Radical action is needed to reform home care services to ensure that elderly people are not being denied access to services they would previously have received.
New research by Scottish Care, the representative body for the country’s independent social care services, has found that:
- Tightened eligibility criteria means the number of people assessed as requiring Free Personal and Nursing Care has reduced, and that those who do receive it generally have higher support needs
- This means older people who would previously have received support at an earlier stage for tasks such as housework, shopping and cooking now receive either much less support or none at all
- The commissioning of home care services on a ‘time and task’ basis compromises staff’s ability to deliver personalised, high quality care and support and puts this workforce under a huge amount of pressure.
The findings come from ‘Bringing Home Care’: a new report by Scottish Care which outlines the development of home care services over the past century, the impact of Free Personal Care and other policies, and the role of home care in providing preventative care. It also sets out a vision for the future of home care services
Speaking ahead of Scottish Care’s conference for Care at Home and Housing Support Services today, where the report will be launched, CEO Dr Donald Macaskill said:
“Whilst we fully support the existence of Free Personal and Nursing Care and value its role in supporting people with social care costs, what we have seen since its introduction in 2002 is a move towards less people receiving more care. Whilst this reflects the reality of constrained budgets, it means that many older people are being denied the support they need to enable them to live for as long as possible in their own homes.
“What’s more, delaying or denying someone’s access to care and support is counterproductive from a financial perspective anyway, never mind the negative impact this has on an older person’s health and wellbeing. A lack of appropriate and timely support being provided in someone’s own home or in a care home is likely to lead to more presentations at A&E departments and hospital admissions that may have been preventable.
“That’s why, in this report and at our conference, we will be calling for a reformed approach to homecare which is preventative in nature and values relationships and spending time with people, in whatever way suits an individual’s needs. It is only through this sort of care that individuals can be supported effectively to live at home and the strain on acute services can be relieved.”
The report also highlights that a failure to reform home care will be extremely costly, not only in financial terms but in human terms. It found that:
- Over one third of publicly funded care packages are commissioned for visits lasting under half an hour.
- Even a 30 minute visit means that in reality, an average of only 24 minutes of care can be provided in that time.
- 90% of organisations have difficulty filling support worker vacancies
- One third of total staff leave every year
- Of the support workers who leave organisations, 41% leave within the first 12 months.
Dr Macaskill added:
“The negative consequences of limited funding and time-restrictive commissioning are already impacting extremely negatively on the existing home care workforce.
“Not only are individuals in receipt of support services being denied the holistic care they deserve, which is not rushed or time-pressured, but the workforce who deliver this are being faced with impossible decisions about what care to deliver within such restrictive time and task commissioning. It is no wonder that this is leading to so many individuals leaving the sector or not coming into it in the first place.
“We as a society need to better value the work that these extremely skilled and dedicated care workers undertake, and support them to deliver the high quality, relationship-based and flexible care that Scotland’s older citizens deserve.
“If urgent action isn’t taken, the reality is that there simply won’t be the workforce or services to deliver home care in the future.”
You can follow conference updates at @scottishcare and by following #bringhomecare