Social care sector risks cracking under the strain

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Shona Robison, cabinet secretary for health and sport pictured with Robert MacPherson, adisabled person talking about his experience of social care, and Sally Witcher, chief executive of Inclusion Scotland, at the Social Care Ambition launch.

A coalition of charities is calling for a wholesale review of the social care system to prevent it cracking under increasing pressures

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27th July 2016 by Susan Smith 1 Comment

Scotland’s social care support system increasingly risks cracking under the strain as demand rises and funding fails to keep pace, a group of charities has said. 

With the current system negatively impacting on the life of disabled people, the coalition of 16 organisations has called for the urgent establishment of a national independent commission to explore the problem.

The charities, representing disabled people and older people, women, care providers and paid and unpaid carers, launched a Shared Ambition for the Future of Social Care report. It calls for urgent action by national and local government and policymakers to develop new approaches to funding social care.

The report urges the Scottish Government, local government and care providers to work alongside disabled people and carers towards a wholesale review of what social care support is for and Scotland’s system of funding it for the future.

Underfunded social care support leads to isolation and deprivation for disabled people and prevents them from having dignity and choice and control over their own lives - Jim Elder-Woodward

Scotland spends £3.9 billion a year on social care support, yet for many reasons a lot of disabled people are go without support beyond basic washing and dressing. This means they struggle to access the support they need to work, study, contribute to their communities and lead normal lives.

Meanwhile carers – both paid support workers and unpaid family members – and service providers often report that they are struggling to cope, which impacts on the quality of care they can give.

Independent Living in Scotland, the report’s authors, believe that April’s introduction of health and social care integration offers a timely opportunity to establish an independent commission to examine the best way to fund the social care support that meets the needs of current and future service users and their carers. Those who signed up to the report say that any review of social care support should look at what it should achieve for society and Scotland’s prosperity as well as individuals and should recognise it as an infrastructure investment in the social and economic well-being of Scotland.

Chief executive of Inclusion Scotland, Dr Sally Witcher, said the Scottish Government has already introduced positive initiatives such as self-directed support, which aims to ensure that service users have a choice of how they access the support they need, and they have a track record of engaging with disabled people and carers and voluntary organisations to design these changes. 

She said: “The introduction of health and social care integration marks a seismic shift in the way health and social care services are delivered. It would therefore be timely to establish an independent commission to have a thorough examination of the best way to fund social care support and ensure it plays a full role in enabling people to really live their lives, rather than just stay alive.

“Such a commission would be collaborative and would be helpful to national and local government and disabled people themselves. We hope to have the opportunity to make a constructive contribution to the development of a new, effective way forward, starting by articulating our shared ambition for social care support and using this to inspire and galvanise widespread action.”

Independent chair of the Scottish Independent Living Coalition, Dr Jim Elder-Woodward OBE, added: “Disabled people seek a life, not a service. This is about human rights. Disabled people are paying the price, along with their family carers. Carers, both paid and unpaid, are mostly women, so it’s also a gender issue.

“Underfunded social care support leads to isolation and deprivation for disabled people and prevents them from having dignity and choice and control over their own lives and participating in the civic and social life of society as full and equal citizens. Good social care support is also key to the success of the current integration of health and social care services in Scotland, otherwise there will be even more delayed discharges from hospital and repeat admissions, which is damaging both socially and economically.”

The Shared Statement of Ambition is part of a wider civic society dialogue hosted by the Independent Living in Scotland project and supported by Inclusion Scotland, Scottish Council for Voluntary Organisations, Self-directed Support Scotland, Coalition of Carers in Scotland, VoX Scotland, Glasgow Disability Alliance, Lothian Centre for Inclusive Living, Glasgow Centre for Inclusive Living, Engender, Disability Agenda Scotland, Learning Disability Alliance Scotland, Health and Social Care Alliance Scotland, IRISS, Scottish Care and Coalition of Care and Support Providers in Scotland. 

29th July 2016 by Ian Davidson

Since 19.7.16, I have become a carer when my mother was discharged (with inadequate community care preparation) from hospital. The first 48 hours in particular were a nightmare until basic home care and other services were in place. This involved two overnight stays by myself. Had I been in employment, the situation would have been impossible. The Glasgow Cordia Home Care staff are brilliant; however these workers (female) are far too busy; they have too many clients to visit in too short a time. Travel time is included in the client's time! 20-25 years ago, many of the vital care (i.e. we are NOT talking about a wee bit of shopping, cuppa tea and a chat!) functions which they perform would be carried out by NHS District Nurses on higher pay grades and with more training and status. Likewise the community NHS OT and physiotherapy staff have been great; how long this input will last is unclear. I have started the process of social care assessment and a carers assessment; thus far GCC staff have been very helpful but they are not in a position to give any undertakings about what service will be provided etc. Voluntary organisations, eg Care and Repair have been great, responding to my plea for a "key safe" within 24 hours with no charge for fitting! As an advice worker, I am better resourced than most to negotiate the complex social care system and act as a "co-ordinator". However, already I feel stressed so how do other carers less well-resourced cope? It is essential that the new integrated NHS/local authority boards work well in every part of Scotland; funding, communication, management practices, staff pay and conditions.. and more.. all these inter-related factors must be looked at. There is no point in having an elderly person given the best possible medical care in a brand new hospital, with a (lonely) hotel-standard accommodation, only to be discharged to unsuitable housing with 4 brief visits by under-pressure home care staff! It is essential that NHS/social care works seamlessly at the delivery end.. where it matters... rather than in lengthy "strategy" documents and Boardrooms far removed from the day to day reality of ensuring that vulnerable people have a decent quality of life (e.g. they can get safely to the toilet as and when they wish, just as any fit adult human being would expect! Scotland has a great opportunity to get things right - NHS, social care, devolved social security. We must not waste this opportunity.