This media statement is being released in response to a number of recent queries.
For the last 15 years Scotland has benefitted from a National Care Home Contract (NCHC) which has provided stability for those organisations who provide care and support in both residential and nursing homes, continuity for those who act as commissioners and purchase care home places for local people and transparency for those who are residents. This stability is very important because over 70% of care home residents are funded by the State and it is the national Government that essentially sets the pay and terms and conditions of the thousands of workers who are employed by charities, voluntary organisations and private providers.
At the moment the NCHC rates for residential and 24/7 nursing care are £838 for a nursing home and £719 for a residential care home. This is equivalent to less than £5 per hour for complex care and support.
The NCHC is renewed annually between Scottish Care which represents providers and COSLA representing Local Government. It is based upon a cost model which is now outdated, but offers transparency, including putting a cap on profit at 4%. Since the model was developed, the role of a care home has changed, now having an increased role in its community, undertaking many of the activities that would previously have been carried out by a cottage hospital. This means that some of the costs cannot be covered in the way that the model would suggest, something that is made worse by the current financial and other pressures.
Over the last few years despite the many challenges facing the sector it has been possible to arrive at an agreement which has enabled the NCHC to continue. This year this has not been possible.
Care home providers are being faced with immense and unique challenges at the present time. The primary one of these relate to the challenge of recruiting and retaining staff. This has been made significantly harder since the Scottish Government funded Agenda for Change settlement which means that from April this year a care-worker in the NHS undertaking the same or similar role as a care home care worker is now being paid over 19% more. In addition, like many other sectors care homes have been faced with crippling cost of living pressures most especially in relation to energy costs which for smaller care homes have resulted in a 500% plus increase. The difference with other sectors is care homes cannot simply put their NCHC rates up.
Faced with these significant pressures we have sadly witnessed the largest number of care home closures the sector has experienced in the last few months and the very real fear is that this will escalate at speed. Unfortunately, it is the small, rural, and remote private and charitable care homes which are not managing to continue operating. This is an especial risk in Scotland where most private providers are small family run businesses.
Since January 2023 COSLA has made two offers which have been rejected by Scottish care home providers. The two main reasons for these are a desire from Scottish Care to pay a minimum of £12 an hour to every care worker, a desire to pay the Scottish living Wage to all staff in a care home who are currently on the National Minimum Wage (cooks, domestics etc), and a requirement to meet the sharp energy and other cost increases.
Scottish Care recognises the immense pressure that local government is under, and we recognise that the offer currently on the table – a 6% increase – is realistically the best that they can offer. However, this will not pay frontline workers the £12 an hour they deserve and address the critical energy and other cost issues. If accepted this will inevitably lead to a huge number of homes closing their doors with all the devastation that brings to vulnerable older residents and loss of employment for staff.
Since April 2023 Scottish Care has been engaged in discussions with the new Scottish Government and with senior officials to seek to address this critical issue. Following the announcement by the First Minster on the 19th of April of his desire to pay staff £12 an hour we have urgently been seeking clarification and a timeframe for this commitment. Regretfully seven weeks on since our discussions started, we are no further ahead. We recognise the stated commitment of Scottish Government, but we now need targeted action. After two further meetings of care home members, we have been asked to make this statement to raise awareness of the urgency of these discussions and the importance of intervention by the Scottish Government.
Our care homes are at a critical juncture. We need to all work together to preserve the NCHC and to ensure continued care and support is possible in a local care home. The loss of the NCHC will result in the closure of many more care homes across the country most especially in rural and remote communities and even more importantly will cause huge damage and distress to hundreds of care home residents.
There is a real urgency to save Scotland’s care homes.