that information and ht1 have been extremely helpful in providing me with the updated information today and information yesterday, and I'm very thankful for that. I will. I have sent that information today to nhs loading and to the health and care partnership, so that information is there with those two organizations. You know that's. The cabinet's actually helped to have an immediate inquiry into what has happened in this case, because this cannot continue and when there are lives.

C

So I'm not at all by what I'm about to say casting any uh aspersions on what mr finley is telling me by any means whatsoever, but but that is not the information I have from nhs lothian. It's not the information I had from the care inspector, whom I spoke to this morning, nor from scottish care, whom I also spoke to this morning, both of whom had been in contact with hc1 and the other provider.

C

So when I get that information from mr findlay and I'm grateful to him for sending it to me, I'm sure it will be waiting for me when I get upstairs. I will look in great detail and have that investigated and get straight back to him and other members who may be affected so that we can understand exactly what has happened here. What the facts of the matter are why?

C

If there is a problem, there has been that problem and make sure importantly, not only is it resolved for those two care homes, but it is not replicated anywhere else in the system.

A

I have requests for two supplementaries. I can take them both if members are brief, miles breaks.

D

Thank you deputy president officer. My thoughts are with the families and loved ones of those um who have died from the virus at these care homes.

D

And can I ask the cabinet secretary further to neil finley's question whether or not nhs lothian have currently said that they believe that they met the care, inspector's, stated guidelines, and can I also ask if she'll investigate the ability to reopen the temporary lab at edinburgh university and given that it's been currently put into hibernation, so that we can look towards additional capacity for care home testing across the east of scotland?.

A

C

So, as I said, the both homes, neither home, has been flagged as either amber or red by either the care inspector in the regular assessment that they do or the local director of public health and those assessments are done. Weekly and I get a report of all of them and neither home has appeared as amber or red and, as we know, neither home has had an outbreak before and- and that is in part, why I know um care home staff across the country are very concerned when they have positive cases.

C

But, additionally, in the case of these two homes, I know how upset and anxious the staff are, because this has not happened before, and so they are very worried about that, which is why the root cause analysis is so important. We need to understand um in two care homes which have been as far as all the data I have been following all the guidance and all the procedures.

C

What has happened here um in terms of the particular lab and the capacity as I think the first minister said in her statement. We are busy increasing the nhs capacity across the country. um The particular lab in edinburgh has been returned to its earlier work and we need to maintain capacity, not just increased capacity, not just for covet testing, but we need to maintain capacity for nhs testing for the normal diagnostic and other tests that are done as we the service.

C

We can't um give that up if you like, otherwise we wouldn't be able to do some of the procedures that we are doing so we have scaled up nhs, scotland capacity and, as the first minister said in her earlier statement, we will come back with the review that we are doing as we scale up nhs and we see what uk lighthouse lab is also scaling up, how we can strategically use that additional capacity to look at other areas of testing that is clinically advised, but just in final point in relation to care homes, we are incrementally transitioning, all our care home staff testing away from lighthouse into nhs labs.

C

That's partly to protect that testing from where lighthouse has to deal with a uk, wide surge in demand, which can sometimes increase turnaround times.

A

E

Thank you, my colleagues. I also associate myself with the comment about the devastating impact of these outbreaks. Can the cabinet secretary tell us what enhanced infection and prevention control mechanisms will actually be put in place both in these care homes, um but the lessons for other care homes, not just in lothian but across the country which can be taken from these outbreaks, and has she seen the research from nhs lothian about the correlation between the size of care, homes and outbreaks.

C

Yes, yes, I have seen that research and actually it's backed by some of the data that the care inspector has also produced in terms of, and it's partly about the size of care homes.

C

It's also about the configuration of care homes where they are configured in such a way that you can isolate a whole floor, for example, uh then responding to cases of infection it could be covered, but it could be other um norovirus or flu or other infections that can break out in these settings is more straightforward, and but overall in general, um it appears that the data is clear, that the smaller care homes are more effective in the impact of the infection, prevention and control work that they do, and so there is more work to do on that and there's obviously implications in terms of the business model for some care homes about uh how they go forward, and all of that is factored in, of course, into the independent review that derrick feeley is leading enhanced infection prevention and control is particularly assisted by what we have now introduced, where we have the majority of care homes now signed up to this, which is it's called the safety tool.

C

It's essentially the same safety huddle tool that we have used so successfully in hospital settings as part of our patient safety program transferred over but applied appropriately into the care home setting, and what that allows us to see under the home itself to see undercare, inspector and local directors of public health to see on a regular basis, not only stock levels of ppe.

C

And of course, we continue to supply that, where that is needed, but also staffing voters to ensure that, particularly as we want to open up visiting where that is possible in a safe way, that requires particular levels of staffing routers. So the safety huddle tool, as it is called, um allows us now to see on a much more regular, indeed a daily and a weekly basis where homes might need additional support, either from their local nhs teams or from the local health protection teams.

C

But the the core work, the core basic infection prevention and control is the the the absolute standard that we need to ensure is there in all our care homes. The safety huddle tool helps us identify where there may be difficulties in delivering that, so that we can intervene and offer that support. Direct.

A

Thank you. That concludes the urgent question. Can I remind members that social distancing measures are in place in the chamber and across the hollywood campus, and please take care to observe these measures this afternoon, including when entering and exiting the chamber we'll move on in a moment to the next item of.

A