Media Statement – “I worry about the Future” – 49% of Care Homes Report a Decrease in Placements

In January 2025, Scottish Care drew attention to the stark impact of ongoing funding pressures for the independent care at home and housing support sector, the untold stress on the sustainability of vital care providers across Scotland, and diminished access to an adequate level of person-led care. We now turn our attention to the #SocialCareCrisis facing the independent care home sector, through the significant decrease in Local Authority or Health Board placements across the country.

Scottish Care received 146 responses from our membership, overseeing the delivery of residential and/or nursing care across 403 homes in Scotland. We found:

  • A total of 1,463 placement vacancies. 
    • 4 vacancies for every home our respondents oversee.
    • 68% of these vacancies are accessible through Local Authority or Health Board placement and the subsequent National Care Home Contract (NCHC) funding model, providing an essential public service.
  • A significant decrease in the numbers of individuals placed by the Local Authority or Health Board in care homes across Scotland compared to the same period in 2022:  
    • 20.0% of respondents stated that the number of placements had decreased significantly.
    • 29.0% of respondents stated that the number of placements had decreased.
    • 45.5% of respondents stated that placements have stayed the same.
    • 6.2% of respondents stated that the number of placements had increased.

A practice of particular concern is the increased prevalence of ‘2:1’ placement policies in various localities, that Local Authority or Health Boards must recoup the equivalent money of two placements before funding the place of a new individual. Communities across Scotland should not have to wait for fellow citizens to pass away before being able to receive the care home they desire:

“Since before Christmas, there has been a big reduction in social workers seeking rooms for local authority clients. Sometimes, despite the family feeling care home is more appropriate, only homecare funding is offered”. 

Such stark results highlight the unsustainability of the independent care home sector in Scotland. There has been a 18% decrease in the number of care homes for adults in Scotland over the previous decade, and without the sufficient delivery of placements by Local Authorities or Health Boards, this trend will continue. Which each closure, an individual’s choice of and control over their care and support diminishes.

Without a robust and sustainable social care sector, able to promptly place individuals requiring and choosing residential or nursing care, delayed discharge will continue to exert immense pressure on the NHS and other services. More than five million bed days have been lost to delayed discharge since March 2015, at a cost of approximately £1.5 billion.

Never has ring-fenced funding for the social care sector, to meet service demand and support efficiencies across the NHS, been more required. Such funding is notably absent from a Scottish Government budget “that kills”, a very real risk that is summarises by one survey respondent:

“Historically, we had a system aiming to do the right thing but operating poorly, taking too much time to assess and place people appropriately. Now, whether by design or just acceptance, we have a system prepared to let people deteriorate or die without the correct care to save money”. 

We must address the #SocialCareCrisis in Scotland. This begins with the urgent delivery of ring-fenced funding for the adult social care sector to sustain the commissioning of placements within care homes. This is critical to safeguarding a care system that prioritises dignity and delivers high-quality, person-led care. One that looks forward to a future where those delivering or receiving care and support no longer worry about the future.

Dr Donald Macaskill, Chief Executive of Scottish Care, said: 

“Scottish Care’s research demonstrates the profound social injustice of how our crises-driven care home sector operates. People are desperate to move into care homes across Scotland, not least those stuck in our hospitals, and yet local authorities are choosing or simply do not have the money to pay for their care and support. Because of this underfunding, care homes across Scotland are in crisis, and empty beds will lead to care home closures. 

We need a long-term strategy which sustains the care home sector in Scotland rather than what we have at the moment, a reactive, damaging short termism. It is an indignity that we are waiting for two people to die in order for there to be money to pay for one resident.”

 

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Blog – The Great ‘Doughnut Fallacy’ of social care in Scotland 

The Great ‘Doughnut Fallacy’ of social care in Scotland 

Minister for Social Care Marie Todd last week announced changes to the proposed National Care Service (NCS) Bill. The most significant of which is the removal of Part 1 of the bill, which focused on the structural reform of integrated social care and community health. This means the bill will now proceed with only Parts 2 and 3. I can’t help but note the passing of the ‘Welfare of Dogs’ Act in the same week and reflect upon what that means for how we value our citizens. What is crucial now is that we do not wait for the Bill to reform social care. A briefing was sent to all Scottish Care members with more detail, but here’s what we know: 

First, it’s important to acknowledge that the plan for a complete overhaul of the social care system, through the structural reforms in Part 1 of the National Care Service (NCS) Bill, has been dropped. This is where the system arguing with itself about who should run things got in the way of making a difference for people. It’s the great doughnut fallacy of social care. 

During the pandemic we experienced a health takeover of social care. They brought with them outdated ideals of person-centred social care. Whilst this was a positive initiative of its time, over 2 decades ago social care switched to person-led care and support. Person-centred was a way of reinforcing the need of the system to connect with itself with the individual citizen at the centre. However all too often what would happen is that the individual in the centre would find themselves in a vacuum surrounded by a system determining their needs, often to the detriment of the individual. This regression to person-centred caused a culture change which ripped a hole in the heart of the independent review of adult social care and delayed the implementation of meaningful change.  

With the structural reform proving too difficult, I am however reassured by the clear language shift to person-led in the Ministers speech reinforcing the need to remember why we are doing this. Put simply, for people not power. 

So what remains in the bill? 

  • It includes “Anne’s Law”, which appears to strengthen visiting rights in care homes although in practice the role of Public Health still has a power to overrule any decisions, making this legislation have no greater impact that what already exists. 
  • It aims to improve information sharing between health and social care services. Many of you will know data is one of the pedestals I like to climb upon, but that is because it is a real area of opportunity. Especially with the adoption of ethical AI. However, it will only work if it meets a vision to reduce bureaucracy and improve the user experience. I wrote about this with Dr Tara French some years ago now in Seeing the Diamond in Social Care Data, but the principles remain the same. Alongside this, there is a need to embrace digital to augment the care experience, offering people more autonomy and freeing up care workers to get back to delivering care. 
  • There’s also a plan to establish a national care service advisory board. This is meant to be an independent body, including people with lived experience, that will help to improve the quality of care across the country. It will provide advice on national programs to support improvements and will monitor and report on local frameworks. However, it’s not statutory, so it may not be as powerful as it could be. What is important here is how the board can ensure transparency and influence over poor practice in all parts of the system. This will be supported by work on  
  • Ethical commissioning and procurement which remains in the bill. This is where real change towards person-led sustainable and quality care can be made, but only if it is enforceable. Financial constraints and the persistent underfunding of social care and support for a decade has led to a time and task takeover meaning that providers are not commissioned to deliver the care and support that people really need to live well. In addition, delays in payments to care providers are putting them at further risk of collapse because they cannot meet cash flow demands. Providers are closing. Staff are exhausted and undermined. There is additional pressure on families, and worst of all, people are being failed. In response to the statement that Scottish Government has increased funding for social care by 25%, two years earlier than planned. I wonder how much of this has been used to meet public sector pay increases or simply to meet inflationary rises. Funding remains a concern and transparency, and good governance is still needed for system change to embed. 

So there we have a list of what should perhaps be the items for the agenda of the first National Care Service Advisory Board. Whatever happens next, it is critical that changes are person-led and focus on the needs of individuals, ensure care workers are properly supported, care providers experience full economic cost recovery, and that the system is accountable, flexible and efficient. Without these critical foundations, the changes to the NCS bill will not deliver the required improvements of the Independent Review of Adult Social Care and the doughnut fallacy will remain strong. However, if we collaborate with intent, we can have our cake and eat it. 

 

Karen Hedge
Deputy CEO, Scottish Care

Media Statement: “It Feels Like We Don’t Exist’ – Scottish Care Calls for Urgent Action

“It Feels Like We Don’t Exist”: Scottish Care Reiterates Call for Urgent Action Following Sky News Report  

Scottish Care is deeply concerned with the findings of Sky News’ recent report into the experiences of homecare and housing support providers delivering commissioned care packages, summarised within our Briefing Report.

Specific results from Scottish Care membership are as follows:

  • Over 80% stated that councils have reduced the number of care packages that would previously have been awarded.
  • 90% stated that councils have reduced the overall number of hours commissioned within care packages.
  • Over 90% stated that councils have asked providers’ to complete care tasks that are unrealistic within the commissioned time.

Such reductions place untold stress on the sustainability of vital care providers across Scotland and diminishes access to an adequate level of person-led care. As commissioning and procurement bodies cut packages beyond the true cost of adequate care for our communities, care providers are struggling to stay afloat amongst increasing operational costs:

“For the first time in 27 years I am genuinely scared for our future.” 

Reversing this reduction in service availability is vital, with funding for care providers that is commensurate to the true cost and value of the vital work they do.

Sky News’ report reaffirms the inadequacy of time and task models of commissioning homecare and housing support, typified by 15-minute visits and the lack of person-led care on offer:

“How are carers supposed to provide high quality care if they only have 5 minutes! This is not enough time to take off your jacket let alone assess the persons wellbeing.” 

As opposed to tailored packages that meet the individual needs of service users, carers must complete multiple complex tasks within this narrow timeframe (personal care, medication administration and meal preparation). Increasingly, basic needs cannot be met. Moreover, by removing the vital human element of care, individual citizens feel rushed and undignified.

The results also highlight a breakdown in partnership working between commissioning bodies, providers and service users when making significant decisions regarding the future of a care package:

“We seem to be in a situation where there is no transparency or honesty”. 

The whole adult social care sector must commit to greater communication with providers on any decisions that affect service delivery.

Scottish Care’s recent response to the Scottish Budget describes a “budget that kills”. Sky News report exemplifies this very real risk without sufficient support at all levels of government.

We must address the #SocialCareCrisis in Scotland. This begins with a truly ethical approach to commissioning and procurement that respects the true cost of care, communicates openly with service users and their care providers, and works collaboratively to advance the much needed change away from time and task models of care. These steps are vital to safeguarding a care system that prioritises dignity and delivers high-quality, person-led care.

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Menopause Matters Webinar – 6 February

Scottish Care & alsico – Menopause Matters Webinar 

Exploring Menopause Support in Care Homes (6 February)
1 in 5 care workers say menopause symptoms affect their job performance, and 1 in 10 consider leaving their jobs because of it.

To address this critical issue, Scottish Care is hosting a webinar in collaboration with leading uniform supplier alsico. Building on the success of alsico’s Menopause Matters event at the Care Show last year (learn more here), which brought together some of the UK’s largest care providers—this webinar will focus on practical ways to support staff navigating menopause.

Date: Thursday 6 February
Time: 2pm – 3pm
Location: Teams Webinar

Speakers include:

  • Caroline Deane – Scottish Care
  • Sara Catanzaro – Alsico
  • Flora Neville – Citation
  • Pauline Ritchie – Oakminster Healthcare
  • Alyson Vale – Abbotsford Care
  • Rachel Payne – Bandrum Nursing Home

Topics will cover:

  • Misconceptions about menopause and how to address them
  • The importance of uniform considerations in care homes
  • Exploring practical menopause policies
  • Insights from care home providers implementing menopause-friendly practices

This webinar will share resources, explore ideas, and foster collaboration within Scotland’s care sector to create more supportive workplaces.

Register here

Join us to continue the vital work of improving menopause awareness and support for care workers across Scotland.

Winter Bulletin 2024

The 2024 Winter Bulletin is now live and brimming with valuable updates, inspiring stories, and highlights from the social care sector. This year’s edition includes a festive feature from pages 26 to 29, showcasing heartwarming stories and creative activities shared by our members. Thank you to everyone who contributed to making this bulletin truly special!

We always welcome your feedback and ideas. If you have thoughts to share or suggestions for future editions, please get in touch at [email protected].

Download bulletin

Winter Bulletin 2024 FINAL-compressed

Human Rights Day 2024 Blog

Human Rights Day is celebrated globally on December the 10th, the day serves as a powerful reminder to protect fundamental rights for all. In Scotland, organisations like Scottish Care use the occasion to highlight challenges and progress in social care. Scotland also observes this day with organisations, activists, and communities hosting events, discussions, and campaigns to raise awareness about ongoing human rights challenges and celebrating advancements in this field. 

At Scottish Care, we utilise this day to celebrate the amazing work from our members and colleagues championing human rights in their communities. One standout example is the Silver Pride Project, where our colleagues in Ayrshire are contributing to creating safe and inclusive spaces for older LGBT adults living with dementia. It showcases how celebrating the right to freedom of expression can translate into practical change for marginalised communities. 

Scottish Care also celebrates the work of our colleagues in Ethical Commissioning, which emphasises integrating human rights into social care contracting. In 2023, workshops highlighted how current social care procurement models can infringe on the rights of those who access care and support. Recommendations from the subsequent report included making rights-based care a contractual prerequisite and ensuring shared accountability between providers and commissioning bodies. This approach aims to enhance the dignity, independence, and outcomes for those accessing care. 

However, despite these examples, systemic issues persist. For one the Scottish Government’s 2024 Budget. This budget allocated £21 billion to health and social care but failed to provide ring-fenced funding for social care services. Scottish Care’s response to the budget highlighted that this omission places providers under immense financial strain, exacerbated by unaddressed National Insurance increases. We are working actively to address our concern with the Scottish Government.  

Another issue that persists is the pushback of the Human Rights Bill. This Bill was supposed to create a legal framework for the Scottish Government to embed international human rights within domestic law and drive transformative, positive change for people. We responded to the call for consultation of the Bill, though we had concerns we supported the ambitions of the Bill. However earlier this year the Bill was taken out of the 2024-2025 programme for government, with no clear plan of a way forward. 

As part of the Scottish Food Coalition, we are advocating for the reintroduction of the Scottish Human Rights Bill into the Scottish Government’s agenda for this term, through the #BringBackTheBill campaign. The delay in the Bill’s progress has sparked widespread concern amidst worsening economic conditions. This event will unite organisations, grassroots groups, and individuals under the banner #OurRightsOurFuture, urging the government to prioritise human rights protections.  

Demonstration details:  

  • Date: Tuesday, 10 December 2024 
  • Time: 10:00 – 14:00 GMT 
  • Location: Scottish Parliament Building, Edinburgh 
  •  More information is available via Eventbrite 

 

Care at Home & Housing Support Awards 2025 – Entries Now Open!

Submissions are now open for the 2025 National Care at Home and Housing Support Awards! This prestigious event celebrates the outstanding achievements of our dedicated homecare workforce and the individuals they support.

Marking its 19th year, the awards ceremony will take place on Friday 16 May 2025, at Radisson Blu, Glasgow. The event will be hosted by Michelle McManus and our CEO, Dr Donald Macaskill.

Nominations close on Friday 28 February 2025, at 5:00 pm. If you know exceptional individuals, teams, or services, be sure to nominate them.

Find out more about the awards and submit your entries here.

LGBT & Dementia – Training Resources

Scottish Care’s Independent Sector Lead for East Ayrshire, Arlene Bunton, has been recognised for her outstanding work in LGBT and Dementia care, recently winning the ‘Best Inclusive Dementia Care in Our Diverse Society’ award from Dementia Community at a gala lunch in Sheffield. Find out more about this achievement here.

Arlene has also been collaborating with Stirling University to develop a new resource aimed at frontline workers. This resource is set to launch on 27 February, with further details to be shared in early December.

In the meantime, an introduction taster resource has been created. See the document below for more information, with QR codes to different resources. Those who complete it can email Arlene to receive a certificate and badges by post! Please feel free to share this resource widely.

Download the taster resource here