'Staff are not adequately valued or rewarded' in social care

Social care services in Scotland are in crisis and need urgent improvements, the Scottish Government has been told.

The Auditor General for Scotland has warned there are “huge challenges facing the sustainability of social care” and reform “cannot wait” for the Government to set up its National Care Service.

Problems include rising demand for social care and the “fragility” of the workforce, which is often undervalued and underpaid, according to the stark report.

The joint briefing from Audit Scotland and the Accounts Commission states: “The 209,690 people working in social care are under immense pressure, and the sector faces ongoing challenges with recruitment and retention.

“Staff are not adequately valued, engaged, or rewarded for their vitally important role.

“The workforce is predominantly female and poor terms and conditions for staff contribute to recruitment difficulties, rising sickness absence and high vacancy levels.

“This puts the capacity, sustainability, and quality of care services at a considerable risk.”

Despite £5.3bn being spent on Scottish social care annually – including £4.08bn on adult social care and £993m for children and families – there is a “focus on cost rather than quality or outcomes”, the report adds.

Furthermore, it expresses concern that carers and the people receiving support do not always have a say in what help they receive and the Scottish Government should listen to their experiences.

Auditor General Stephen Boyle, who will give evidence to a Holyrood Committee on Thursday, said: “We cannot wait another five years until the planned National Care Service is in place.

“Action must happen now, and at speed, by the Scottish Government.

“There must be clear timescales for delivery, demonstrating that lessons have been learnt from previous reforms of health and social care services.

“This will create a strong foundation for the Government’s vision to create a National Care Service.”

William Moyes, chairman of the Accounts Commission, added: “There are significant problems with the delivery of social care services.

“These services are vital, yet we have a workforce that’s not adequately valued or regarded.

“Staffing shortages are a major issue across the sector and not all people’s needs are being met.

“Too often a focus on costs comes at the expense of delivering high-quality services that aren’t at the heart of the needs of individuals.

“The additional funding to achieve this will be significant.

“Not taking action now presents a serious risk to the delivery of care services for the people who depend on them.”

Social care minister Kevin Stewart said: “We are committed to delivering a National Care Service by the end of this Parliament in order to ensure everyone gets the high-quality care they are entitled to, regardless of where they live in Scotland.

“As part of this we are already considering many of the issues raised by Audit Scotland, including staff recruitment and retention, the need for a greater emphasis on preventative care and meeting individual needs, a focus on ethical commissioning and ensuring the voices of people who are receiving care services are amplified.

“However we are not waiting to act to protect and enhance Scotland’s social care services, which we know are facing intense pressure at present.”

Stewart cited a £300m funding announcement last October for the NHS and social care and increasing the minimum wage for staff in adult social care to £10.02 per hour.

He added: “We have recently announced an additional £4m to expand support for unpaid carers this winter, including to enable them to take breaks from caring. We are continuing to work with those with lived experience to shape the response to the ongoing impact of the pandemic.

“We remain committed to developing options to remove non-residential charging as soon as possible.”

Scottish Conservative social care spokesman Craig Hoy said: “This report should be a wake-up call for SNP ministers. The SNP urgently need to address the social care crisis that has occurred on their watch.

“Heroic staff are overwhelmed, having gone above and beyond during the pandemic. But they have not been given the leadership they need from the SNP Government. People who require care services are suffering as a result.

“This is not the time to centralise care services as the SNP are planning to.

“Instead of pressing ahead with a wholesale bureaucratic overhaul of services, ministers must engage with carers, staff and those who need support to ensure the highest level of care is being delivered.”

Scottish Liberal Democrat leader Alex Cole-Hamilton said: “The Scottish Government needs to get serious about pay and conditions in our social care system.

“Unfortunately, there is a real risk that their obsession with hoovering up power will lead them to waste millions on structural reforms rather than getting to grips with the changes that would actually benefit both staff and those who rely on care services.

“Scottish Liberal Democrats will fight the SNP’s takeover over social care every step of the way because it reduces local control and puts the same ministers who shipped Covid positive patients into care homes in charge forever.”