Families 'heartbroken' and 'appalled' at Home Farm care home reports

Residents of Home Farm care home in the Isle of Skye “were living in an unsafe and unclean environment that posed a risk to their life, health and wellbeing,” a damning report has found.

The Care Inspectorate revealed the findings from inspections of the privately owned home after a severe COVID-19 outbreak that caused the deaths of 10 residents.

Bereaved family members described the report’s findings as “appalling” and as resembling “conditions that existed in Victorian Britain,” and criticised the Scottish Government for its handling of the report’s release.

The findings from an inspection report in May, as well as two follow-ups, were made public at the same time as Health Secretary Jeane Freeman announced plans on Thursday for the purchase and takeover of the care home by NHS Highland. 

The home had been owned and operated by HC-One, which runs over 300 care homes across the UK.

According to the report, residents were left lying in urine and faeces for long periods of time and one person was served a meal that “increased their risk of choking”. 

Medication was not always administered safely and bed-ridden residents experienced skin problems indicating they had not been moved regularly enough.

Additionally, some people did not have toothbrushes and did not receive basic mouth care, the report says. 

The home itself was described as “very dirty and looked like it had not been properly cleaned for some time,” leading to concerns over infection control in some areas.

Bereaved family members said they were “heartbroken” and “appalled” by the revelations.

John Gordon, a councillor whose father died of COVID-19 in the home, compared the report’s findings to “conditions that existed in Victorian Britain”. 

He said: “It may sound far-fetched, but what I read was overwhelming and distressing and I struggled to believe this was healthcare in Scotland in 2020.”

A member of another bereaved family told Holyrood after reading the report: "Tonight, I feel totally heartbroken all over again.

“Things that I overlooked or we could do ourselves we did, as we knew how hard the staff worked and never seen anything but heartfelt love and care from staff."

A member of a third bereaved family, who did not want to be named, said she was “angry that the home was run such an appalling way in 2020”.  

She also criticised the Care Inspectorate, the Scottish Government and HC-One for the way the reports and separate announcements were handled.

She said: “We had no warning, other than being told from the care home the day before that they wanted my email address to send it out.

“The government must have known what was in the report and so timed its announcement so that they could take away the sting of the report.”

She added: “I’m disgusted that none of those organisations reached out to the families."

Family members received copies of the reports after the Care Inspectorate had made them public, along with a letter from John Kirk, the managing director of HC-One.

Kirk said he was “truly sorry” and that he and his team were “extremely disappointed with the Care Inspectorate’s findings as outlined in the May report”.

He added that subsequent reports had demonstrated that “considerable improvements” had been made in the home since May.

The May report also highlights “serious concerns” that HC-One had failed to prepare for a potential outbreak of COVID-19 and had even been “resistant” to accepting NHS help early on in the pandemic.

The inspectorate raised concerns about “the provider’s lack of transparency” in the wake of the COVID-19 outbreak.

Home Farm care home to be bought and managed by NHS Highland

The report states: “While we acknowledged the challenging circumstances caused by the outbreak, we were concerned that the provider's failure to prepare for a potential outbreak, poor quality care planning and a lack of well established safe and person-centred work practices contributed to the poor care people experienced.

It added: “At the start of the outbreak the provider was resistant to working effectively with NHS Highland and did not make the most of the support that was available despite serious concerns about the quality of people's care, the environment, staffing and leadership.

“For example, initial offers to assist with cleaning the care home and disinfecting it with a recommended cleaning product were refused. This placed people at unnecessary risk.”

The Care Inspectorate brought legal action to revoke the provider’s licence for the home in May after these inspections raised “serious concerns” about the standard of care at the home.

NHS staff were then brought in to supervise and supplement care.

The legal action was dropped in August, however, after the inspectorate found “significant improvement” had been made.

The Scottish Government on Thursday announced the plans for purchase and takeover of the home by NHS Highland with £900,000 of Scottish Government funding.

HC-One said: “The latest Care Inspectorate reports should reassure the whole local community that the care provision and the environment at the home have significantly improved over recent months. 

“Lessons have been and will continue to be learned from this experience, and we have taken steps to strengthen our oversight process so that we can prevent anything like this happening again.”

A spokesperson for the Care Inspectorate said: "Publication of the May and July inspection reports on Home Farm had been delayed until the conclusion of legal proceedings to cancel the registration of the service.

"The Care Inspectorate follows a clear legal process when publishing inspection reports which includes a requirement to allow the care provider to respond to our findings before publication.

"We took the decision that in order to provide the most clear and accurate picture of our findings to date it would be best to publish all three reports at the same time, and only once the most recent report was completed.

"To do otherwise would have been to present as current information we knew was no longer up to date.

"We never share the contents of inspection reports with the public ahead of publication although a summary of inspection reports is laid before the Scottish Parliament every two weeks.

"The Care Inspectorate has been aware of discussions between NHS Highland and the Scottish Government and welcomes [Thursday’s] announcement.

"It is important to stress that we have seen evidence that the quality of care experienced by residents at Home Farm has improved in recent months.”

They added: "We understand this has been a distressing time for those living and working in the home, their loved ones and the wider community.

"We have worked closely with the care provider, the health and social care partnership and the NHS to ensure residents at Home Farm experienced the significant improvements in their care which we identified as being required.

"Two subsequent inspections were carried out in July and August to monitor progress and improvements.

"On 18 August we announced we had seen evidence of considerable improvement in the quality of care experienced by residents and the issues that were putting them at serious risk had been addressed.

"We also announced that in light of this we are not pursuing the cancellation of the service's registration through the courts.

"We continue to monitor Home Farm Care Home and the quality of care experienced by residents who live there."

An NHS Highland spokesperson said: “The observations and risks highlighted within the Care Inspectorate report were shared verbally with NHS Highland immediately following the inspection.

“This led to the initiation of a large-scale investigation as well as increased support from NHS Highland of the running of Home Farm care home to raise the standards of care within the home.

“We have worked closely with the Care Inspectorate and HC-One during this intervening period and have seen the standards of care improve. This was formally recognised by the Care Inspectorate.”

A Scottish Government spokesperson said: “The safeguarding of the care of residents at Home Farm in Portree has been a priority for the Scottish Government. We welcome the publication of the Care Inspectorate’s inspection reports.

“The findings clearly demonstrate that the robust action and support taken by the regulatory bodies and NHS Highland was right, and have been crucial in making significant improvements in care for all residents at this care home.

“We welcome the agreement that NHS Highland are to purchase and take over the running of Home Farm to ensure the best long-term outcome for the home and the safety and wellbeing of residents.”