Scotland needs a quality home care service to meet the growing demand and also ensures that patients who shouldn’t be in hospital are cared for at home. While there is a welcome commitment to address this, the service at present is struggling.
I recently outlined the reasons our social care system is in crisis in an article in The Scotsman. Essentially, we have growing demand being met by a fragmented, largely outsourced workforce that has been subjected to a race to the bottom with their pay and conditions of work.
This is reinforced in a report UNISON Scotland has published today. ‘We care, do you?’ looks at the state of social care in Scotland and asks the staff who deliver the service to describe their experiences. The survey revealed:
• 9 in 10 (88%) said they were limited to specific times for client visits, with many reporting this was too short a period to properly cater to a client’s needs.
• Four in five said they believe the service has been affected by budget cuts or privatisation with carers saying the emphasis was now on “quantity rather than quality”.
• Over a quarter (26%) said they were not paid for their travelling time.
• Two thirds (66.5%) said they did not have anywhere to go between visits to have a meal, hot drink or toilet break.
• Nearly half (43%) said they worked longer than their contracted hours.
The Scottish Government is committed to paying care workers the Scottish Living Wage by 1st October this year. It remains to be seen if that will be delivered, as local authorities and providers struggle with the funding arrangements. It is important that the additional resources are distributed equitably and that the poor employers are not rewarded for past bad behaviour. It is equally important that pay is not increased at the expense of other conditions.
Fair pay and conditions are vital to recruit and retain staff. I have read several internal reports that highlight very high turnover rates amongst even the better contractors. Service users need continuity of service provision and turnover rates above 25% per annum cannot deliver this outcome.
Time to care is another key outcome. In today’s report, workers paint a picture of not having enough time to properly care for the vulnerable people who rely on them. The assertion that 15 minute care visits are only for the most minimal needs was roundly contradicted by carers, with some stating that scheduling did not account for travel time between visits. As one worker described it:
“Sometimes I have 4 clients with all 15min scheduled time in the space of 1 hour with no travel time to each one.”
The section in today’s report on the times service users are helped out of bed and provided with breakfast makes particularly grim reading. As one worker put it:
“Earliest 7am but can still be doing breakfast at 11am, after giving the client a shower so be nearer 11.30 when they eat.”
Getting fair pay and conditions is the important starting point in resolving the social care crisis. However, it’s not enough on its own. That’s why UNISON Scotland is campaigning for local authorities to sign up to its Ethical Care Charter, which sets minimum standards to protect the dignity and quality of life for people who need home care.
It commits councils to buying home care only from providers who give workers enough time, training and a living wage, so they can provide a better quality care for thousands of service users who rely on it.