Is social care in Scotland really in crisis? It’s hard to open a paper these days without reading about staff shortages, vulnerable people left at risk, or the “ticking timebomb” of an increasing older population.
Financial services firm JLL recently advised that 90,000 new care staff will be needed in the next two decades to meet the expected rise in the number of older people requiring care. Yet local authorities are already struggling to fill vacancies, and cope with sky-high staff turnover.
This is having a knock-on impact on the quality of care in many areas, with reports of older clients being left for prolonged periods in bed without food or essential medicines.
The revelation that care workers are routinely paid less than dog walkers in Edinburgh highlights the fact that this vital job is chronically low-paid and undervalued.
Of course, the picture is not quite as bleak as it initially appears. Care workers are often the unsung heroes of the health system. The myriad examples of older service users who are happy with their care providers rarely make headlines.
In many ways, the Scottish Government’s free personal and nursing care policy has been a success. It has helped more people access and afford the care they need, whether at home or in a residential setting, avoiding worrying situations we see south of the border.
The commitment to “Frank’s Law”, which will extend this to younger patients with dementia or other degenerative conditions, is very welcome. The drive towards better health and social care integration is another step in the right direction.
But it’s hard to ignore the very real challenges that the sector faces around funding and staffing.
At Age Scotland, we believe that we should all be able to love later life. This includes being cared for with respect and dignity when we need it. But there is still a gap between our vision of care and the reality of provision in many parts of the country.
We see significant delays in assessing, delivering and paying for care – as councils struggle to manage demand – which can be stressful for those in need and their families.
Our recent report, Meeting our Commitment to Care, revealed that delays in making assessments and providing services were routine in many areas. We estimate that more than 1300 people each year wait longer than the maximum six weeks when their care needs are considered to be “critical” or “substantial”. A Scottish Government survey showed that three quarters of local authorities failed to meet that six-week period for some service users last year.
Our helpline often hears from people who are struggling to access care. We hear from family members who are told that there are no funds available and they must meet the cost from their own savings. Others complain that their older relative hasn’t been washed for a week, or a care package fell apart once they were admitted to hospital. Waiting months for an assessment puts additional strain on families at an already difficult time.
Managing care needs can be a very complex issue. But one essential step is working together to make jobs in the care sector more attractive. This is especially urgent with Brexit on the horizon, since many care providers rely on immigrants from European Union countries to fill vacancies.
It’s hardly surprising that many people prefer to work in other low-paid jobs such as supermarket check-out or dog-walking, rather than take on the demands of caring.
The Scottish Government has already committed to providing a living wage, but we need to go further to ensure that care workers feel appreciated and rewarded for the vital work they do. This involves making sure they actually have the time and resources to really care for clients, and tackle the high level of burn-out in the profession.
Most older people prefer to be cared for in their own homes, maintaining their independence as long as possible. At the same time, providing appropriate social care reduces the need for expensive hospital visits, saving money in the longer term. A significant amount of money in the NHSis due to delayed discharges, which often occur when older patients don’t have the care they need in their community.
Of course, it’s great news that more of us are living longer and staying healthier for longer. But this means that more people are likely to be living with long-term health conditions and needing assistance.
It’s essential that we plan together to meet future care needs if we really want to make Scotland the best place in the world to grow older.
Keith Robson, charity director of Age Scotland.