Sweeping changes must be made to social care

Charities have welcomed the publication of the independent review of adult social care in Scotland and called on political leaders to implement its far-reaching recommendations.

The review, commissioned in response to the catastrophic impact of covid on care homes, calls for urgent improvements in workforce planning, pay and conditions and a re-think on charging policies.

Social care staff say support and training opportunities are lacking in the sector, which had led to “serious consequences for those who use services”. 

Age Scotland’s chief executive Brian Sloan said too often social care has played second fiddle to the NHS in terms of funding and status.

He said: “It shouldn’t have taken a worldwide pandemic to realise the value of social care but it has drawn into sharp focus its vital role and that reform is needed now more than ever.

“We know that the idea of a National Care Service has meant many things to many different people and while the review doesn’t advocate for national ownership of social care provision, the reforms it recommends are wide ranging and bold.

“It includes many things which we have been calling for such as increased financial investment, equity of access, choice, human rights and people at its heart, considerable changes to charging arrangements, improved opportunities and conditions for staff, and more government responsibility and accountability.

“The review rightly identifies that there are significant gaps between what should be happening in social care and what happens in reality. Ensuring that these are addressed would be a major first step.”

Overall the document makes more than 50 recommendations, including the appointment of a Minister for Social Care to oversee improvements.

Chair of the independent review, Derek Feeley, said: "This is a time to be bold and radical. Scotland needs a National Care Service to deliver the high quality, human rights-based services people need to life fulfilling lives, whatever their circumstances.

"Scotland has ground breaking legislation on social care but there is a gap, sometimes a chasm, between the intent and the lived experiences of those who access support.

"We have a system that gets unwarranted local variation, crisis intervention, a focus on inputs, a reliance on the market, and an undervalued workforce."

The report recommends that the free personal care and nursing allowances for self-funding care home residents should be increased in line with those who do not pay, which would cost an additional £116 million annually. It found that those who pay are facing shortfalls of around £191 and £230 per week.

Annie Gunner Logan, chief executive of Community Care Providers Scotland congratulated the review for listening to "many voices."

She added: “Reform of social care in Scotland is long overdue. The pandemic has exposed fault lines which require radical overhaul and long-term change. It has also revealed what can be achieved when obstacles are removed in a crisis.

“We are heartened by the direction of travel set out in the Review. The challenge now must be to turn aspiration into implementation. Change is needed urgently but how it is achieved matters too.”

“The debate about a National Care Service must not become a bunfight at the expense of those who provide social care and the people they support. The upcoming election period provides an opportunity to discuss the Review’s recommendations openly and widely. But when the votes have been counted, and Scotland gets down to the series business of design and implementation, their voices must be in every room, every step of the way.”

A spokesperson for the The Alliance said the Review echoes its call for social care to be reframed as an investment that enables rights and capabilities, rather than a burden.

And Henry Simmons, chief executive of Alzheimer Scotland, welcomed the review’s recommendation to stop charging those with advanced dementia for their care in nursing homes.

He added: “We would like to see further details on this particular recommendation, as it is our main objective to bring an end to this inequality.”

Health secretary Jeane Freeman said the government is considering the review and would respond in due course.