Scottish Care chief executive Dr Donald Macaskill analyses a tough week for the care sector
In the space of a week, two events have highlighted the fragility of the care sector in Scotland. The first was the decision of Bield, a major charitable care home provider, to withdraw from operating older people’s care homes. The second was the report from the Care Inspectorate which indicated that whilst the whole social care sector is facing recruitment and retention challenges, these were at their most acute in older people's care.
At the heart of the issue is the extent to which as a society we are willing to pay to properly fund the care and support of some of our most vulnerable citizens. At current care home fee rates we are effectively paying less than £4 an hour for older individuals, often living with dementia, to be cared for in our nursing homes.
The Care Inspectorate has rightly argued that a stable and consistent staff group is a key component in the delivery of high-quality social care. It is to the credit of organisations and their staff that despite the inadequacy of public funding, currently over 80% of care services in Scotland are judged to be good, very good or excellent in respect of the quality of care they provide. However that quality cannot continue if there aren't enough workers or resources.
This is compounded by the critical state of the workforce. Currently we know that there is a 28% vacancy level for nurses in care homes, that some homes are paying nurse agencies £1,000 for a shift and over 70% of care homes are operating with a large number of positions unfilled by permanent staff. In care at home services for older people, whether voluntary or private sector, 9 in 10 organisations reported to us difficulties in recruiting staff.
Scotland is privileged to have thousands of dedicated professional care workers who support some of our most vulnerable citizens, but they are at breaking point.
Is it right as a society that we continue to expect so much from a workforce that we fail to adequately remunerate? How can we possibly attract staff to consider this amazing work when the public purse values them so poorly? How can we possibly create a career in care when folks can earn so much more stacking shelves in a supermarket without the need for registration and the qualifications which our care staff face?
We can't for much longer fail to ask fundamental questions about how we fund care. We cannot for too long expect dedicated organisations and their workforce to continue to deliver care bought on the cheap by procurement methods which limit dignity and lessen humanity. We cannot continue to expect more for less.
Quality care enhances humanity, promotes worth, transforms lives and grants assurance. If we are to truly create a Scotland where the old can spend their later years in dignity then we have to start acting now because we are already seeing what the alternative is like.
Dr Donald Macaskill is chief executive of Scottish Care, the representative body for independent social care services in Scotland
