Media statement: Care homes warn of fragility of sector, including mental health of workforce

National Care Home Conference

Hilton Hotel Glasgow

Friday 17 November 2017

Pushing the boundaries: care home reform and reality”


Care home operators say more needs to be done to stabilise the care sector to avoid not only a breakdown in the workforce but in the very existence of large parts of the sector.  And unless immediate action is taken the sector has warned there may be a crisis in both workforce numbers and the availability of care home places across Scotland.

The message will be delivered at the National Care Home Conference in Glasgow today (FRI NOV 17) by Dr Donald Macaskill, Chief Executive of Scottish Care, the representative body for the country’s independent social care services. The 450 delegate event, which is sponsored by the Clydesdale & Yorkshire Bank, will see addresses by Cabinet Secretary for Health & Sport Shona Robison and Professor Sir Harry Burns.

Unveiling a new report on mental health – ‘Fragile Foundations: Exploring the Mental Health of the Social Care Workforce and the People They Support’ – Dr Macaskill said that research with front line staff has highlighted just how much strain is on this workforce because of the issues facing the provision of care home support in Scotland, resulting in poor mental health being commonplace.

He said:

“This report tells the stories of the hundreds of individuals who live with mental health challenges and who access social care support, often in old age. It highlights that for many, their mental health needs are not being addressed adequately due to an inherent societal ageism and a lack of adequate resourcing of social care supports.  The report challenges us to do more as a society to recognise, support and care for those who are old and facing mental health issues. It is unapologetic about what appears to be at times a wilful disregard for the mental health needs of older citizens in Scotland.”

“But this report also seeks to describe the experiences of those who work in care at home and care home services and who every day are supporting individuals to live fulfilling lives. It shares the voices of a workforce offering dedicated, person centred care but which is itself struggling to deal with the very real challenges which caring itself brings and who are often struggling to cope.”

Detailing the scale of the problem facing the care sector in relation to its stretched workforce, Dr Macaskill will tell delegates:

“This research further underlines the significant recruitment and retention challenges which are facing both the care home, care at home and housing support sector in Scotland. The impact of effectively losing a third of the workforce each year is being felt both by those who remain in the sector to work and those who are in receipt of care and support.”

One of the biggest problems identified in the report is the levels of physical and mental exhaustion being experienced by the workforce as a result of the time and staffing pressures they face, whilst continuing to strive to meet the diverse and changing needs of the individuals they support.

Dr Macaskill said:

“The foundations of social care are rapidly being eroded. In the name of efficiencies and limited resource, more and more elements are being removed or minimised from social care services and their workforce through commissioning and procurement processes, from the time allocated to visiting clients to staffing levels to training budgets. What’s more, Scottish Care’s previous research has highlighted that many services’ viability is under significant threat. This new research has shown that, to many providers and care workers, the increasing demands and expectations on services combined with the constant stripping out of elements which stabilise a service and allow it to develop means that they are constantly trying to maintain a precarious balance.  It very much feels like a game of Jenga: pull one more piece out, and the whole thing may collapse.  Except this is not a game.  We’re talking about people’s lives.

“This raises questions about how long we can continue to damage the quality of care provided to our older citizens and the mental wellbeing of the crucial social care workforce through the under-resourcing and undervaluing of care services.

 “The voices of care staff heard in this report make for an uncomfortable read. They ask us to challenge the lack of recognition and resource we allocate to the mental health supports of individuals who are often hidden at the heart of our communities. They challenge us to acknowledge just how precarious the system of care and support is at this present time right across Scotland.”

Conference Chair Ranald Mair OBE will also issue a warning of the looming crisis in care provision in Scotland:

“The current national care home contract runs out at the end of March.  As yet there is no clarity about what will take its place. Local Councils and partnerships need to urgently engage care home providers on what provision they require going forward and what the funding arrangements in each area will be.  The current uncertainty threatens to further destabilise the sector at a point when more providers are looking to exit and very few are looking to come in. Against the backdrop of austerity, the challenges of having adequate funding and being able to recruit and retain staff are making providing care home provision a less and less attractive proposition.  The Government, Councils and Health Boards need to get real and put in place a framework which guarantees sustainable commissioning, sustainable funding and a sustainable workforce.  Failure to do so could well result in a collapse of provision across the country.  All parties need to rise to the challenge and use the next 20 weeks, nationally and locally, to create a sustainable future.  The security and wellbeing of over 33,000 residents and over 46,000 staff depends on getting it right.”

You can follow updates from the conference on Twitter at #carehome17

Last Updated on 17th November 2017 by Scottish Care

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