Only 4% of whistleblowing complaints about Scottish care homes were fully investigated last year as thousands succumbed to Coronavirus, according to a report.
Of the 1340 concerns reported by staff and former workers, 56 were escalated to a full inquiry by the Care Inspectorate, which said the pandemic "significantly" affected its response to disclosures.
The regulator said onsite complaint investigations were not always possible due to public health guidance and the risk of transmitting and spreading infection.
It meant that 61% percent of complaints received in 2020-2021 were simply logged as 'intelligence' compared to 34%, the previous year.
Scottish Labour's health spokeswoman Jackie Baillie described the figures as "utterly astonishing" saying staff sounding the alarm had been "ignored".
The report also found that 7% of whistleblowing concerns were referred to providers to investigate compared to 18% the previous years.
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The campaign group Care Home Relatives Scotland said it was of concern that the number of disclosures was broadly similar to the previous year (1377) despite the Care Inspectorate acknowledging that many services were shut during the first wave of the pandemic. This also suggests that the majority of complaints concerned care homes.
Of those complaints that were investigated, 44 were upheld and 23 resulted in a requirement for the service to make improvements and staffing was highlighted most often.
The Care Inspectorate said a higher number of complaints were upheld last year - 78% compared with 52% in 2019 - which it said was evidence of "strong assessment."
They are suspicious that you just have an axe to grind.
It said additional risk assessments were carried out on all complaints to determine the most appropriate response to "identify the most urgent and serious concerns and take robust action."
A total of 818 disclosures (61%) were filed as 'intelligence' while 174 were resolved by direct service action and 101 were passed directly to providers to investigate.
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Of the 1340 whistleblowing complaints received in 2020/2021, 191 (14%) were revoked.
One Glasgow care home worker said he was not surprised by the report's findings.
He said: "There has to be a better system for complaining, people like myself dont complain for the sake of it, it takes a long while to sum up the courage to actually put your complaint in writing etc.
"The care inspectorate when they finally realise there is a problem are on the whole reactive but it's getting them to that point that is hard work and I can see why whistle-blowers give up and think they will let someone else complain.
"If a family complains they act quicker but if its staff who are there up to 48 hours a week. They are suspicious that you just have an axe to grind."
Data released by the Crown Office shows the prosecution service was considering at least 3,400 deaths in care homes linked to Coronavirus as of April 8.
Nicola Sturgeon has said the way elderly people were discharged from hospital to care homes in the early stages of the pandemic was a mistake.
More than 1,300 elderly people were sent to care homes before a robust testing regime was in place.
A spokeswoman for the group Care Home Relatives Scotland said the report "lacked clarity".
She said: "What is needed is more detail on the type of services that the complaints were about.
"The raw figures suggest there is a similar number of reports but if that is related to a smaller group of services then that is a concern.
"In a normal year would there have been a significantly higher proportion which were fully investigated?"
According to the report, there were no internal whistleblowing complaints from staff.
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A previous investigation involving The Herald found that of the 20 facilities with the most complaints last year, 18 were privately run.
Those included the Queensberry and Westfield homes in Dumfries and Galloway, which were the subject of 27 and 26 complaints, respectively.
The next highest number last year was for Abbey House at Kirriemuir in Angus, and Springvale in East Dunbartonshire, which both received 24.
Scottish Labour’s Health spokesperson Jackie Baillie said: “The way our care homes were abandoned during the pandemic is nothing short of scandalous.
“Services were buckling under unprecedented pressure, but while staff tried to sound the alarm they were ignored.
“We need to stand with whistleblowers and ensure any ongoing complaints are looked into as a matter of urgency.”
A recent report by Scottish Care, involving providers raised several areas where oversight and regulation is said to have "failed" during the pandemic.
Care home owners raised concern about "increasingly clinicalised approaches" which disregarded the distinctive role and purpose of social care as well as inconsistencies in grading and a lack of objectivity and consideration given to the effects of the pandemic on the sector.
A spokesman for the Care Inspectorate said: “All concerns received by the Care Inspectorate are assessed and resolved in the most appropriate way.
"In March 2020, in line with guidance from Directors of Public Health and after consultation with the Scottish Government, we rapidly adapted the way we worked because it was critical to minimise the spread of the virus, to keep people safe.
"Part of this meant on-site complaint investigations had to be limited to those that were deemed essential following an enhanced risk assessment. However, we were able to ensure that all complaints were assessed and dealt with appropriately by other means, including working with services to resolve complaints or bringing forward a full inspection.
"Every concern raised is risk-assessed and dealt with appropriately and proportionately. During the pandemic it has also been imperative to minimise the risk of spreading Covid-19 in care settings.
"At that time we also significantly increased our contact with services and made use of technology to do so where appropriate.
"The pandemic caused changes to how services operated. Some closed, and others restricted non-essential visitors. As a result, the trends and patterns in complaints noted in previous years were disrupted with falls in complaints received in the past year.
"The Care Inspectorate continually reviews our learning and experience across all our work to improve how we support care services."
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