Scotland’s Care Home Tragedy

Isolation, Neglect, and Human Rights Violations

The Scottish Inquiry has heard closing testimonies from their first investigation which shed a light on one of the darkest chapters of Scotland’s pandemic response - the harrowing practices in care homes. They reveal a profound neglect of basic humanity. The evidence paints a grim picture of isolation, neglect, and systemic disregard for the rights and dignity of some of the most vulnerable in society. HART has previously reported on the testimonies from the inquiry here and here and now we look at these conclusions.

Isolation as a Weapon

Throughout the pandemic, care home residents were subjected to draconian lockdowns that far outlasted restrictions in other settings. In fact, restrictions still abound in care home settings even now. Witnesses recounted the devastating effects of isolation, particularly for residents with dementia. "Routine and physical touch is so important," said Dr. Donald Macaskill, CEO of Scottish Care. Yet, these lifelines were stripped away.

The inquiry heard tales of residents asking if they were in prison. Verona Gibson’s daughter described feeling like an inmate, while Kathy Russell's mother struggled to understand the conditions she was subjected to. As Simon Crabb, advocate for Care Home Relatives Scotland, bluntly put it, “The denial of contact had a devastating effect. Residents quite simply did not understand what was happening to them.”

Neglect and the Collapse of Care

Lockdowns weren’t the only issue. Basic healthcare services were withdrawn from care homes, leaving residents to deteriorate. Staff recounted calling ambulances only to have paramedics refuse transport. Kirstyn Burke, solicitor for Scottish Care said, “Guidance issued by the Scottish Government created an impression of a blanket ban on COVID-positive residents being transferred to hospital”. Even after the guidance was clarified, this perception lingered, and lives were lost.

Nursing care, already stretched thin, faced a tsunami of challenges. Primary healthcare services moved to telephone appointments, leaving residents without essential physical assessments. Kirstyn Burke emphasised “Care homes, unlike nursing homes, are not designed to provide clinical care”. Yet, the withdrawal of healthcare left care home staff overwhelmed, and residents suffered the consequences.

A Human Rights Crisis

At the heart of the inquiry lies a damning indictment of the government’s disregard for human rights. The use—or misuse—of “Do Not Attempt CPR” (DNACPR) notices emerged as a particularly distressing issue. Witnesses described these notices being applied without adequate consultation, sometimes even without family consent. Families were denied the opportunity to discuss end-of-life care decisions, some even claimed their signatures had been forged on forms.

Alistair Gray, Solicitor advocate for Central Scotland Care homes said, “The perception was that there was a push from the NHS to get more of these decisions in place”. In some instances, according to Aamer Anwar, Solicitor for Scottish Covid Bereaved, DNACPR notices were based on “flimsy and irrelevant clinical information,” with no special consideration given to the vulnerabilities of elderly care home residents.

Sick residents were often denied the compassionate care they deserved. Instead, as one speaker put it, Aamer Anwar continued that “There appeared to be a focus on providing end-of-life medication to residents,” while neglecting their broader needs. As HART has previously described, these medications, which suppress the respiratory drive, could accelerate or cause death in an acute respiratory tract infection where the drive to breath is keeping people alive.

Mental Health Devastation

Isolation exacted a terrible toll on residents’ mental and physical well-being. Speaker after speaker highlighted the foreseeability of these outcomes. Stuart Gayle KC Senior counsel to the inquiry said “Lockdown affected many older people's ability to undertake activities such as regular exercise, social interaction and a sense of purpose, and the longer term impact is likely to be negative for their physical and mental health… Social isolation is harmful”. For residents with dementia, the loss of routine and familial connection was catastrophic. Witnesses spoke of residents experiencing cognitive and functional decline, low mood, and even death—not from covid, but from loneliness and despair.

A Systemic Failure

Kirstyn Burke, spoke of the sense of “clinical abandonment” felt by care homes as healthcare professionals ceased visiting altogether. This left care home staff in untenable positions, tasked with enforcing restrictions they didn’t design while simultaneously trying to fill the void left by absent medical services.

Shelagh McCall KC, representing the Bereaved Relatives Group (Syke) said, “The approach to lockdown was nothing short of a callous disregard of people’s right to family life”. She chillingly noted that “the extent of the deterioration of conditions may have breached the Article 3 rights of residents.” Article 3 of the European Convention on Human Rights protects individuals from inhumane and degrading treatment and was clearly violated in many instances.

A Call for Accountability

This is not just a story of mismanagement but of a complete breakdown of empathy and humanity in Scotland’s care homes. The evidence presented to the inquiry reveals systemic failings that placed the burden of the pandemic disproportionately on the frailest members of society.

Aamer Anwar summed up saying, “It should not surprise our politicians that when problems arise in society, it is the weakest and the most vulnerable who are the most likely to be badly affected.”

For the families of those who suffered, the inquiry offers a glimmer of hope for justice. But it also demands a reckoning—a collective commitment to ensure such a tragedy is never repeated. For a modern society to leave its elderly and vulnerable to languish in such conditions is nothing less than a moral failure.