Highland care services are ‘creaking’: how did we fix them?
Last Friday I visited the impressive £11 million new care home in Inverness, Pittyvaich.
The new flagship, 58-bedroom property is the brainchild of Parklands Care Homes boss, Ron Taylor.
From my original career in social work, I have visited my fair share of care and nursing homes.
Pittyvaich, in Milton of Leys, hits the heights in quality of the facilities: a café, four dining quarters – and even a self-playing piano! The home is already full, with a waiting list in place, and fully staffed.
This positive story is not typical of the care service in Highland and beyond.
Social care is becoming a major and pressing political issue, driven by the three main factors – chronic under-funding, workforce shortages and increased demand, due to changing age profiles of the population.
We have a system which is struggling to cope with vulnerable adults and younger people, those with a mental or physical disability, or other special needs, as well as the elderly. Frontline staff and managers, in my experience, are dedicated and committed – and often under-recognised for their skills.
The key problem is staffing, across the board. Care providers report problems in recruiting and retaining staff, due to relatively poor pay and occasionally poor working conditions, as well as a lack of recognition. Many carers are paid only just about the minimum wage. This has led to high staff turnover rates, burnout and dependency on agency staff.
Lack of sustainable funding for commissioning care services is a further problem, as councils have faced years of budget cuts.
This has led to less service availability, stricter eligibility criteria and long waiting lists for assessments and care packages.
Many families do not get the care they need and end up as unpaid care-givers. Many cannot afford private care, creating a postcode lottery in terms of access to, and quality of, care.
The Scottish Government had proposed a National Care Service (NCS) – good in theory, but more difficult in practice. There was also a danger of centralisation to the central belt and a loss of local accountability in the Highlands.
These plans were presented in a flagship announcement by Nicola Sturgeon as First Minister. £30 million was spent in the process, through consultations, legislative redrafts and acrimonious debate, both within the SNP itself and parliament as a whole.
The initial plans for NCS brought widespread, cross-party support for the principle of reforming social care. A key gain from the proposals was the objective of ending the perceived postcode lottery of inequality in care provision across Scotland.
The Scottish Government may argue that new legislation was proposed and enacted on the care sector earlier this year, but the (then) Care Minister, Maree Todd, agreed to remove part one of the bill – the section titled ‘The National Care Service’. The original concept from former First Minister Nicola Sturgeon of a dynamic, exciting and innovative network of care boards across the country has now been binned.
What is left? We now have a non-statutory advisory board and sensible proposals to strengthen the rights of people living in care homes, known as ‘Anne’s Law’. As Phil Sim, the BBC Scotland political correspondent, said: “The vision of a groundbreaking new care service began its slow-motion crash into harsh reality when the government started trying to construct a legal framework for it.”
The Scottish Parliament passed the Care Reform (Scotland) Bill earlier this month. Whilst it is a pale imitation of the earlier, meatier version of the proposed legislation, which included the National Care Service, in fairness it does give new rights to unpaid carers and residents of care homes.
However, the fundamental question still remains: how do we fix a creaking care service in Scotland, facing increasing demand, a staffing crisis and growing financial constraints?
Care services in many areas in the north are themselves on life support, kept going by the goodwill and dedication of frontline staff. Surely, now is time for a radical change?
