Latest Blog from our CEO: Facing up to care reality

Speaking at a fringe meeting of the Conservative Party conference the Social Care Minister Jackie Doyle-Price suggested that people should not expect that the houses they live in should be able to be passed on to the next generation as an inheritance. She said that it should not be seen as the role of the state to pay for our care in old age if we can afford to do so ourselves.

Her intervention has led to the start of a strident debate and media discussion. Language such as ‘dementia tax‘ has reappeared in the political lexicon. Inescapably, however, as I said on the BBC last week this is a discussion we badly need to have in Scotland.

Over the past year Scottish Care has continually articulated a message that the older peoples care sector in Scotland is at a point of real challenge if not crisis. We have a nursing shortage of 28% average vacancies; 9 out of 10 care at home providers are unable to recruit to key posts, and nursing care home providers have recently told me they are paying £1000 for one agency nurse to do a night-shift in some parts of the country. Pressures from growing costs, increased registration and regulatory requirements and increasing levels of clinical demand are pushing providers to the very edge.

Faced with such realities people can react in diverse ways.

There might be a tendency on the part of some to bury their heads and assume things will get better without any strategic intervention. They won’t!
There is an equal tendency to seek to do less for more – however, any short term financial gains achieved by such an approach will soon evaporate as individuals no longer deemed eligible for support become more and more unwell and are put at increasing risk. The reduction in the use of care home placements combined with a lack of adequately resourcing care at home and housing support is a game of care roulette with only one victim, the vulnerable older person desperately in need of support and care.

Another reaction is the desire to reform and change. This is undeniably necessary not least in the way we purchase care and treat older people in a discriminatory manner with regards to choice and control such as through the operation of self-directed support. Equally important is the desire to innovate and re-design but if ‘new models of care’ are viewed as some sort of panacea for our current ills we risk losing creative innovation and care entrepreneurship as fatigue and failure take root. Even with progressive use of technology we aren’t going to find a magic chic of gold at the bottom of the care garden.

Overarching all this is a response which says we are doing a lot anyway, we are doing better than others and that we are spending more than we ever have. All of these might very well be true as is the oft heard statement that we need to transfer resources from acute clinical delivery into primary and community health and social care.

But …
and it is a big but. The fact is we have not robustly undertaken an analysis of whether even with reformed, dynamic, localised, non- institutionalised interventions, there will indeed be sufficiency of financial resource it is difficult not to conclude that there is a substantial inadequacy of resource in social care. That is what frontline staff and providers are telling me up and down the country. In particular as we live for longer and with better health, how will we pay for increased dependencies and an even greater volume of care and health need?

Integration is part of the answer to that puzzle but so too is a serious debate about the mechanisms needed to be able to pay for health and care. We need to collectively have a debate about the ethics of being treated free at the point of care if you develop one condition such as cancer but if you live with dementia there will be a greater likelihood you will have to pay. We need to have a debate about the ethics of inheritance and contribution. We need to start to shape the nature of decisions around personal insurance, income tax, separate taxation for care etc.

And we need to do so urgently. This goes way way beyond our politicians. In no way should the care and support of the most vulnerable be used as a party political football. We deserve better and need to find political and societal consensus, agreement and collective resolve.

The debate is urgent. The decisions are necessary. The desired resolution desperately needed.

In our capital city you can now earn more from being a dog walker than supporting the old in their home to live independently and with dignity.
I’m not sure that is the sort of society most of us would want but that is what is our real inheritance unless we act to change it.

Donald Macaskill


Home Care Day – 25 October 2017

Following the success of Care Home Week in June 2017, Scottish Care is delighted to be launching the inaugural Home Care Day on Wednesday 25 October 2017.

Throughout Home Care Day on, we will be celebrating and raising awareness of Scotland’s care at home and housing support services – the individuals who access this support, those who work in the community and the opportunities home care services offer to enhance lives and improve wellbeing for a wide range of people and to support people to live well in their own homes.

We’ll be celebrating different elements of home care life each hour:

  • 9am – Good Care
  • 10am – Prevention
  • 11am – Extraordinary Lives
  • 12pm – Vision
  • 1pm – Workforce
  • 2pm – Commissioning
  • 3pm – Palliative and End of Life Care
  • 4pm – Politics & Policy

This day is an opportunity to share good news stories and promote the positive things that services and their local communities are doing.

What we would like from you…

  • Short blogs/good news stories/examples/resources from:
    • Individuals and families who are supported by home care services
    • Home care providers and workers
    • Organisations and individuals who are engaged in home care development and delivery
    • Partner organisations
  • If you’re on Twitter, use the hashtag #homecare17
  • Spreading the word!

Please feel free to download and share the Home Care Day flyer.

Any individual, organisation or sector body is welcome to join us to celebrate this week - we'd love to hear from you!

Please feel free to give Becca Gatherum a call or email to discuss any aspect of the day, or if you’ve got something you think would be good to share – 01292 27040 / [email protected]

Scottish Care CEO calls for changes in the way we commission care

Dr Donald Macaskill was interviewed  on BBC Radio Scotland’s Good Morning Scotland programme following the showing in BBC’s Timeline programme of two carers who spoke about the struggle of working within 15 minute care packages. Dr Macaskill argues for the need for us to move from a ‘time and task’ purchase of care towards a relationship-based, time-flexible model.

The interview can be heard at 1 hour 7 mins at


Grab Life with Both Hands: final Directed by North Merchiston film now available

The fifth and final in a series of short films, made with the collaboration of the residents at North Merchiston Care Home, is now available online.

The Directed by North Merchiston films have been made in partnership with the residents at North Merchiston Care Home. Lead by award winning documentary film maker Duncan Cowles, each resident was encouraged to take control of the filmmaking process and decide upon the direction and what content they’d like to be included and focussed on within the films.

The films were commissioned through Luminate Creative Ageing Festival in association with Scottish Care.

This film, entitled Grab Life with Both Hands stars Margaret Henderson, a resident of North Merchiston.

Grab Life with Both Hands

Each of the residents' films - May, Charlie, Edith, John and Margaret - have now been made available online.

Please feel free to share this information and the films more widely. We'd also love for you to share your response to them through Twitter at @scottishcare or @DuncanCowles

For more information, please visit:

It’s Always Nice to be Needed


The third ‘Directed by North Merchiston’ film is now available online.

Directed by North Merchiston is a series of five short films, made with the collaboration of the residents at North Merchiston Care Home. Lead by award winning documentary film maker Duncan Cowles, each resident was encouraged to take control of the filmmaking process and decide upon the direction and what content they’d like to be included and focussed on within the films.

The films were commissioned through Luminate Creative Ageing Festival in association with Scottish Care.

This film is entitled “It’s Always Nice to be Needed” and focuses on 90 year old Edith’s ode to her grandmother.

It's Always Nice to be Needed

Each of the residents' films - May, Charlie, Edith, John and Margaret - will be made available online on consecutive Mondays between 20 March and 17 April.

Please feel free to share this information and the films more widely. We'd also love for you to share your response to them through Twitter at @scottishcare or @DuncanCowles

For more information, please visit:

Five Nations Care Forum issue Statement on Severe Underfunding in Social Care

Following a meeting in Scotland, the Five Nations Care Forum is calling for remedial action to the severe underfunding of the social care sector.

People are living longer, often with more complex needs, and demand for care is increasing all the time.

At the same time, the funding of social care across the five nations remains wholly inadequate. This has resulted in serious constraints on the delivery of social care services to individuals who need state support.

We know that these people want reliable, sustainable services, delivered consistently by people known to them who understand their needs, preferences and aspirations. The current funding shortage has a number of negative impacts:

  • State funded support being delivered too little, too late, meaning that opportunities are missed to support people in a way that anticipates their current and future care needs and prevents them receiving inappropriate support
  • People being admitted to hospital unnecessarily and remaining there too long, resulting in negative impacts on individuals’ health and wellbeing, delays for those who do require hospital support and additional costs being incurred by health services
  • Staff shortages resulting from low salaries and poor terms and conditions
  • Providers of social care withdrawing from the market, causing changes in or complete removal of support to individuals who require it
  • More individuals and their families having to bear the cost burdens and physical, emotional and time outlays of providing care, which will stack up problems for the future.

This is not acceptable for a civilised society – it does not adequately support people’s rights and interests, and undermines the dignity, value and worth of people who need care and support.

Social care is a sector of national strategic importance; being a major employer, providing essential support to individuals and families, and enabling family carers to remain economically active.

The Five Nations Care Forum calls on the five governments to take urgent corrective action to protect people’s rights and to ensure a sustainable social care sector now and for the future.


The Five Nations Care Forum is an alliance of representative independent sector care organisations across England, Northern Ireland, the Republic of Ireland, Scotland and Wales.

The Forum meets twice annually, providing a platform to discuss and inform practice in each administration, challenge and share successes.  In doing this, the Forum also seeks to identify opportunities for cross-country collaboration and learning where this will be of value to service users and citizens.

The Five Nations Care Forum met on 27-28 March 2017 in Edinburgh, where this statement was agreed. The meeting was attended by representatives from:

  • Scottish Care
  • United Kingdom Home Care Association
  • Care England
  • National Care Forum
  • Care Forum Wales
  • Independent Health and Care Providers (IHCP) Northern Ireland
  • Nursing Homes Ireland

For more information, please see:

Self-directed support systems – Mind the gap

The Scottish Social Services Council (SSSC) is to hold a free workshop to discuss a whole systems approach to self-directed support (SDS) implementation.

Can taking a whole systems approach work? What resources would the health and social care sector need to help to engage in whole systems thinking? You are invited to explore these questions.

In the continuing Adventures In Systems (AS IS) series of workshops the SSSC welcomes Julian Corner from the Lankelly Chase Foundation

Julian will explain whole systems approaches and help to consider how this might work from an SDS perspective. The workshop will give participants the chance to think about what’s happening and working well now in their services and how thinking at a systems level can help to improve future collaboration. The workshop will also discuss what resources workers and organisations need to support systems thinking.

We will hear from our colleagues in the Living Well in Communities Team at Healthcare Improvement Scotland about how they are working to support system change in Scotland.

This event is for people working in any part of the health and social care system including: commissioners, finance staff, procurement staff, policy officers, risk compliance officers, legal officers, social workers and their managers, service providers, support organisations, people who use services and their families and friends.

The workshop is free although places are limited so please book early. Lunch and refreshments will be provided.

Please click here to confirm your place.

Effective Leadership in Dementia Care

The University of Stirling is to hold a two-day course designed to develop effective and efficient leadership in dementia care.

Strong clinical leadership is arguably the hardest of all roles to embed in an improvement culture. Yet leadership plays such an important role in the care of people with dementia.

Historically, emphasis has been placed on management style and strategies as opposed to leadership. But there is a difference. Often, health and social care systems are over-managed and under-led. Leaders need to have the capacity to influence others, to inspire and articulate their vision to move the workforce to the end goal.

Dr Kevin Hope, Honorary Professor at the University of Stirling and DSDC Associate, explores the importance of leadership in the workplace in this blog.

DSDC’s new programme, Effective Leadership for Dementia Care Services, addresses the important topic of leadership and dementia care. Aimed at Front-line Leaders and Operational Leaders, the course explores a range of relevant information aimed at developing leadership skills will help to identify what characterises good leadership and its associated traits and behaviours.

The course, which takes place on Tuesday 4 and Wednesday 5 April, provides an important opportunity to network within and beyond dementia communities, including the potential to liaise with and gain support from other like-minded people who have undertaken this programme of development.

Please click here to confirm your place.

Scotland’s Dementia Awards 2017 – Entries Open

Scotland’s Dementia Awards celebrate and recognise projects and the people behind them who are going the extra mile to support people living with dementia and their families across Scottish communities.

Entries are encouraged from teams and projects that support people with dementia to enhancing the health, wellbeing and experience of people with dementia and their families, and from those involved in the education of these communities and sectors.

From the Scottish Borders to the Highlands and Islands, all entries are welcomed.

There are 6 categories to enter; –

• Best Acute Care Initiative,

• Best Community Support Initiative,

• Best Dementia Friendly Community Initiative,

• Best Educational Initiative,

• Best Innovation in Continuing Care,

• Most Innovative Partnership.

By showcasing creative approaches from policy to practice, the awards recognise the country’s most innovative and ambitious projects, celebrating the passion and dedication of those who work to support people living with dementia and their families in services and projects up and down the country.

Entries close at 5pm on 31st March 2017. For more details and to enter your application visit

The entrants that make it to the shortlist of Scotland’s Dementia Awards 2017 will go on to attend an awards ceremony held at the Glasgow Marriott Hotel on 21 September 2017 – World Alzheimer’s Day.

Scottish Care launches Care Home Survey

Scottish Care has decided to undertake a survey of the nature and extent of the current status and challenges facing the Care Home sector in Scotland.

We are aware that we are undertaking this research in the midst of ongoing discussions and negotiations around form. However the information and data which we are asking for will be invaluable in evidencing the status of the sector and the issues of concern and priority.

This is a major piece of work which will form the basis with other research for a Report on Care Home services in Scotland. This report will be published as soon as practicable.

The survey explores issues such as workforce challenges, including recruitment and retention; financial and operational sustainability and wider stakeholder relationships

The survey can be accessed at

The survey closes on the survey by the 10th March