National Homecare Council Scotland Conference

Alexis Jay, Chief Social Work Inspector 4th February 2010

Home care in Scotland

• 80% of home care is used by older people• 51% provided by voluntary or private sector• 11% of home care support is from more than one sector• good investment in home care over last five years, but• significant reductions in the last year in levels of home

care• intensive home care steadily increasing in many councils

Impact on people who use services

• older people generally most satisfied and express appreciation of service and staff

• they found services good quality and reliable but no choice

• criticisms of time allocations, changes in personnel and communication

• Comparatively well developed use of surveys in home care

Deployment of resources (in-house services)• Optimising use of in-house staffing• Efficient deployment• Staff preferred patch – based and teamwork

models• Significant pressures from demand

Staff issues (in-house services)

• recruitment a problem in many parts of Scotland • work pressures on home care managers• high absence levels• some good examples of learning and career

development• workforce planning still needed attention

Assessment of need

• Variable practice in eligibility criteria and assessment process

• Problems with Single Shared Assessment• Communication of information to home carers

uneven• Variable practice in recording and involvement of

home carers in reviews

Risk assessment and adult protection• Recommendation in almost all SWIA reports• Home carers not well informed about an

individual’s risk assessment• Well developed awareness training on adult

protection• Home carers raising more adult protection

issues than expected

Strategic Planning and Commissioning• In house services under review in many places• Usually driven by cost efficiencies rather than

quality• Underdeveloped strategic commissioning• Planning not done in a comprehensive way

Strategic Planning and Commissioning continued• Re-tendering issues• Variable understanding of social care markets,

local and national• In some areas no clear rationale for council role

as provider• Some contracting offered little stability to

providers

What staff said …….• Rated working relations with health much higher

than with education or housing• Did not rate relations with other social services

highly• Had concerns about actions for reviews and

care plans not acted upon quickly• Agreed there were clear guidelines when dealing

with risk

What staff said …..

• Agreed they knew their responsibilities re financial matters, and standards overall

• High level of agreement that social work is highly valued by elected members in their authority

• Did not agree they received adequate supervision or regular team meetings

• High level of agreement (93%) that they enjoyed their work