Since the last update it has become increasingly clear that we are witnessing in many parts of the country a determined assault by the public sector on non-statutory providers of social care and support. At a meeting of the Scottish Care Executive this past week it was agreed by all that Scottish Care officers and staff will start to adopt a much more robust approach to what we are seeing and to challenge where possible (and strategically helpful) some of the practices we are seeing. These affect both home care and care home services. I want to update you here on both what we are seeing and how we plan to and have started to respond.
Homecare
What we seem to be witnessing is two broad approaches – one is to bring services in house and the other is to engage in a radical review of packages. Both are being defended as seeking the best outcomes for clients and as being evidence of best value for money. North Ayrshire is the authority which has gone the furthest in that they have informed independent providers that after June all home care will be brought in-house. In response to this action and what we consider to be a clear denial of the statutory rights of individuals we issued an extended media release on Friday – it is contained at the end of this update. We will also engage in a similar exercise, emphasising SDS, removal of choice, failure to develop the market and ethical commissioning wherever we see evidence of such practice.
The other approach which is the withdrawing of packages of support is evident in East Renfrewshire and elsewhere. Again, we will work with local providers to address these concerns in a publicly robust manner. I have already spoken to media contacts around what could be done to raise some atrocious practices which are making people highly vulnerable.
In addition, we are preparing a Freedom of Information process in which we will ask every partnership to publish the cost of care at home. We are very aware that these exercises have occurred before and have not resulted in the change we wanted to see, so we are taking a bit of time to frame the request properly so that all costs are captured.
I want to assure our members that whether through media, FOI, or direct contact with COSLA, Partnerships and Ministers that we will continue to raise the very serious issues we are coming across.
Care Homes
Members will be aware that the majority of care home providers have accepted the offer from COSLA/Scotland Excel. This does not remove issues of sustainability and we are very aware of the large amount of debt that is being carried by both care home and care at home providers because of late payments from local authorities or delays in assessments, or back-dating assessments.
We are going to undertake a survey of all members in the very near future to get some information for each Partnership area around the level of debt owed to members.
I find it quite shocking that there have been extended delays – in some cases for up to 6 months of tens of thousands of pounds.
After we have undertaken this survey, we will publish results (all anonymously but directed to each Partnership) to raise public and political awareness of the fact that organisations are being pushed to the edge of sustainability in part because of the lack of cashflow as a result of late payment and bad debt.
When the survey concludes the Executive will also consider whether we should all collectively charge interest for such debt and late payment.
We also hope to have our independent True Cost of Care Model available at the end of the month. At this stage we intend this to be available to all members, but also published for commissioners, politicians and the public to better understand the costs of residential and nursing home provision.
International recruitment.
Many members will have taken part in our quick survey on the extent of international recruitment in the sector. We hope to publish the findings of this in the week ahead, using three areas as a case example. On Monday coming, the 11th March, we will have the date at which individuals will no longer be able to be joined by their dependents. Having this past week spoken to colleagues in England, we are all collectively concerned about what impact this may have on existing staff to say nothing of the early evidence that this is already impacting on recruitment and attraction. Members may have seen the piece on STV News yesterday evening.
We will engage with Scottish Government officials, ministers and COSLA after the research is published. At this stage it would appear to indicate that between 10 and 15% of all staff in social care services in the country come from the international community, with high levels of variation in different areas.
Covid Inquiries.
I held a further meeting with the Counsel to the Scottish Inquiry a couple of days ago. Karen and I have both been cited to appear and give evidence before the Inquiry on the 22nd March.
Care at Home and Housing Support Awards
It has been decided to extend submissions for these Awards by a further week until Monday 18th March. I know it is very challenging to even consider filling out a form when services and supports are so fragile and at risk, but this is our one national opportunity to both put the sector into the shop window and to elevate the amazing work undertaken by the forgotten workforce in our communities. So please consider nominating folks and putting forward a submission.
Find out about the awards and enter here.
Care at Home and Housing Support Conference and Exhibition;
We’re thrilled to announce that early bird tickets for the highly anticipated Care at Home & Housing Support Conference & Exhibition 2024 are now available! This year’s event, themed “Care Revolution – Time to Act” will take place on Friday, 17 May 2024 at the Radisson Blu Hotel in Glasgow.
This is an exclusive opportunity to secure your spot at a discounted rate! By booking before 5:00 pm on Friday 29th March 2024, you’ll not only guarantee your attendance but also save on ticket prices.
This will be a different style and very participative event so please look at the programme and buy your tickets. See Care at Home & Housing Support Conference 2024 – Scottish Care
State of the system
General picture:
The general picture remains positive regarding Covid and there has also been a weekly reduction in influenza cases. I am intending that this is the last fortnightly report which will carry this data unless there is significant change to report.
Data for the week to the 3rd March on the PHS database indicated that there were 98 people admitted to hospital described as acute Covid admissions. This was slightly up from 91 a week before. This meant that there were 137 people in hospital with Covid19 on the 3rd March compared to 149 the week before.
There is evidence of a decrease in influenza with a 13% decrease in cases across the country. In the week to 3rd March there were 165 admissions to hospital which was down from 214 a week before.
According to data from NRS for deaths to the 3rd March there were 22 deaths involving COVID-19 in the preceding week.
The Care Inspectorate reported that for the week to the 3rd March there was 1 death of a resident which was Covid or suspected Covid. This was 0% (statistically) of all deaths. In terms of the number of care homes with suspected cases in the week to the 5th March there were 16 compared to 17 the previous week, and this is 2% of all homes reporting.
Covid absence amongst care staff for the homes which reported to the week ending the 5th March was 19 which is 0.1% of the workforce from those 61% of homes which reported.
Surgeries
The next Surgery will be held on Thursday 14th March at 1.00 pm.
And finally, …
On Tuesday I continue to light the weekly #candleforcare with a different focus each week. Please join me in lighting a candle every Tuesday at 7pm to keep issues of care before folks.
This CEO update will next appear on Saturday 23rd March 2024.
Many thanks
Donald
Media Statement: Concerns over North Ayrshire Homecare Support
Scottish Care Media Release
Scottish Care voices concern over North Ayrshire homecare support
Scottish Care is the representative body of care at home providers who are charitable, not for profit, private and employee owned. Our members deliver most of the care and support for adults and older adults right across Scotland. As an organisation we very rarely make public comment on local actions, but we find ourselves unable to remain silent about what is happening in North Ayrshire at the present time.
In a recent statement North Ayrshire Health and Social Care Partnership (NAHSCP) has stated that they have decided to take all homecare support ‘in house’ and to end the contracts of existing non-Council providers from June 2024.
Scottish Care is concerned that actions of the NAHSCP endangers the care and support of those who are at the moment receiving services in the North Ayrshire area and which in the future will limit the legal rights and choices of residents in the area.
Scottish Care has several major concerns:
- The NAHSCP has stated that their decision to bring all homecare services in house is for reasons of quality and that they have ‘invested’ in this decision. The NAHSCP has not published the costs of in-house services although precedent suggests they will cost more than double the cost of outsourced care and support it is possible therefore that in a time of austerity and service cuts that this decision will result in fewer people in North Ayrshire receiving the care and support they deserve and require, in an effort to balance books.
- Whilst the NAHSCP has sought to reassure individuals that they will have the right to remain with existing providers and staff, we have no confidence of the independence of information and support being given to people. Will citizens have real choice and an independent support to allow them to make the decision which is right for them rather than what suits the NAHSCP?
- Every person who requires social care and support, anywhere in Scotland, has the right to choose a provider (whether the Council or not) to provide that care. Scottish Care is concerned that in the future residents of North Ayrshire will be denied this legal right. We need assurance from the NAHSCP that they will continue to make available the services of other providers and that they will give independent information about their availability, and that they will comply with their legal duties in terms of the Social Care (Self-directed Support) (Scotland) Act 2013 (SDS Act).
- The SDS Act places a requirement upon a local authority or HSCPs ‘to promote a variety of providers of support and a variety of support’ (sections 19 of the Act). This means that people have a range of providers to choose from. Scottish Care does not believe that anyone (whether a public, private or charitable provider) should have an effective monopoly in any area. The right to informed choice which the SDS Act enshrines requires there to be real choice. How can that be the case if the Council delivers all services? We would like North Ayrshire HSCP to communicate with ourselves and more importantly to the citizens of North Ayrshire as to how they will fulfil their legal requirements and how they intend to ‘promote a variety of providers.?
- Scottish Care also highlights the report on the National Care Service (NCS)(Scotland) Bill (Stage 1), in relation to ethical commissioning. Recommendation 86 emphasises a “personalisation agenda as established within self-directed support legislation, ensuring choice and control for individuals to ensure the best possible outcomes”. This is achieved through a “plurality of provider to ensure that local care meets the needs and preferences of individuals”. Given this, Scottish Care seeks clarification surrounding the NAHSCP’s decision to conflict with the recommendations of the Scottish Parliament’s Health, Social Care and Sport Committee, and the subsequent legislative direction of Scotland in regard to ethical commissioning.
- Lastly, the NAHSCP believes that most of the workers employed by existing providers will want to transfer to their employment. We already know many will not because they simply do not want to work for the Council. This will mean an even greater shortage of workers at such a critical time. Scottish Care would like to know if the NAHSCP has undertaken an equality and human rights risk assessment on their decision especially as it affects the rights of this predominantly female and older workforce. Sadly, we do not believe the rights of frontline workers have been respected.
In conclusion every citizen in Scotland who requires social care and support deserves to be treated in a manner that respects their individual dignity and the right to have control and choice over their lives. The SDS Act came about after years of campaigning by disability and older people groups who were tired of a situation where there was a take it or leave it approach, where people had no choice or control over the social care and support they receive. Scottish Care is very concerned that these hard fought for human rights are effectively being denied by the actions of the North Ayrshire Health and Social Care Partnership. By their actions NAHSCP have taken a step back in time rather than a step forward. Local residents and users of services both now and in the future, urgently need the NAHSCP to answer some fundamental questions.
Ends./
