Weekly Poll – National Care Service: Access to Care and Support
Each week Disability Equality Scotland send out a poll question to our members on a topical issue. For the week beginning 4 October 2021, we asked a question about the National Care Service consultation.
Question 1. Do you think the proposed changes to care services and support will allow more people to access the care they need?
- YES – 55% (33 respondents)
- NO – 45% (27 respondents)
We provide verbatim comments where appropriate to illustrate strength of feeling or personal experience.
Joining Up Services
A narrow majority of respondents (55%) believed the proposals would allow for greater access to care services in Scotland. One of the proposed changes featured in the National Care Service consultation is to create a single approach to care and support services covering all types of care and support from early intervention to specialist intervention. This would aim to create a joined-up approached between advice, support, and care services, to enable people to easily move between different types of care and support. Respondents reflected on the prospect of greater links between social care services.
“I think it’s a good start in the right direction. In particular, joining up the services will help a lot. I’m taking part in a panel right now with people across the UK and one of the biggest issues that keeps cropping up is a lack of connection between services.”
“A joined-up service is great if done properly, it saves time, stress and money. But it can have the opposite effect and cause havoc if it goes wrong.”
“We need joined up service in psychiatry and social care as well as medicine. A more wholistic service all round.”
“Joined up social services should be the norm, especially with the use of IT services, so that, in theory at least, people can be assessed quickly.”
Standard of Care
One of the ambitions of the National Care Service is to ensure the same standard of care is offered to all with some flexibility depending on location and need. Respondents reflected on the standard of care that they or a family member have received through existing social care arrangements.
“The quality of service varies between care companies. I don’t think the vetting process done by social work departments is carried out correctly. Companies are taking on clients without having sufficient staff to cover the area. Care staff are taken away from areas to cover in another town because of staff shortages. The Care Commission should examine the records of clients randomly to determine whether the correct amount of care has been given. The current system is not working.”
“My friend died last year at the age of 60. She had to pay for her own care when she was under 60. This added stress for the family as she had to choose the care, she could afford not what she needed.”
“When my late wife needed a carer when terminally ill with breast cancer, we were extremely lucky to find someone who was prepared to go the extra mile by doing things which strictly speaking she wasn’t contracted to do but took the pressure off both my wife and I. Things like running the kids to school on days when I wasn’t fit to do it, getting messages, cleaning the house, doing the laundry, providing any support that gave us peace of mind and generally easing the pressure to enable us to battle the cancer together. We both felt this was an invaluable part of care during those testing months and I strongly believe that this type of support should be included for people who receive care at home, furthermore it should be part of what is considered care for people with long term conditions and disabilities.”
“After having a bad car accident more than seven months ago I had carers coming in twice a day but that stopped when social work tried to pass me onto the private sector without informing me and people turning up without prior notice, no identification and expecting to deliver very personal care needs. This I did not accept and I’m now left without any care.”
“What with the national shortage, it is very hard to get care.”
The National Care Service would aim to simplify the support planning process, which is sometimes referred to as an assessment. This will be rights based and focused on putting the adult at the centre of decision making to manage their own care as far as possible. Respondents reflected on the existing assessment and appeals process for receiving social care services.
“It’s hard to know if or how one is assessed for this. After I was diagnosed with autism the care was a sheet of paper with out-of-date contacts on it which was no use at all and no follow up to see how I got on. Similar after returning home after a stroke: no after care just ‘Do it Yourself’, trying to get help via GP has been hellish. Best help has been the community link worker.”
“I’ve been waiting 18 months for an assessment.”
“Many carers are unaware of the help available. This could perhaps be improved.”
“The classification system for diagnosing and treating health conditions ensures people with chronic, possibly invisible illnesses are purposely being cut out of the care sector and we are expected to just cope.”
“The best way to standardise care needs assessments is to introduce an appeals system for challenging social worker decisions on care needs assessment. This could easily be done by using the same tribunals that hear appeals about disability benefits.”
Funding and Resources
In order for a National Care Service to be effective, it must be appropriately funded and resourced. Respondents questioned how the National Care Service would be funded and whether there is enough staffing resource to cope with the high levels of demand for social care services in Scotland.
“It is good that they are inviting charity groups and individuals to get involved and share their experiences and thoughts on social care. However, for the system that everyone is looking for will take a lot of money and that is not going to happen any time soon.”
“The main problems with care provision are a lack of resources and training of care staff – sticking a label on it doesn’t resolve these issues.”
“When the government decide to “improve” service, it means another cost cutting lean approach to quality improvement. It’s always about money and never the individual in need of support.”
“The inevitable problems are, of course, both money and availability of staffing.”
“I’m saying yes. But where is the money and carers coming from?”
“I don’t believe these changes will help with resources, it will take a long time to implement and the people who need to access care will have the same issues as they do now, limited staff, limited services, long waiting times, poor GP surgery communication. Think how long it took for integration of health and social care to become even close to efficient, that still has a long way to go. Efforts should be on getting what is already in place right rather than looking for more ways to complicate and burden services that are on their knees.”
There was a consensus amongst respondents to ensure that a National Care Service is carefully designed with meaningful engagement with various groups that are impacted by social care services. This includes ongoing engagement with disabled people across Scotland. At Disability Equality Scotland, we recommend working closely with our members and Access Panels to ensure that any proposed changes to social care are shaped by the lived experiences of disabled people.
“Although I have ticked yes I do this on the proviso that it is dependent on a knowledgeable working group being put together to ensure that a number of issues are addressed, such as, a level playing field for carers, ensuring that people’s needs are actually met and care is not solely dependent on what time is available, that the proper choices for the delivery of care are explained to the person in need, etc.”
“It must be flexible as all disabilities do not fit in the same shoe! Community based services are always much better. The local knowledge is invaluable.”
“It will only work if it is properly designed, implemented and supervised. Bigger does not necessarily mean better.”
“This is something that cannot be fixed overnight, it needs a lot of thought from specialists, family doctors, nurses in what is needed and what other people think.”
“Great thought should be given with proper consultation to see what is really needed. The telling of disabled people what they need has to stop, along with assumptions of what people can or cannot do.”
“Let service users and lived experience evolve the service.”
There was a mixed response from respondents as to whether the National Care Service will result in more people accessing the care that they require. It was recognised that there are significant benefits that can be achieved by creating a joined-up approach between advice, support, and care services. Respondents shared emotive comments reflecting on the care they or a family member have received, highlighting the need for improvements to the standard of care provision. This extends to the assessment process, where there is currently a lack of consistency regarding the outcome of an assessment. There was overwhelming consensus from respondents on the need for significant funding to be made available to deliver the ambitions featured in the consultation. Proactive engagement with a wide variety of stakeholders, including disabled people, can help to ensure that the service is designed with lived experience at its core.