1. To ask the Scottish Government what its response is to the reports of at least 14 deaths at Redmill Care Home. Tragically, earlier today I was advised that that number is now 15. (S5T-02459)

My first response is that the thoughts of the Government are with the residents, staff and families who have loved ones at Redmill, and our condolences go to those families who sadly have lost relatives. Dedicated daily support is being provided to the home by NHS Lothian and the health and social care partnership. That includes the provision of support in the form of staffing and infection prevention and control measures.

The Care Inspectorate is closely monitoring the home and has undertaken an unannounced inspection of it to ensure the safety and wellbeing of the residents, with a further return inspection taking place yesterday and today.

The situation at Redmill is heartbreaking. My thoughts and prayers are with all the families of the bereaved, and the care home staff, many of whom have been affected by the virus themselves and who have been going way beyond the call of duty in trying to help residents at this awful time. No one—and I mean no one—has contacted me to complain about their commitment to residents during this period, but many families and staff have raised concerns about confusion and delays over testing. Why did it take six days for whole-home testing at Redmill? Did residents become infected and subsequently die during that delay? What type of support is being provided by the national health service? Is it right that agency staff who potentially work across different homes are working at a home with such a significant outbreak? What action is being taken to keep Covid-positive patients and Covid-negative patients safe during this time? Will the Cabinet secretary comment on those important issues?

I am grateful to Mr Findlay for raising those questions. When he previously asked about the issue at topical Question Time, he raised a series of points, which I replied to on 9 October. I understand that he has also received correspondence from NHS Lothian and HC-One.

That being said, a number of issues need to be addressed. Following its second inspection, which, as I said, has been happening yesterday and today, the Care Inspectorate will provide me with its view on what level of improvement is required and on whether improvements that it highlighted following its unannounced inspection have been followed through, and, if they have not, what it believes should be done about it, including what action it might want to take and what action the Government might take.

My understanding is that, at the moment, the health protection team is in the home twice a week to test residents and staff. It seems to me that, in this, as in other areas, communication with residents and their families—and, indeed, with staff—could be considerably improved. I am very happy to take that on and see whether we can ensure that there is greater transparency in the information and the updates available to those individuals in particular, but also, of course, to the local members—here and elsewhere—who represent people in care homes.

Families have indeed raised the lack of communication with them and the lack of answers to very basic questions such as, “Has my mum or dad been tested? When were they tested? What was the result? Why am I finding out more information from the media than from HC-One? Why has my loved one not been admitted to hospital for treatment when they are seriously ill?”

The Government says that it is being straight and transparent with people, but just because it says that, that does not mean that it is true. Every bit of information that people are getting is having to be dragged out of HC-One, the NHS or, indeed, the Care Inspectorate. The families are asking basic questions, and they and staff deserve so much better.

Will the Cabinet secretary ensure that families get straight answers to their straight questions? Can she advise why relatives believe that elderly people are still being denied hospital treatment?

I cannot answer the latter part of Mr Findlay’s question at this point because I have no information about what the specific instances might be or what clinical decisions have been made around any particular individual. Members would not expect me to have that information because I am not a clinician and I do not make those decisions. However, if any family wants to write to me about that, I would, of course, take that seriously and look to see what further information I could provide to them.

On the first part of Mr Findlay’s question, my track record on ensuring that our health boards in particular are clear with families, relatives, patients and residents in care homes is there for members to make a judgment on. I am very keen that everyone gets the information that they need timeously and in language that is easily understood, that their questions are answered, and that, if they have repeat questions, they are answered. That is central to the health and social care system that we should have.

As far as HC-One and what it does as a private sector provider is concerned, I can require and request it to answer those questions, and I can take up that matter with the Care Inspectorate. The bit that I can ensure happens is the bit that happens with NHS Lothian and, through it, the health and social care partnership. I will take that on board, and I hope that, perhaps with Mr Findlay’s assistance and that of any other member with a Constituency interest in the area, I can be clear in my mind about exactly what all the questions are that families want to know the answers to right now, as well as putting in place a system that allows them to be regularly and properly updated.

HC-One has provided more information to me than the NHS, the health and social care partnership and the Care Inspectorate combined. The key point is that families should not have to write to the Cabinet secretary to get those answers—indeed, they should not even have to write to me to get them. Those answers should be given as of right, and those families deserve transparency.

I agree with that: families should not have to write to me. However, if HC-One is giving Mr Findlay more information than NHS Lothian or the health and social care partnership is, it should be giving that information to families without waiting to be asked and without having to use Mr Findlay as the conduit to do that. HC-One, as the provider, has a clear responsibility to provide that information to the residents of the care home that it receives money to run and to ensure that it is properly provided for, and to their families. I will take up the question with NHS Lothian and, through it, the health and social care partnership, and I am confident that Mr Findlay will join me in pressing HC-One to be as transparent with residents and families as it is with him.

I think that we all understand that regularity in staff testing is vital in preventing the spread of Covid-19 in care homes. The tragic case that the member has mentioned and evidence from the rest of Scotland highlight that the system that is in place is perhaps not working quite as well as it could be. Will the Cabinet secretary commit today to publishing the data on how many care home staff are tested and the frequency of those tests?

The data on the number of care home staff who are tested on a weekly basis is published every week. I think that Mr Whittle knows that staff testing in care homes is undertaken using the satellite channel, which is part of the United Kingdom Government’s Lighthouse programme. Despite a number of efforts, the satellite channel has had the least consistent test turnaround times. In order to improve that and to free up capacity in the Lighthouse programme, we are, as Mr Whittle knows, transitioning the testing in care homes to the NHS labs, which will be completed. Our three new regional NHS lab hubs will come on stream from early November, build to full capacity by the middle to the end of December, and provide an additional 22,000 tests per day. That will allow us to have greater control over the speed of the test turnaround times. As Mr Whittle knows, the NHS has an average turnaround time of 27 hours for the tests that it processes.

I, too, express my condolences to all those who have lost loved ones as a result of the outbreak.

After the new outbreaks in care homes, questions will be raised about how exactly the virus was able to enter and spread through the care homes involved. Will the exact reasons for that outbreak be revealed in due course, including what role, if any, the availability of personal protective equipment might have played?

I thank the member for his question. As he knows, we commissioned Public Health Scotland to undertake work on the discharge and admission of patients into care homes, looking at a range of data. That involved the body working with the University of Edinburgh and the University of Glasgow and that report will be published tomorrow. I have offered to write to the Health and Sport Committee with a link to that report and those organisations have offered to give a briefing to the committee on the work that they undertook, the basis on which they gathered the data and the basis on which they reached their conclusions and made their recommendations.

However, in addition, I have commissioned a root cause analysis on the recent occurrences of outbreaks in our care homes, to understand why those outbreaks are happening in a system in which we have confidence in the distribution and supply of PPE when providers are asking us for it—the Care Inspectorate is inspecting on that basis and on the basis of infection prevention and control—and in which we have testing and the primary care wraparound. I, too, need to understand the basis on which, or the route by which, the Covid-19 infection is entering care homes and what more we need to do. I hope to be able to update the member on that root cause analysis and the steps that we are taking in the near future in the chamber when I publish the winter preparedness plan for adult social care.