Latest Blog from our CEO: Is choice a human right?

Is choice a human right?

I want to reflect on two remarks within speeches I heard yesterday to celebrate World Social Work Day and the 50th anniversary of the Social Work Scotland Act. They both had to do with choice.

The first speech was making a comparison between different approaches and philosophies around social care and social work, evidencing the change from the spirit of the 1968 Kilbrandon Report which assumed that social work would be delivered by local authorities, much in the vein as some politicians have recently articulated a desire to return to. But then with the passage of the 1970s and 1980s the speaker commented that consumerism and choice within a mixed economy of care had replaced what had happened previously.

The second remark was within an inspiring speech by a young man, Thomas Timlin, who told his own personal story from living in a neglectful environment, being taken into care, experiencing abuse at the hands of foster parents, through the separation from siblings and his natural mother, being told at 16 that the State had fulfilled its duties of care, to enduring periods of homelessness and eventually becoming a children and families social worker. He commented that no-one had asked his views at any time, no-one had given him choice, had asked him what he wanted at any stage whether during fostering or adoption. The lack of choice had denied him a voice.

Two very different comments about choice but they are at the centre of the current debate about social care in Scotland. They are for me at the heart of what a human rights based, person led approach to care and support is all about.

Choice is after all at the core of our primary social care legislation in Scotland. The Self-directed Support (SDS) Act states in its Principles that an individual shall be enabled to have choice whether that be in an outcomes assessment or in support planning or indeed in the delivery of their care and support. They shall have a choice of four options over which to decide how their personal indicative budget should be spent. They shall have a choice on which provider of social care they want and is best fit to meet their own individual needs. There is also a duty upon a local authority to promote such diversity within the ‘market’ and ‘local community’ to enabling a real exercising of choice. After all presenting a person with one provider (statutory or not) as a take it or leave it – is not choice its instruction.

The SDS Act is a true democratisation of control, consent, participation and empowerment. Choice is part of the DNA of social care legislation in Scotland. Our new National Health and Care Standards go even further and articulate this human rights emphasis and root good care and support within the principles of autonomy, control and choice.

So, is choice a right? Is choice just another term for consumerism and therefore should it be limited and curtailed? Is there anything wrong with the consumer (the citizen) exercising control rather than being told what to do or having their options limited by the State? Is choice a human right?

These are all important and critical questions because they are likely to shape debate within the social care sector in the months and years to come.

For me, personally, choice is an alienable right. My perspective is influenced by being a member of the Same As You? Implementation Group nearly two decades ago. This was a key and ground-breaking strategic Scottish Executive policy which stated that someone with a learning disability was deserving of the same rights, dignity, treatment and citizenship as any other person in Scotland. I remember one person with a learning disability speaking at a meeting and summing up what it meant to have choice. She said:

“It isn’t just that I should have the right to choose what to eat, to choose what I should wear, to choose who I spend my time with, to choose where I live as far as I can; it is fundamentally that I should have the right to choose who comes into my home, who attends to my personal needs, who supports me to fulfil my life. It is my right to choose who sees me naked.”

Choice for countless thousands who have been denied control and autonomy means absolutely everything. It is the vibrant spirit of freedom that gives purpose to activity and underpins individual contribution.

So be very careful of those who wish to undermine the choice that has been achieved for citizens in Scotland, whether they have a disability, live with a mental health condition, or live their lives in a nursing or residential care home.

Choice is fundamental and that choice critically includes the right to decide what organisation provides care and support to me should I require it. Our politicians need to tread warily on any of the human rights citizens have struggled for, rights for social care choice which have been achieved over the last two decades.

For many the freedom to exercise choice is about the ability to be fully a person. Choice has no sell-by date; choice is not an option, it is intrinsic to being an autonomous human being. Choice is a human right.

Dr Donald Macaskill
@DrDMacaskill

Latest Blog from our National Director: Self Directed Support

Perhaps controversial, and the jury is still out on whether I am a cynic or a realist, but this month I am sharing good news.

It has been refreshing to see positivity in the media, albeit few in number, there have been images and snow stories celebrating care staff who go above and beyond to ensure our most vulnerable citizens remain safe and cared for. And whilst I continue to wonder why it took the ‘Beast from the East’ for many to notice that it’s what our workforce do everyday, I want to eek out that celebration for as long as possible. Hopefully it will help folks through the oft overlooked aftermath.

Perhaps even more controversially, I want to talk about that other oft overlooked subject; Self Directed Support.

Today is Self Directed Support Scotland’s Conference, and whilst they have an excellent range of speakers including support from Scottish Government, I want to direct attention to Norma who will be there presenting her journey to receiving SDS. I became aware of this film via our SDS project funded by Support in The Right Direction in the Highlands, where Anne MacDonald has been working to promote the uptake of SDS. (A similar project has been on-going in the Ayrshires to produce tools and materials to promote SDS, but also with a focus on supporting the introduction of SDS for carers). It’s also worth noting here that in the second half of the week, Anne works for Highland Senior Citizens Network, making her an all-round expert.

As part of the SDS project, she has facilitated the co-production of materials such as a leaflet on SDS from an older person’s perspective in an ‘what I wish I had known’ format, and tested and localised tools to support practitioners and care staff. The key word in all of this is facilitation. The work Anne does is always lead by those who use services, and this is where Norma comes in. Norma worked with Anne to film her experience, and direct and cut the film, with a view to sharing a personal perspective on what SDS offered her.

Norma has allowed us to share the film on the Scottish Care website, so whether you are still ‘on the fence’, or an SDS convert, I urge you to watch it, it’s evidence that SDS can and does make a difference. For many people, it’s not new or rocket science, but simply the delivery of good human rights based care where people are offered the choice control and dignity they deserve.

So to Norma, thank you for sharing your experiences and allowing this to go on our website – if you ever fancy writing a blog for Scottish Care, we would love to hear more.

And while we are celebrating – if you care about those who provide care at home, then let them know. The deadline for submitting a nomination for the Scottish Care Annual Care at Home Awards is fast approaching. I have the privilege of chairing the judging and I can’t wait to read about all of the good work that is going on. We need to make a concerted effort to challenge the negativity in the press and celebrate and share our successes. #careaboutcare

 

Karen Hedge

National Director

@Hegeit

Weather blog: Carers brave the elements

Guest post from Claire Samson, Supervisor, Carewatch Ayrshire

Winter 2017/2018 has proved to be a challenge for many due to severe weather conditions.  At the end of February, Mother Nature dealt a blow by way of:

“The Beast from the East” 

Seemingly unequipped to deal with the heavy snowfall, which had been forecast for weeks prior to the event, the country almost came to a standstill with many companies closing early to allow staff to get home safely. Some closing due to not being able to receive deliveries. Schools and local services all closed down for Health and Safety reasons.

One employment sector, however, carried on regardless. 

HOMECARE

A wee bit of snow did not deter the carers from the Ayrshire branch of Carewatch, who fought their way through the storm to ensure that care was delivered to North and East Ayrshire’s most vulnerable people.

Carewatch Care Staff abandoned their cars (safely), donned their wellies and waded through the sometimes knee-deep snow, in order to reach their clients.  With some carers walking in excess of 20 miles over the course of a day, to ensure that they carried out personal care, prepared meals and gave important medication to some of the country’s most vulnerable and elderly people.

All Hands on Deck

Management staff and Supervisors all mucked in as the company adopted an “All Hands on Deck” strategy. Calls were made to clients offering them reassurance that their visits would be carried out, although, their care staff may be running late due to the weather conditions.  The office kept in regular contact with the community carers to make sure that they were managing ok, and where possible, supervisors and response staff assisted to cover some of their visits, and helped to get them to and from different areas, which were barely accessible by car. 

Every effort was made to ensure that care staff, as well as the Service Users, were safe and comfortable as they endured the weather. In one Ayrshire area, a supervisor walked almost a mile carrying a bin bag full of wellies and thick socks, which the company paid for,  to give to the care staff as the conditions worsened.  Ironically the local welly shop was closed as their staff were snowed in at home. Thank goodness for the Home Hardware store.

Staff all kept their sense of humour throughout. A couple of snowball fights here and there, and even taking over an Igloo built by the locals – well at least it would have came in handy if the carers got stuck overnight. Not to forget the good exercise for those of us who were still trying to shed the Christmas weight. Walking through snow gives 5 times the impact of regular walking. All in all, a good job done by everyone involved and it shows the dedication and continued hard work of care at home staff, and it just goes to show -

The Beast from the East

Couldn’t defeat

The Best from the West!!

Who Cares if it’s Snowing?

Recent days in Scotland have been rather cold.

Now there is an understatement. 

It will come as no surprise that the weather has been extremely challenging for people right across Scotland. In several places, snow has been measured in feet rather than inches over the past week and this has had a huge impact on the transport and connectivity links that we normally take for granted. During this time countless people involved in care home, care at home and housing support have gone above and beyond to deliver care to those who are most vulnerable. Below we've gathered some stories of just what it has been like at the sharp end of the weather for those in the care sector. 

Guest Post from Annie Devlin, Care Assistant (Bluebird Edinburgh)

The snow is nearly all gone now on the street where I live. Just a few patches of compacted ice here and there. They'll be gone soon too. The thaw is nearly complete.
It was a different story over the last few days. Tuesday and Wednesday last week the skies opened and deluged the majority of Scotland with the white stuff. Here in Edinburgh the snow came down thick and fast, and the Amber Warning issued by the Met Office was upgraded to Red, soon the buses would stop running.
As Home Carers we still need to get to the homes of the vulnerable people we look after. Medications need to be given, continence pads must be changed, food and drink are essential. We have obligations.
Driving conditions were difficult and getting worse. I keep a bag of grit in my car. A handful or two in front of each tyre and wheels that had been uselessly spinning grip and move. A shovel (admission: I was using a dustpan) can dig away deeper snowfall at the roadside where the car has been parked. I lost count of the number of times members of the public came to my and my colleagues aid with a much needed push. There's nothing like extreme conditions to bring out the best in people.
But Thursday morning on the street where I live was different. 6:30 am and I was the only one up and about. The snow was so thick. I dug my car out but only got a few feet and got stuck. So, wellies on, overcoat, hat, scarf, gloves, and as my mother would have said, it was down to ‘Shank’s pony’. I set off on foot.

Guest Post from Jim Gatherum, Dumfries and Galloway Scottish Care Branch Chair

Our care home (Notwen House) is a small (24 bed) care home in the east of Dumfries and Galloway, situated between Lockerbie and Gretna.

We are situated in the very small village of Kirkpatrick Fleming and many of our staff team live in very remote areas, some on farms or in isolated locations.

The past few days have been very challenging for our Care Manager John Whitehouse as the extreme weather has caused significant challenges in terms of staff getting into and back from work- some travel over 15 miles to get to us.

On the morning of Wednesday 28 Feb, Gillian (our carer worker with 15 year’s experience in care) finished her night shift and set of for the 15-mile drive home. Along the way the snow intensified and she eventually had to abandon her car on the A7. This was a stressful and frightening experience for Gillian but despite this she was back on shift on Wednesday and Thursday nights – turning up 1 hour before each of those shifts were due to start -"so I am not late". Furthermore, Gillian volunteered to work extra shifts over the weekend to cover for sickness.

When  it became apparent that the weather conditions were proving to be extremely hazardous, we were independently approached by two local small businessmen who offered to collect staff and take them home at the end of their shifts. Neither knew of the other's kind offer and neither wanted any form of remuneration. Indeed, the snow was so bad on Wednesday evening that Graham’s (one of the local businessmen) 4x4 vehicle became stuck in the snow when collecting one of our care staff and he had to call out 2 of his men and tractors to pull them out. These kind volunteers have continued to venture out in all weathers to ensure we have a full staff compliment to be able to support the vulnerable old people in our care.

Lastly Kerry, another of our Carers, lives on a farm in Dumfries & Galloway and was due to work on Saturday evening and Sunday morning. Her house is surrounded by drift snow – some as high as 4 feet. She has a very young family but this did not deter her. Kerry developed a plan whereby her husband transported her by quad bike over several fields to meet with the aforementioned driver to take her into work. She offered to bring an overnight bag and sleep over so that she could be at work for 7am on Sunday morning.

Without real heroes, such as these we simply would not be able to continue to offer our frail and vulnerable residents the highest possible level of support – with the support of these heroes and the many other staff who have worked 12-14 hour shifts to ensure we have a full staff compliment at all times, our residents can look outside and enjoy the winter scenes and not have to worry about who is going to care for them.

Latest blog from our CEO: The fallacy of failing social care 

The Scottish Budget was passed by the Scottish Parliament yesterday evening. So that’s it over for another year. The chance of smaller political parties to get their pound of flesh from a minority administration has passed over the yard arm.

And what’s it done for social care in Scotland? Well pathetically little.

Admittedly we got our £66million, which is amongst other things supposed to cover the increase in the Scottish Living Wage, the effect of changes on sleepovers, Free Personal Care increases and the start of the Carers Act. Mind you last year we had £100 million allocated for the Scottish Living Wage which had then just gone up by 20p- but it’s amazing what £66million is going to stretch to given it’s a 30p increase this year! That’ll be one to watch!

But I don’t want to just dwell on the Budget because no doubt I’ll be back talking about the back of a fag packet economics of it all at a date in the not too distant future. What I want to talk about is that I’m scunnered and getting really quite angry at the whole charade.

I’m scunnered at what feels like standing in the middle of the public square with a begging bowl each year calling for extra funding for some of our most vulnerable watching out for a passing MSP who might hear the need for serious investment in care.

I’m scunnered at saying we need a dramatic serious investment – I called for a third of a billion in December and we got £66million and at the time I was made to feel as if I was dreaming of Utopia rather than the socially just and human-rights based country that I thought I was a citizen of.

I’m scunnered that there seems to be no real debate despite political rhetoric that admits that the sums are simply just not adding up – and that’s a lesson in the arithmetic of austerity that people who are today grabbing 15 mins of rushed care rather than being treated with respect and dignity have learnt only too well.

But I’m also angry…

I’m angry at the wasted opportunity of having a grown up non-partisan political debate about what is the real and not the affordable cost of rights-based dignified social care and not the system we have at the moment where eligibility makes social care the preserve of the few and not the requirement of those who need it.

I’m angry that a week after the Kings Fund published a major report offering a range of proposals for the funding of public social care in England, no political party north of the Wall seems prepared to look beyond the next ballot box to think seriously about how we are going to pay for care into the future, what system will fit us and how we are to create equity rather than accidental access.

I’m angry that we seem to spend so much of our time hiding behind data to show that what we are doing is making an apparent difference to the health and care experience of our fellow Scots, and that we engage in a self-congratulatory back-slapping of what’s going well. Let us hear the good news stories but let’s not pretend everything in the garden is blooming!

And I’m angry that despite the rhetoric of prevention and self-management we are still dominated by the sacred cow of the NHS against whom no critique should be offered and are thus failing to address the fact that we need to transfer resources from the privileged few in that system to the majority in communities who experience inadequate social care provision.

So yes, the Budget may be over for another year but for goodness sake let’s not be here next year arguing over scraps for a crumbling social care system where the word ‘crisis’ is already beginning to sound empty and hollow. Let’s start to work together to transform the woefully inadequate funding and priority given to social care. And that means we all of us have to take charge and control and start talking up the critical importance of social care.

Social care should not just be for an election debate or a budget negotiation – it should be the central characteristic of the society we wish Scotland to be.

 

Dr Donald Macaskill

@DrDMacaskill

 

Latest Blog from our CEO, Donald Macaskill

Love is all around…

The 14th February has become synonymous with love and depending upon your perspective it is either a day for the purchase of over-priced red roses or a day of true romance.
It’s a little known fact that some of the relics of the famous St Valentine, whose day it is, lie in a church in the City of Love. Paris? Rome? Venice? I hear you suggest but No – Glasgow. St Valentine is (at least in part) resting in the unlikeliest of places – in the Church of the Blessed Duns Scotus – in the Gorbals, a part of the city once synonymous with gang violence and searing poverty.

Just like any relationship, expecting the unexpected and challenging stereotype are probably two useful characteristics for this St Valentine’s Day. In that light three stories struck me in the last week that have relevance and challenge for the care sector. They are each about relationship and value, about human contact and dignity.

The first was the news of the growing challenge of loneliness facing our population.

In a world which presupposes relationship as being intrinsic to well-being it was noticeable that last week saw the launch in Glasgow of research by the National Campaign to End Loneliness which found that of the 15,000 older people in the city, it is estimated that 10% can go days or weeks without having any contact with anyone. It is stated that loneliness and its impact can have such negative health determinants that it is the equivalent of smoking fifteen cigarettes a day.

With over 1.4 million in the United Kingdom reported as being lonely, the issue has not surprisingly become one of great significance with both a Scottish Government Strategy and a UK Minister with responsibility for loneliness to name but two political responses.

With around 7.7 million people living on their own, of whom around 2.2 million people are over 75, the issue of loneliness is likely to become of even greater prominence.

But I for one have become increasingly uneasy with some of the loneliness narrative. It is certainly important that as individuals and communities we should try to include, involve, engage and enable participation and contact. But we also have to be careful that we don’t develop some reverse morality when faced with such loneliness data.

Being on your own is not intrinsically negative and much of the recent debate has ignored the benefits of solitude. There is a world of difference between social isolation and forced loneliness over which you have no control and which you do not desire, and the reality for many which is a decision to be single and alone. Have we lost the capacity and ability to be alone? There has been an automatic presumption of the negativity of aloneness in much of the consideration of these issues. What we need rather is a serious debate about what loneliness is and what interventions are needed, which will be beneficial for both the individual citizen and society as large. I am not convinced our sometimes guilt-ridden knee-jerk reactions have developed such maturity.

The second insight from last week’s media came from a disturbing report from the Leonard Cheshire charity. This research is not unrelated to the issue of isolation and loneliness we have just considered. The research undertaken as a result of a Freedom of Information (FOI) request has shown that a third of Scottish councils commissioned 15 minute visits for the provision of personal care in 2016/17. This has meant that over 5,000 Scots were being subjected to the degrading practice of flying visits. At least 5,182 people received personal care visits of 15 minutes or less for support with intimate care, based on data from councils that responded to the FOI request.

Freedom of Information responses from councils in Scotland found that one in three – 31% – were commissioning 15 minute visits for the provision of personal care in 2016/17.

For many individuals receiving support at home, 15-minute personal care visits barely allow for tasks to be completed, let alone to develop a positive relationship between the individual and their carer.

Given that in January, the Scottish Government’s Minister for Social Security Jeanne Freeman launched a consultation and draft strategy on isolation and loneliness, highlighting the link between loneliness, poor physical and mental health, one might ask what benefit such short, task-oriented visits are making. They do little for effective mental well-being but then given the Mental Health Strategy hardly mentions older people its maybe not a surprise that there is a priority on loneliness but not on some of the causes of it.

Leonard Cheshire’s Director for Scotland, Stuart Robertson said:

“These damning figures show that many vulnerable people are being failed by the social care system… We have to urgently address this scandal and ensure people receive the person-centred care they deserve. No one should have to choose between going to the toilet or having a cup of tea, and this practice must come to an end.”

I couldn’t agree more with Stuart Robertson and Scottish Care has called over a long period of time for an end to the shame of short time and task oriented visits which leave no room for dialogue and dignity, never mind conversation and relationship. It is really sad that on a day we are celebrating love and relationship, for so many their only opportunity for exchange and interaction is reduced to a fragment of time.

The third media story I remember from last week was the report that the well-known and formerly respected broadcaster Jeremy Paxman, told an audience last week that he is in favour of removing the vote from anyone over the age of 65. This is somewhat ironic in the week we celebrated the 100th anniversary of woman’s suffrage.

Paxman’s easy dismissal of the contribution and role of the over 65s is indicative of the acceptable ageism that is all too prevalent today. Paxman states that the elderly have done very well out of life and that they are now using their voting power to ensure that they, rather than young people, are getting the best out of the state.

On St Valentine’s Day love has surely to be for more than a Hallmark day. A society where loneliness becomes a political policy priority, but not where the same political system is prepared to allocate resource to address the issue is less than it should be; a community where contact is reduced by the arithmetic of affordability does not in any sense value those who it should care for; and a place where older age is considered to be beyond contribution – such a society needs to rediscover the essence of a love and regard for others, which can’t just be for one day.

Donald Macaskill
@DrDMacaskill

Guest Post from Local Integration Lead, Ivan Cornford

2017 saw Angus Health and Social Care Partnership provide funding for care home staff to attend a series of learning and development days. Staff were able to hear speakers on a variety of subjects including – UTI Prevention; Well Being in Dementia Care; Adult Protection; Maintenance of Hearing Aids and Management of Chronic Pain. Events were held locally and care homes sent staff within their own locality. Having secured funded places I felt sure that this would be of interest to all care homes in Angus and the majority of care homes took up this offer. Sessions involved presentations from a range of services. Interestingly, those people who previously had had little contact with care homes would remark on the enthusiasm and knowledge of care home staff.

After the sessions, homes developed action plans for change and then reported back to session presenters as to how they had got on. Many of the homes came up with well thought out plans but for me one home stood out.

The staff of a small home in Carnoustie rose to the challenge and the range of actions was inspiring – from developing posters for families on over use of antibiotics to starting up a “relax shack” for supporting people with chronic pain. Time and again they would come to follow up sessions with their new ideas and brimming with enthusiasm for further knowledge which they would then use to improve the lives of the people in their care.

I would like to say well done to the team at Braehill Lodge in Carnoustie – at a time of worry and concern over funding and the future of care homes they have taken advantage of opportunities offered.

For 2018 we are going to continue our development days but in a different format making full use of new technology in an effort to make the sessions more accessible across Angus. I suppose the message here is to take the opportunity and try to use it for improving the lives of people living in care.

 

Ivan Cornford,

Local Integration Lead, Angus

Latest Blog from our National Director, Karen Hedge

Since I started at Scottish Care I have noticed a change in the advertising feeds that show up on my computer. Clearly some algorithm has assumed that my interest in health and social care, and the human rights of older people is because I have aged significantly in the last 6 months (mind you, given what I have seen by way of pressures on the sector, there could indeed be some figurative truth there).

It has been an interesting experience to see aging through the eyes of an advertiser. Many of the photographs contain trendy looking silver haired ladies – ‘move over sage and beige, grey and black are where it’s at’. The women smile back at me with a confidence that I could only have dreamt of in my twenties. They have seen, and quite possibly, done it all.

But as the products move from beauty and adventure to assistive, there is a marked change in the photographs. The face vanishes to be replaced by hands. Oh so many wrinkly hands. Or backs, they are popular too.

The philosopher Levinas describes the face as “Living presence”, the Oxford Dictionary defines faceless as “remote and impersonal”. Whilst there is countless research into the reasons behind this de-personalisation, and campaigning to refocus the lens, the reality remains that the portrayal of older people in advertisements is often the opposite of presence. It is absence.

And whilst it may be a reaction associated with ignoring the stark reality that will affect us all, surely this is a point where we should afford ourselves some dignity.

Perhaps then it is of no surprise that theme of absence is what I also see the social care sector battling with.

In my final blog of 2017, I raised a thank you to our partner organisations for our invitation to the table, but this is still work in progress – the independent sector have representation at only 7 out of 32 IJB’s. I also asked our partners to listen. If presence is only notional, then there will be no useful impact. Without our voice, it is not possible to properly map and evidence the landscape of the health and social care sector as a whole. Without that map, it is not possible to commission or deliver effectively.

At yesterday’s Scottish Evidence Summit hosted by the Alliance for Useful Evidence and Iriss, everyone was asked to take away an action – mine is to tackle that disconnect between evidence and implementation. The health and social care sector as a whole needs to incorporate our evidence and make it real and applicable, and, have the bravery to follow through with necessary action.

So, let us stand up proud of our contribution to the sector – social care is so often the buffer for health care, it seems obvious that they need to be considered in totality.

And with that, let us stand up proud of aging – 2018 may be the year of the young person, but do not let that distract us from the bigger picture. Young people will get old too.

Greater presence and indeed prescience of aging and older people should bring greater presence and prescience of the sector, so let’s ban those faceless photos, and raise our voice in a manner that will be heard.

Guest Post from SDS National Lead (seconded), Carlyn Miller

Plans, plans, perseverance and pies

I’ve landed the New Year blog post which seems like a terrifying opportunity to reflect on the previous year. Where did it go? If I close my eyes and think back I  find vague memories of being on trains; of starting a new job; of a whirlwind of new people; of meetings, of minutes, of work plan after work plan; of avoiding going to the gym; of late nights typing reports; of panicking over panel discussions I’d somehow ended up on; of strong coffee and then suddenly of Christmas, of Jackie Bird and a bombardment of instagram “My year in photos”,  New Year engagements and steak pies.

Now it’s 2018, no more steak pies for anyone apparently. Only kale.

This change in year means that I’ve been on secondment to the Scottish Government Self-directed Support Policy team for 10 months, full time for 7 of these. It’s been such a steep learning curve for me, being totally new to the inner workings of government and probably too comfortable in the self-managing ways of Scottish Care. There’s now a work plan of a work plan of a work plan, a sub group of a sub group of a sub group and the most challenging part…Blackberry phones? Seriously though, I thought they were discontinued 10 years ago?! It’s a whole new world. But being here has been and continues to be absolutely invaluable to my learning and development and similar to being at Scottish Care (had to put that in there!) I’ve met so many hugely hard working and passionate people

Looking back, at the end of my Scottish Care Self-directed Support project which looked at the uptake of SDS for older people, I’d be lying if I didn’t admit that I was exhausted, de-motivated and missing seeing the impact of my work. It wasn’t like teaching where I could relax at the end of the day as I saw the kids progress. The light bulb moment where a small Korean child finally understood rock, paper, scissors or something equally as valuable- these didn’t seem to be there anymore. Self-directed Support was too huge, there were too many barriers. I lost the enthusiastic, idealistic, passionate person I was 15 months earlier. I still truly believed in Self-directed Support but I was bogged down in the system blocks, in the lack of awareness, in the blame chain, in the financial climate, in the difficult reality for a lot of people.

When the opportunity for secondment emerged I thought, “YES” I’ll go to the government and I’ll sort it out from there. Nae bother at all.

The End

Except not. Of course. I’m part of a wonderful, passionate team who truly believe in the Act and work their socks off every day (I know, I know, my dad’s already told me that I’ve become a government apologist). But I’m there, my eyes are open to how incredibly difficult this is at all levels. When I worked at Scottish Care, I thought, like many people, the government just need to wave a big stick at everyone and scare them into implementing this properly. Human rights were at stake after all. But it’s slowly set in that it’s not that simple. Waving a big stick doesn’t change mind-sets, culture, systems or the hard realities on the ground for people and for staff. There’s a fundamental question there about what drives people to make something truly happen- I don’t think it’s fear or threat or at least I don’t think it should be.

My role at Scottish Government is communications, working to ensure a shared understanding and commitment to SDS both internally and externally. I’ve accepted that this won’t change the world but alongside all of the tremendous work going on within the sector things are changing. I’d like to use this part of the blog to ask you, the reader, how do you feel about Self-directed Support? In your role, do you feel you/or the providers you support have the opportunity and understanding to make Self-directed Support a reality? After all, it’s not just about Options, it’s about how we see and work with others. If the answer is no, ask yourself what you can do to change that? Yes, it’s massive and requires whole system change but sometimes you have to take the first step even if you can’t see the whole staircase.

As Martin Luther King Jr said;

“Human Progress is neither automatic nor inevitable…Every step towards the goal of justice requires sacrifice, suffering and struggle; the tireless exertions and passionate concern of dedicated individuals.”

I still have days where I put my head on the desk and think, this isn’t making a difference. But then I meet families like the McTaggarts (the part of the blog I’ve been waiting to get to) and I feel inspired about the importance of Self-directed Support all over again. Please watch Grant’s story. This blog is dedicated to him and his family for their time, honesty and chocolate muffins.

Peace, love and perseverance for 2018 

Carlyn Miller

Guest Post from Policy and Research Manager, Becca Gatherum

2018: The year of positivity or negativity?

So here we are… the second week of 2018 and I have already written a report about how strained the social care sector is and why partners need to start listening to us.

This particular report focuses on the sustainability or otherwise of the care at home sector, with survey data from members telling us that 2017 saw half of providers not tendering for Local Authority contracts and 40% handing work back to councils.

Looking ahead to 2018, home care services tell us they are concerned about their ability to continue operating this year.  In fact, only 14% feel confident about their provision this year and nearly a quarter have extreme concerns.

What a way to start to the year.

A noticeable trend over the past 12 months has been the extent to which Scottish Care’s research and statements have gained widespread media coverage in a way that didn’t happen before.  The publication of today’s report is no different, with STV and the Herald already covering it this morning.  Whilst this is a positive reflection on Scottish Care’s ability to reach and influence others, it is probably much more an indication of just how important the issues we raise really are, not only to the sector but to the whole of Scotland and to the health and social care infrastructure which as a whole seems so fragile.  Does it mean people are starting to listen?

This new report comes on the back of the 2017 reports I wrote, which included work to highlight the lack of support for care staff’s palliative and end of live provision (Trees that Bend in the Wind), the impact of the removal of preventative homecare (Bringing Home Care), the growing recruitment & retention crises (Care Home Workforce Data & Independent Sector Nursing Data) and the strain placed on care staff’s mental health (Fragile Foundations).

And coming up in the next few weeks will be the uncertainty around the future of the National Care Home Contract.

This all sounds extremely negative and in many ways it is, showing again and again just how undervalued and under-resourced the independent care sector is.  So is this negativity the theme of 2018?

Well, not entirely.  All these reports also highlighted how many examples of compassionate, innovative care take place in spite of the vast array of challenges. Even today’s report highlights that care services are trying their utmost to continue delivering high quality care and won’t allow their values to be continually undermined by poor contract terms.

A planning meeting that we held last week within Scottish Care highlighted how many exciting projects and initiatives aimed at supporting reform will be undertaken in 2018.  These include work with the Glasgow School of Art on reforming home care and many other proposals in the pipeline which we’ll share through our blogs in the coming weeks and months.

What’s more, there are so many good news stories to be told about care.  Just this week, I’ve been made aware of a relative of a care home resident who wants to recognise the amazing care they received over the 14 years up to and including their death.  I also heard of another service who realised that across 7 of their staff, they had a combined sector experience of 130 years (an average of over 18 years each), so there are still many people who pursue care as a career and love it.

So is 2018 a year of positivity or negativity?  I would contend that it is partly both, but more importantly it needs to be the year of listening, and of acting.

The challenges won’t be solved overnight, not by a long shot.  And the positive work will continue in terms of everyday good care and the learning and sharing of new ways of working.  Both of those things are a given.

What will really make the difference (and determine whether we have a sector to survey next year on their sustainability), is what partners, policy makers and practice influencers do with the messages we continue to give to them – of the real challenges and the real difference our services make.

As we say in the new report:

“We can no longer tinker around the edges of social care – the challenge needs to be grasped with both hands and driven forward by a political will to ensure there are a range of high quality, sustainable services.”

2018 needs to be the year we move past a flurry of media coverage, a wringing of hands and then a return to the status quo.  It simply can’t happen anymore if we want there to be a social care sector.

Scottish Care doesn’t want to be the constant bearer of bad news.  We want to be a positive partner in finding practical and meaningful solutions so that everyone who requires social care can receive the best.  So this year I ask that you listen to us, and act with us, to ensure the positivity outweighs the negativity in social care.

Becca Gatherum

Policy and Research Manager, Scottish Care