Scottish Care Homes and COVID-19

Key Findings • As with other parts of the UK, COVID-19 has caused a significant increase in deaths in Scotland, particularly amongst older individuals. • Scotland’s care home sector has not expanded in response to demographic change: rather the focus of care provision has moved to care at home. • Many of the characteristics of the care home sector in Scotland are similar to those in the rest of the UK. • The COVID-19 epidemic has spread to the majority of Scotland’s care homes. • The impact of COVID-19 on deaths in care homes lagged those in hospitals but have now surpassed deaths in all other settings. • Although the total number of deaths is now declining, the share of care home deaths in the total continues to increase. • Excess mortality during the pandemic has been high in all settings in Scotland, but has been particularly high in care homes. • Non-COVID deaths in hospital settings have declined during the pandemic, which may be the result of re-orienting hospital activity towards dealing with the immediate crisis. Increased deaths in other settings, including care homes, may have been the consequence. • Whereas care homes have been particularly affected by COVID-19, there has also been significant excess deaths attributed to causes other than COVID-19 outside hospitals and care homes. Specifically, there have been 616 non-COVID “excess deaths” in care homes and 1,320 such deaths outside care homes and hospitals. Given the age profile of deaths, these are likely to have been concentrated among the oldest old. • Scotland, unlike England, does not report the number of deaths of care home residents who die in hospital and elsewhere. If the shares of such deaths are similar across both jurisdictions, then the number of care home resident deaths in Scotland attributable to COVID-19-would be significantly larger