Scottish Care survey highlights issues linked with resourcing and call monitoring leading to workforce and financial unsustainability for care at home providers.

In January 2023 Scottish Care undertook a survey among its members regarding sustainability within the care at home sector. The survey findings repeated the concerns of independent providers, summarising that management of dwindling resources is unsustainable for the sector. This raises concern on the impact of such conditions on those working in and accessing social care and support, those they support, and the wider health and social care  system. Themes which were also prevalent in the Independent Review of Adult Social Care, including the unanimous statement that ‘if you could invest in one thing, make it the workforce’.

The way that Care at Home support is arranged differs between Local Authorities yet consistent themes of financial and staffing concerns were prevalent. Other contextual factors raised included an increase in the number of procured 15-minute visits by Local Authorities and the impact of punitive bandings attached to electronic monitoring systems.

The survey revealed that over half of respondents had handed back packages of care delivery hours to their local councils due to an insufficiency in funding to cover increased cost of living and staffing costs such as travel. The lack of appropriate and consistent funding made it difficult to recruit and retain staff. One provider specified that their staff were being recruited by the NHS and agencies where they can be paid more than the increasingly insufficient social care rate set by Government. Friday’s announced uplift for the NHS has widened this gap further, with a hospital cleaner now earning more than a qualified and professionally registered care worker.

Electronic call monitoring was also highlighted in the survey as a tool that, when improperly used, contributed to staff dissatisfaction. Whilst providers recognise that electronic call monitoring could be used to evidence care delivery and to support staff safety when working out in the community yet raised that when this tool was improperly used it made it difficult for staff to apply the personal touch needed for quality care due to its focus on time and task-driven delivery. Additionally, it was at times used by councils to ration funding. Furthermore, most respondents highlighted that they have had to reduce visits with longer travel times, as procurement practice in some areas does not consider the time needed to travel between individuals’ homes and does not adequately compensate staff when an appointment is cancelled at late notice.

Overall, survey respondents reiterated their concerns of how insufficient investment coupled with inadequate commissioning and procurement practices are making the social care sector unsustainable. Recruitment and retention remain a top concern with providers explaining that rising service costs and the costs of living which staff face were not being adequately addressed in pay. Incorporating cost-of-living raises into staff contracts and offering a consistent income were seen as credible solutions for most of the surveyed providers. These solutions were suggested to improve staff retention and quality of care, however it would be impossible to implement without an increase in funding from local councils.

The question remains, now 2 years on from the independent review, are we ready to face the true costs of providing care or should we remain on our crisis led journey into the unknown. Scottish Care is calling for an immediate uplift to all social care staff to £12 per hour.

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