Guest blog: “Which part of the elephant do we start with?”

For things to improve for supported people and carers, they first need to improve for the workforce, says Claire Cairns, Director of the Coalition of Carers in Scotland

As Desmond Tutu once wisely said “there is only one way to eat an elephant: a bite at a time.”

I have recently been reminded of this when considering the seemingly enormous task of how to reform and improve social care. It’s certainly stumped a lot of governments, which is why when I talk to my colleagues in other parts of the UK and Europe, they seem equally overwhelmed by the task.

And the social care system is undeniably complicated. There are so many competing demands, so many inter-connected issues, not to mention deeply embedded cultures, processes and structures that we know don’t work, but we can’t work out how to dismantle them. Where do you start? The legs, the trunk?

The Feeley report has given us a great map, or perhaps more of a hopeful brochure of our final destination, if we can ever get the plane off the runway.

So what is the word from unpaid carers on all this? And specifically what is their view on Fair Work?

When it comes to Feeley and the subsequent National Care Service Bill, the development carers are most invested in is the right to breaks from caring. This is something carers have been campaigning about for well over a decade. At the moment, as well as being unpaid, carers don’t have the right to time off from their caring role.

Let that sink in for a minute. Having to care for someone, 24 hours a day, often with a lack of sleep – yet no guarantee that you will be able to get a regular break. Even those carers who do have a decent support package are just coming out of the last two plus years of the pandemic with their batteries, all but depleted and many of the services they used to rely on, seemingly dismantled.

So you might think that the spotlight on Fair Work and improving the terms and conditions of the paid workforce would have carers saying ‘Hang on a minute’. But I think you would be wrong.

Carers know that very little can be achieved to improve social care without first addressing the existing workforce crisis. The right to breaks from caring is completely unworkable unless there are social care staff and services to meet the increased demand. Not to mention to ensure there is a broad range of services available to ensure the very diverse needs of the carer population can be met.

But more than that, carers see the unfairness of how the social care workforce is treated – overworked, underpaid and often unappreciated. Support workers and personal assistants come into peoples’ homes and are trusted with their loved ones. They build relationships with people and at times become like family members. Sometimes and especially over the last few years, they are the only people the family regularly sees, providing a bit of comfort and chat, as well as support.

Carers are often devastated when support staff move on, particularly when it’s because they need to earn more money elsewhere, but they don’t want to move on to a job they will find less rewarding. Then for the family there is the hard task of recruiting, or securing, alternative support from their local authority – yet another stressful thing to add to the list.

The truth is both unpaid carers and social care support staff are the frontline, often working together, both under-appreciated. Both at times hailed as ‘heroes’, when they would rather be recognised and properly recompensed for their essential and highly skilled labour.

Feeley and the National Care Service is rightly focussed on improving outcomes for people who use services and their carers. But for things to improve for supported people and carers, they first need to improve for the workforce.

I suggest that’s the bit of the elephant we need to start with.

The Coalition of Carers in Scotland exists to advance the voice of carers by facilitating carer engagement and bringing carers and local carer organisations together with decision makers at a national and local level.

Since its inception in 1998 the Coalition has played a fundamental role in advancing carer recognition and support and in establishing a Carers Rights agenda in Scotland.

Find out more here. 

Find out more about the 4 Steps to Fair Work campaign here.

 

NCS agreement: “We need to shape the detail”

Responding to today’s announcement of an agreement between Scottish Government, local authorities and the NHS on the National Care Service, Rachel Cackett says that genuine partnership and participation is key

Responding to today’s announcement from the Scottish Government about an accountability agreement with CoSLA and the NHS on the National Care Service, Rachel Cackett, CEO of the Coalition of Care and Support Providers, said:

“We welcome the Scottish Government and CoSLA’s efforts to find ways of progressing social care reform.

“However, there is very little detail in today’s announcement about what has actually been agreed, and how it will work in practice.  We hope this won’t simply result in the status quo continuing.

“Social care providers – like many others – need to be involved in shaping the detail so that expert views and experiences are reflected in the final legislation and in the way much-needed reform is delivered.

“We look forward to working with the three parties involved in the agreement announced today, alongside all those with experience of social care, in a way that reflects genuine partnership and participation.”

Vison and priorities for social care: Humza Yousaf responds to our questions

One of the three candidates vying to be Scotland’s next First Minister has outlined his commitments.

Humza Yousaf, one of three candidates competing to be Scotland’s next First Minister and leader of the SNP, has responded to a letter sent by our CEO Rachel Cackett and Board chair Andrea Wood.

In the letter, sent on 7 March, the candidates were asked three questions:

  • Will you commit to our 4 Steps to Fair Work?
  • Will you commit to implement social care reform and meet with us, within your first month in post, to discuss constructive ideas for positive and urgent change?
  • How would you articulate your own vision for social care reform in Scotland?

In response Mr Yousaf, who has been Cabinet Secretary for Health and Social Care since 2021, said:

“Thank you for taking the time to contact me as a candidate in the SNP leadership contest and for your patience in waiting for a response.

Currently as Cabinet Secretary of Health and Social Care, the issues you raise are important to me and would continue to be so if elected as First Minister.

There are two key commitments I want to make in regards to the Health and Social Care sector.

We need to make sure that our staff are properly paid – not only to recruit staff but to retain them.

Secondly, we have some reform to do in our NHS which will see as many people as possible treated as close to home as possible, leaving our hospitals available for emergencies only. This means that investment in our Social Care sector is at the heart of NHS reform and for bettering the conditions of work for social care workers.

If we have social care that has the right workforce, that is working for people, then we can stop them from coming in the front door of hospitals or GP practices, but we can also work on stopping the exit block and see people getting out the doors of hospitals as soon as they are fit to do so and back into their community, keeping as close to home as possible.

Therefore, reforming health care and social care has to be at the heart of my leadership. That is why I am passionate about the idea of a National Care Service – although I recognise that current proposals will need amendments, via dialogue with Local Government, Trade Unions, and membership organisations to make sure it works for everyone.

The principle of the National Care Service, where we have fair pay for our social care workers, where we have national collective sectoral bargaining, and where we have ethical commissioning – these markers will solidify a national social care system that is worthy of the name.”

Our letter also argued that a legislative pause could be an opportunity for the new First Minister to look afresh at social care reform based on our model, and to drive forward Fair Work and sustainable funding.

Ash Regan and Kate Forbes have yet to respond.