Scotland’s care system is in crisis – we need to fix it now

Social careweb

Keith Robson on the real gap between our ambition for high-quality care and the reality of high staff turnovers and care packages falling apart

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20th September 2017 by TFN Guest 0 Comments

Age Scotland’s mission is that we should all be able to love later life. That means ensuring we can access the health and care services we require when we need them. So we are concerned about emerging issues in the sector around funding and staffing.

This week, minutes from an emergency meeting by Argyll and Bute Health and Social Care Partnership revealed that a staff shortage was leaving vulnerable people at “high risk”. The care provided had fallen short by 6,000 hours this year, meaning cancelled visits and older clients left in bed for prolonged periods of time.

Sadly, this isn’t an isolated case. It reflects very real challenges across Scotland’s health and social care sector.

Keith Robson

Keith Robson

Just a few months ago, the Care Inspectorate highlighted problems with health and social care services in Edinburgh. Five areas were described as “weak” or “unsatisfactory”, with too many older people and unpaid carers facing long waits for help.

We welcome the drive towards Health and Social Care integration which the Scottish Government has pioneered. But there remains a gap between the ambition for the kind of care services we want to see and what is happening on the ground in our communities.

Our helpline staff often hear from people who have difficulty accessing the care they need. One caller said her mother hadn’t been washed for a week, while others reported that their care packages fell apart after their relatives went into hospital.

People are entitled to a care assessment within a “reasonable period” of time. But what seems reasonable to someone worried about a frail parent with dementia might be very different to an overworked health and social care partnership.

A shortage of care workers is having a serious impact on older, vulnerable people. Although the Scottish Government has taken action through the provision of the living wage, still too often carers are paid relatively poorly for a demanding job.

It’s no surprise that carers grow frustrated when they lack the time and support to really care for their clients. We’ve all heard about flying visits, with carers expected to wash, dress and provide a meal for people against the clock before rushing to the next one. The idea of sitting down for a cup of tea and a chat is unthinkable.

This is reflected in a survey by Scottish Care, which found that 90 per cent of care-at-home services had difficulty filling vacancies. Staff turnover is high, with a third of staff leaving each year.

This is only set to get worse with Brexit on the horizon. Many care providers rely on workers from other European Union countries. At the same time, these immigrants tend to be younger, working adults, whose taxes help fund the social safety net.

Of course, there’s no easy solution. Cutting care budgets might save money in the short term. But it means more hospital visits, putting additional strain on our over-worked NHS. And it makes it more likely that older people will have to leave their own homes to go into residential care.

At the heart of the problem is recruiting and retaining workers who provide these lifeline services. We need to look at ways to make these jobs more attractive to more people, and ensure they have the training and support they need.

In so many ways, the Scottish Government’s flagship free personal and nursing care policy has been a success. We welcome its commitment to extending this to cover younger patients with degenerative conditions.

But as demand grows, it’s vital we ensure it is properly funded and staffed. Our national agencies must work together to address these very real concerns, and ensure that every older person who needs it receives high-quality care with dignity.

Keith Robson is Age Scotland's charity director