14 November 2024

Through a glass darkly: the progress of a National Care Service

Our CEO Rachel Cackett responds to the latest news about the NCS Bill

Ah, the irony.

Today CCPS was to publish its proposals for amendments to the National Care Service Bill. It’s later than we’d have liked because it’d been hard to know what we are attempting to amend. Is it the Bill that was laid, which has been completely overtaken by events; or the proposals for an amended Bill, which the Government published in June – including a shared accountability agreement that has been blown out the water – but which can’t technically be amended, because it’s not an actual bill?

You see our dilemma?

But we’ve done our best because, if the Scottish Parliament has decided to take the Bill this far we have a duty to do all we can to make it work for our social care provider members, their staff and ultimately the people they support.

Then this morning the news broke: the Bill is scrapped… or perhaps bits of it are scrapped…. or perhaps none if it is scrapped but just delayed while it’s re-written again.

So here we are.

In the meantime, far too many people who need support can’t get it, providers are seeing budgets cut, and now we are staring into the face of catastrophic changes to Employers’ National Insurance Contributions.

Ever since Derek Feeley published the Independent Review of Adult Social Care we have been clear: our sector desperately needs reform and we will do all we can to collaborate with government and anyone else who can effect good change. CCPS members have the experience and expertise to help. It’s not always been easy to be heard.

But our commitment remains – and we will still publish our ideas on the Bill as a marker of the commitment (see links below) – but I now make a heartfelt plea.

We’ve been attempting to inform and improve this Bill for nearly three years while at the same time trying to support members through an ever-increasing real-time crisis. So, my plea is for clarity and a shared purpose across the political spectrum as we head towards the 2026 election.

There are many routes to positive reform – and an a much-improved NCS Bill may be one of them.

But either give us the timescales for legislative change and a space for our voice to shape collective reform, or look at alternatives to the current Bill and let us get on with those. Political wrangling, backroom deals and power-struggles for another 18 months won’t help the people who any NCS is meant to be for – the people across Scotland who really need well-resourced, rights-based, accessible, quality support.

Those of us trying to keep a woefully under-resourced sector afloat for the people who need it need more than the hope of reform; we need to know that something better is really coming our way.

Read our Briefing on Priority Areas of Focus for Amendments to the NCS Bill at Stage 2

Read our Thematic Assessment of the Alignment of Principles to Underpin a National Care Service

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26 October 2023

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

 

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15 August 2023

4 Steps 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.

 

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12 July 2023

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.”

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24 March 2023

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.

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