Social care commissioning system is ‘out of whack’, new publication finds

Eight sector leaders provide perspectives on ethical commissioning and procurement, through interviews with journalist Pennie Taylor

A new publication from the Coalition of Care & Support Providers (CCPS) explores the viability of an ethical approach to planning and purchasing social care, with eight sector leaders providing their perspectives on the current landscape through interviews with journalist Pennie Taylor.

The publication, “It’s out of whack!”,  highlights how commissioning and procurement has a significant impact on the delivery of support services, sustainability of providers, the workforce and on people receiving support.

Download the publication (PDF)

Interviewees consider how meaningful partnership, community-level co-production and innovative thinking could address unprecedented service challenges.

As reflected in the publication title, which draws on a comment from C-Change CEO Sam Smith, the consensus view is that the commissioning system as it stands is unbalanced.

CEOs, directors and managers interviewed make clear the risks not implementing reform poses to providers, and the major steps still required to realise the “collaborative, rights-based and participative approach” that was outlined in Derek Feeley’s Independent Review of Adult Scotland Care.

Catherine Garrod, CCPS Programme Manager – Commissioning and Procurement, said: “The expert voices in these interviews demonstrate how Third Sector care and support providers already deliver high quality personalised care and support and work to improve the outcomes of the people they support, in spite of the system.

“These are voices that need to be heard and included in finding the solutions to make the shift we all want – and need – to see for people who require support.

Pennie Taylor said: “The concept of ethical commissioning and procurement has been embedded in the proposals for a National Care Service for Scotland, but a new way of working cannot wait for that. Instead, the people I spoke to for “It’s out of whack!” all want to see action taken to galvanise change, using existing legislation to kickstart widespread reform without delay

“These features spotlight great examples of doing things differently, and describe first-hand experience of current practice that is far from ethical. They eloquently demonstrate the passion, commitment and creativity that keeps the Third Sector going, whatever the odds.”

Interviewees in the publication are Ben Bradbury, Business Development Manager, Capability Scotland; Ian Bruce, CEO, Glasgow Council for the Voluntary Sector; Drew Collier, Director of Development, includem; Dr Ron Culley, Chief Officer, Quarriers; Louise Moth, Contracts & Commissioning Manager, Scottish Autism; Julie Murray, Chief Officer, HSPC; Sam Smith, CEO of C-Change; and Andrew Thomson, Deputy Chief Executive, Carr Gomm.

The publication was commissioned by CCPS’s Commissioning and Procurement Programme, which is funded by the Scottish Government.

Find out more about the Commissioning and Procurement Programme

More than 100 organisations urge First Minister to value social care staff in 2024-25 Budget

110 organisations from across civil society, including providers, anti-poverty groups, faith leaders, carers’ representatives and equality organisations, sign joint letter sent to the First Minister calling on him to increase pay

110 organisations have signed a joint letter sent to the First Minister calling on him to increase pay for social care staff and demonstrate that they are valued.

The letter, led by the Coalition of Care & Support Providers in Scotland (CCPS), is supported by organisations from across civil society, with social care providers joined by anti-poverty groups, faith leaders, carers’ representatives and equality organisations, among many others.

Read the letter and full list of signatories

In September’s Programme for Government, the First Minister announced a new base rate of pay for social care and support staff of £12 from April 2024, increasing from the current rate of £10.90.

As our letter explains, the pledged rate of £12 matches the updated Real Living Wage – sending a clear message to social care staff that they are only worth the bare minimum.

CCPS and signatories to the letter believe that £12 per hour is simply not enough, and that the proposed rate fails to reflect the invaluable societal contribution made by social care staff in supporting people to thrive and live independent lives.

Rachel Cackett, Chief Executive Officer of CCPS, said:

“Social care is at the heart of the First Minister’s vision for ‘Equality, Opportunity and Community’ in Scotland. Yet it is systematically overlooked and undervalued.

“Organisations that provide social care are rapidly losing staff because the current pay of £10.90 is simply too low to retain them and they migrate to better-paid jobs elsewhere.

“It is a scandal that, in communities across Scotland, people who need support to live, thrive and stay independent, can’t get it because there aren’t the staff available.

“As the First Minister will see from the range of signatories to this letter – the first time so many organisations have come together to make a joint call on this issue – we represent an emerging movement who are determined to bring social justice to social care and support.

“We are all clear that a better decision on pay for social care staff is needed in the 2024-25 Budget due to be published next month.”

(ends)

Media contact: Chris Small – chris.small@ccpscotland.org

Notes for editors:

▪ Staff vacancy rate in social care sector

Earlier this year, with the HR Voluntary Sector Forum (HRVSF), CCPS commissioned the University of Strathclyde to conduct a workforce benchmarking survey. In July we published an executive summary from the report finding that social care and support providers in Scotland are struggling with a loss of staff, with an average of 52% of those moving jobs last year leaving the social care sector altogether. Read the report. Read our media release.

▪ Proposed increase to £12 per hour, and Real Living Wage

The proposed rise from £10.90 per hour to £12 per hour for not-for-profit social care staff was announced on 5 September in the Programme for Government. The new rate of £12 for the Real Living Wage was announced on 24 October.

▪ 4 Steps to Fair Work

CCPS’s 4 Steps to Fair Work campaign (June – October 2024) called on the Scottish Government to properly recognise and reward social care staff for the work they do. It shared blogs and video contributions, including from a support worker who said that earning £10.90 per hour means “You can survive, but you can’t really live.”

▪ CCPS

The Coalition of Care & Support Providers in Scotland is the voice of not-for-profit social care providers, with 91 provider organisations in membership.

Joint statement: Scottish Government’s Winter Plan ‘offers no hope for social care’

Our CEO Rachel Cackett and Dr Donald Macaskill, CEO of Scottish Care, respond to this week’s publication of the Scottish Government’s Health and Social Care Winter Preparedness Plan 2023-24

As the CEOs of Scotland’s two major umbrella bodies representing providers of care and support in the third and independent sectors we are dismayed to see yet another Winter Plan which purports to be a whole system response for Scottish citizens but in fact offers almost no hope for social care.

Both of our organisations have attempted to convince both the Scottish Government and CoSLA that the plan was wholly insufficient to address the deep crisis facing our members and a system that is meant to uphold the rights of individuals who require care and support.

We have tried to be constructive in those discussions to which we have been invited, but have certainly not been engaged in any way as equal partners in finding solutions for a system in which our members deliver key public services for some of our country’s most vulnerable individuals and families. This document reflects that. The marginal changes made to an early draft following our strong criticisms do not allay the fundamental concerns we shared.

In particular, we note a deeply disturbing direction for social care providers and, ultimately, for those who rely on services to maintain independence and connection and prevent crisis:

Where necessary, local systems will prioritise social care and support services for those who need it most and are considered to be at a critical or substantial risk level.

In the current climate, where we already see social care budgets being depressed to the detriment of people and, indeed the wider system, we fear this will be read as carte blanche to remove or reduce funding for many people who need support. This cannot be allowed to happen.

We hope that the Cabinet Secretary and CoSLA leaders will clarify their intentions in including this statement and do significantly more to underline their commitment to a thriving social care system for which they wish to share accountability through a National Care Service.

Rachel Cackett, CEO, CCPS, and Dr Donald Macaskill, CEO, Scottish Care

 

Statement: “With promised £12 per hour base pay no more than the Real Living Wage, social care staff need action now to show they are valued”

Our CEO Rachel Cackett responds to today’s announcement that the Real Living Wage will rise to £12 per hour

Responding to today’s announcement that the Real Living Wage will rise to £12 per hour, CCPS’s Chief Executive Rachel Cackett said:

“Back in September, the Scottish Government announced a £12 per hour base rate of pay for social care staff, starting in April 2024. Today, we know that this offer is no more than the new Real Living Wage amount, which will be introduced at the same time.

This means that many not-for-profit social care staff – who work with disabled people, older people, children, families and many others who need support in communities across Scotland – will now receive just the minimum the Living Wage Foundation calculates is needed to meet every day needs.

This is nothing like enough.

Before the new base rate and RLW kick in next spring, social care staff will have to navigate the winter months as an acute cost of living crisis continues, whilst many earn just the £10.90 per hour currently set by the Scottish Government.

The First Minister’s states his priorities are “Equality, Opportunity and Community”. These priorities are at the heart of social care. Yet a workforce that makes such a vital contribution to society, to supporting people to thrive and live independent lives, continues to face inequality and limited opportunities through poor government pay awards. The knock-on is a lack of available support for the most vulnerable people in our communities.

Investing in the value of social care is a political choice, and there is still time to make the right choice in the 2024-25 Budget. We know public finances are tight. We know we won’t get to parity of pay, terms and conditions for equal work with public sector colleagues overnight. We are very far from that now.

But we need to see a clear step to closing the pay gap in April next year and a plan to get to equality; a move towards showing staff that they are truly valued.

So, we are calling on the First Minister to up his offer to at least £13 per hour for all social care staff from April 2024 as part of a published timetable to achieve Fair Work.

Not as an end point, but to indicate in tough times that our government sees the value of our sector and is committed to ending deep inequities for social care staff in Scotland.”

Policy blog: Human Rights Bill’s dignity focus welcome, but more clarity needed on ‘duty bearers’ impact

A comprehensive consultation will be required to ensure not-for-profit social care providers fully understand the implications of the new legislation for their sustainability and resource allocation, writes Jen Goff

Scotland is on the brink of a profound socio-political, cultural and economic shift: the incorporation of human rights into Scots Law. This is not merely about acknowledging that rights exist. Instead, it’s about realising human rights as accessible, applicable and enforceable, for every person in Scotland all of the time.

Context and significance

Some international human rights have already been brought into UK law. These rights have been incorporated in the Human Rights Act 1998 and the Scotland Act 1998. The UN Convention on the Rights of the Child will also be incorporated in Scots law soon. However, the present Human Rights for Scotland Bill answers long-standing calls from Scottish campaigners to include economic, social and cultural rights (ICESCR). It also incorporates the rights of women (CEDAW), disabled people (CRPD) and people from ethnic minority backgrounds (CERD).

The Bill carries profound implications for Scotland’s future. It pledges more than just symbolic support of human rights; its adoption ensures that all legislative and policy decisions undergo human rights scrutiny. Consequently, public bodies will be obliged to prioritise rights in all operations. This will affect everything from how budgets and resources are allocated, to how services are delivered. Crucially, people will be empowered to actively claim their rights, ultimately shaping a society where rights violations are made unacceptable. In this way, the Bill has the potential to transition from acknowledgement that human rights exist, to realising the inherent dignity, respect and fairness every person should be afforded in practice.

In other words, transitioning from acknowledgement to realisation in human rights is like moving from seeing a seed to witnessing a tree in full bloom. Initially, the potential and promise are recognised (acknowledgment). However, only through a process of care and nourishment can a seed grow into a tree that provides tangible shelter and sustenance (realisation).

At CCPS, we understand the profound implications of incorporating human rights and why the third sector needs a voice in the process. Consequently, we took several steps to develop our consultation response,. which you can read here.

We explored potential sectoral impacts by participating in events with experts like the Human Rights Consortium Scotland, Third Sector Human Rights and Equalities and the ALLIANCE Scotland. We grew our internal team and membership’s understanding through an information session led by the Human Rights Consortium Scotland. Additionally, our virtual drop-in and survey offered CCPS members a way of sharing views. Together, these efforts shaped our response, reflecting the perspectives, concerns and hopes of third sector providers.

What we welcome

Our response welcomes the inclusion of the ‘dignity’ principle in the interpretation of rights within the Bill. Recognising the intrinsic worth of every person, especially marginalised groups at heightened risk of rights violations, is a principle that reflects the existential purpose of social care. This proposal therefore not only aligns with the existing commitments and practises of CCPS members, but also paves the way for a culture characterised by empathy, respect and the systemic challenge of inequities.

What needs work

Our response supports a whole systems approach to human rights incorporation. We are nonetheless calling for the Scottish Government to clarify what this means for third sector providers who may become duty bearers. Given the potential implications on sustainability, legalities, procurement, and resource allocation, we’re calling for a comprehensive consultation involving the third sector.

What needs to change

Our response recommends that ‘equalities treaties’ should be termed ‘special protection treaties’, and these should be incorporated in full. In other words, the rights of women, disabled people and people from minority ethnic backgrounds should be acknowledged for the heightened risk of rights violations they face, while their rights must be given due regard and a duty to comply. We also note that Article 19 of CRPD (the right to live independently and be included in the community) is particularly relevant to the realisation of rights via social care.

What’s next

We have reached out to the Scottish Government to extend our support in clarifying what third sector provider’s roles will be within human rights incorporation. Ensuring our membership’s voices are meaningfully included is our priority. That means actively engaging forthcoming incorporation process with third sector resilience at the heart of our work.

Jen Goff is CCPS’s Policy and Projects Officer (National Social Care Resilience and Reform)

Read our consultation response 

Further reading

If you would like to learn more about human rights incorporation, check out the following resources.

1. Read

A quick read: Third Force News blog summarising some issues with the Human Rights Bill from a third sector perspective

A plain English read: Together Scotland has produced child-friendly consultation guides, both of which are excellent plain English introductions useful for anyone to read

The Scottish Government’s guide to the human rights bill

The Human Rights Consortium Scotland’s consultation guide

The ALLIANCE Scotland’s consultation response

The Environmental Rights Centre for Scotland consultation guide

The Equality Network’s consultation response

2. Listen

An audio version of the short guide to the Human Rights Bill consultation

A podcast introduction to the human rights bill by the Scottish Human Rights Consortium

3. Watch

A webinar by the Care Inspectorate on human rights and the health and social care standards

 

 

CCPS Campaigns

This page contains information re current and previous campaigns.

The 4 Steps to Fair Work campaign (June- October 2023)

4 Steps to Fair Work was a CCPS campaign that ran from June to October 2023. It aimed to ensure that social care and support workers began to be properly rewarded, and that the people they supported received the support they needed at the right times and in the right places.

The campaign gained support from multiple CCPS member organisations and external groups including parliamentarians, unpaid carers and faith leaders across Scotland. It will inform our next phase of influencing work through the winter of 2023-24.

Read more about the campaign here.

If you have a question about the campaign, contact our Head of Communications & Engagement, Chris Small: chris.small@ccpscotland.org

4 Steps Comment: “The door is open. Now we need to push it a bit further”

Our CEO Rachel Cackett reflects on the disappointments and successes of our 4 Steps to Fair Work campaign – and what our emerging movement can do next in its fight for social justice

“You can survive, but you can’t really live.”

Those words from Derek, a frontline social care worker, have echoed around my head during our #4StepsToFairWork campaign. They describe what it feels like to live on the amount the Scottish Government makes available to our members to pay staff who provide support to some of the most vulnerable people in our communities.  People we all clapped through COVID. The people who might work to support my family or yours.

It’s the quietest national scandal that, behind doors in streets and villages across Scotland, are people who need support to live, to thrive, to be well, to stay independent, who can’t get it because there simply aren’t the staff.

It’s the quietest national scandal that social care and support staff working in our sector – the vast majority of them women – are paid 20% less to deliver public services, from our taxes, than people doing equivalent work in the NHS.

So, at the start of 2023 we decided it was time to stop being quiet and call for better, loudly.

Our demands weren’t huge.  Simply, we wanted all staff to get at least £12 per hour from April 2023 as the first step of a public plan to pay people fairly. A plan to give staff, and the people they support, hope.

And our #4StepsToFairWork campaign began to snowball.

Frontline staff and CEOs from our member organisations stood up and spoke up. And then others joined.  Carer Organisations, Scotland’s Faith Leaders, partner organisations, people with experience of care and support all spoke up through blogs, emails to MSPs, social media posts. I would like to personally thank every one of you who did so.  In a sector, based on the rights of people to exercise choice and control about their own care and support, our diversity and our voice are our strengths.

Then, early in our campaign, our new First Minister stood up to give his first speech to the Scottish Parliament.

We waited.

“Equality, Opportunity, Community” he said. Those are the government’s new priorities.  “That’s social care!”, we thought.

We waited…

A commitment to £12 an hour, he said.  “At last!”, we thought. The voices had been loud enough for him to hear.

But then he gave no date.

A crisis heard, but half a promise made. And a crashing disappointment for the thousands of committed staff in our sector, and to the leaders trying to keep their organisations open.

140 days later the date came in the Programme for Government – £12ph from April 2024. We hoped for a mistake in the speech, but no. A year late and by then, again too little.

And no plan.

Of course I am disappointed that the voices of so many have not resulted in our asks being met in full. That the national scandal of the Scottish Government baking in inequity to social care, and leaving people without the support they need, remains. But is it over? Absolutely not.

The door is open. We just need to push it a bit further.

Your voices were so loud, your arguments so clear, that our new FM knew he had to make a commitment to our sector in his first speech. We shouldn’t ignore this; we should build on it.

For the first time, the pay award has been extended to those working in children’s services: A first inequity addressed through our campaign.

The collective, public, voice of our sector and our allies is building to bring social justice to social care and support. Nurturing that emerging movement in the run-up to elections, as parties set their new priorities, is crucial.

And finally – and importantly – let’s remember that the £12 announcement might be made, but the Scottish Budget is not yet passed.  Every MSP has an opportunity to speak up to call for more, for better.  All of us can still call on politicians, whose core job is to allocate tax payers’ money to fund priorities for our nation, to make a better decision.

So, our #4StepsToFairWork campaign concludes today; but our campaign for better for our sector does not.

Watch this space….

Blogs, video contributions and resources from our 4 Steps campaign (June – October 2023) are available to read here

4 Steps Guest Blog: “Ending the difference in funding levels between services would be a step towards the fairness we need”

A hierarchy in adults and children’s services or between regulated v unregulated services simply means more inequalities, says Fiona Steel, Action for Children’s Acting National Director for Scotland

In the recent Programme for Government the First Minister announced a commitment to ‘provide the necessary funding in the next Budget to increase the pay of social care workers in a direct care role, to deliver funded early learning and childcare, to at least £12 per hour’. As ever, we await the fine print on how this commitment will operate in practice.

While this is a move in the right direction and may go some way to ‘dealing with pay inequality’ – the first step of the 4 Steps to Fair Work campaign – there is still unfortunately a long journey to go before social care and support workers are properly rewarded and recognised. We can’t forget that The Promise stated, ‘the purpose of the workforce must be to be caring above anything else. That starts with recruiting people with the right ethos and qualities rather than qualifications’.

But how do we get these people into social care?

Action for Children knows that there is a current struggle to attract and retain people into the social care workforce. We also know that social care staff are experts in the people they care for. To provide that vital care requires staff to use multiple skills ranging across the clinical, emotional and academic, while also collaborating closely with a myriad of other professionals.

People who choose to work in the care sector display astonishing levels of compassion, empathy, commitment, and kindness to ensure people they care for are made to feel they belong, are safe, loved and valued.

For too often the perception of social care work as being low skill prevailed. This needs to be challenged and changed.

During Covid we did see the beginning of a shift in people’s attitudes towards the sector: our frontline workers were seen as key workers who added social value. Our staff were the people who society relied on in times of crisis but also in times of normality. It’s disappointing that this view change hasn’t been built upon.

We need renewed government support and help to attract and retain staff in the sector.

As an organisation we are focused on investing in our staff. We are dedicated to building a diverse, inclusive, and authentic workplace. We pay the real living wage; we embrace the Government’s Fair Work agenda. We offer excellent training and developments opportunities; we help staff gain professional qualifications and offer flexible working hours. We encourage young people into our workforce, highlighted by the fact we recently gained a Platinum Award from Investors in Young People (IIYP).

However we are still facing recruitment challenges, especially when it comes to the complexity of commissioning of services.

We as a sector need parity. We shouldn’t have a hierarchy between adult and children services or between regulated vs unregulated services. The difference in the levels of funding between each of these areas can create inequalities.

That’s why Action for Children fully supports CCPS’s campaign calls to ensure equal pay for equal work and value all staff who play their part by delivering funding packages that value the crucial role of the different staff who make up the social care workforce.

The third sector delivers many local authority services, but councils are competing with these providers for staff. They are offering more in wages to attract staff than they give in rates in the contracts for providers, ironically making it harder to staff these local services.

Something fundamental needs to change to make sure Scotland has a talent pool for social care that is deeper not shallower. Action for Children believes the 4 Steps to Fair Work campaign can be the catalyst for change needed. That is why we offer it our full support.

Find out more about Action for Children’s work

Read more about the 4 Steps to Fair Work campaign

4 Steps Guest Blog: “In all good conscience, we cannot allow the support of vulnerable children to be devalued”

We refuse to accept that our children’s services staff are any less important than their adult counterparts, writes Cosgrove Care’s Depute Chief Executive Pauline Boyce

Cosgrove Care is proud to work with children and adults with learning disabilities, mental health issues, autism and other support needs. We want to see them thrive and grow, realise their human rights and live life to the full. We simply cannot do that without our dedicated, committed and skilled team. That means the direct support workers and their managers, in both our children’s and adult services.

In recent years the uplift in pay for adult social care staff has been welcome.  However, the consistent failure to equally value the children’s social care workforce has placed a significant financial burden on organisations such as ours, who refuse to accept that our children’s services staff are any less valuable than their adult counterparts.

How do you explain to a skilled support worker that, in the eyes of the powers that be, the work they do on a Monday morning, caring for a vulnerable adult at our wellbeing group, is of more value than the care and they provide at 3pm the same day, to a vulnerable child after school?

The answer is you do not. You simply cannot in good conscience allow the support of vulnerable children to be devalued. As an organisation you absorb the cost of increasing wages for children’s service staff, carrying an unsustainable financial burden.

The First Minister’s recent statement announcing an uplift to £12 an hour – which does appear to include both adult and children’s services staff – is again welcome. But it does not recognise the burden organisations such as ours have carried in the last few years supporting children’s services staff.

Equally, the provision of funding to increase the rate of pay for social care workers in direct care roles does not recognise the burden that we carry in maintaining a differential for our first and second level managers. It fails to value our team leaders and managers.

Are they less deserving of a pay increase? Are their families less deserving of their support? How do you explain to your managers that the work they do supporting staff, managing and deploying ever more stretched resources, all whilst ensuring quality services, are delivered and improving outcomes is of less value than direct support work?

The answer is you do not. You simply cannot in good conscience allow the support of your staff to be devalued. As an organisation you absorb the cost of increasing wages for front line managers, carrying an unsustainable financial burden.

If we are genuine about valuing social care, in recognising it as a worthwhile service and career we need to ensure funding increases value all aspects of the social care work force, without placing further burdens directly onto organisations.

Find out more about Cosgrove Care

Find out more about our 4 Steps to Fair Work campaign and take part

4 Steps Guest Blog: “Funding packages that value all staff will play a crucial part in developing a motivated workforce”

Alex Cumming, SAMH’s Executive Director of Operations, on why social care and support managers need our backing to ensure not just that they don’t leave the sector, but that they can thrive in it

At SAMH (the Scottish Association for Mental Health) we believe everyone is entitled to hope and choice, and to achieve personal fulfilment. We know from 100 years of working in mental health that the key to delivering on these values – and the success of services – is a sustainable, happy and valued workforce.

Critical to our frontline workforce is the support given by managers across the country. Within moments they move from crisis management, to hands-on delivery, meeting ever-more demanding compliance requirements and regulations. They do all this while embedding organisational changes, leading service improvements and delivering contractual obligations. Our ask of them is vast.

The role they play in creating and embedding a culture of compassion and providing the environment for staff to develop cannot be exaggerated. They provide support for improving practice and negotiate delicate performance conversations. They do all this at the same time as bringing the team together to work on the collective goal of improving outcomes for people we work with.

This means that the ability to sustain and develop management and leadership pathways is essential, and just as urgent as the frontline challenge all providers are facing. One way to address both these issues is delivering funding packages that value all staff, which will play a crucial part in developing a motivated health and social care workforce that functions effectively, safety and consistently.

All of us are planning for the future, and considering what’s needed for management and leadership roles is key to that. However, we need a longer term view as well as support from government that delivers greater parity, enables us to harness the passion and skills to develop our managers, and reduces the fatigue our staff are feeling.

So where are the positives? Having spent time with more than 50 of our managers in the last week, I’m reminded of the drive and determination of our workforce and their unyielding commitment to those we support. Their resilience motivates others, but they need our backing and support to make sure not just that they don’t leave the sector, but that they can thrive in it.