Hannah reflects on the Scottish Government’s new vision statement for the reform of adult social care in Scotland.
Following an extensive consultation period, in June 2019 the Scottish Government launched their vision statement (this link will take you away from our website) and programme framework (this link will take you away from our website) for the reform of adult social care.
Cumulatively, these documents are the product of over three years of consultation and discussion. They span the continued implementation of Self-directed Support (SDS) across Scotland, and the Carers (Scotland) Act 2016. They’re intended to outline the future of adult social care in Scotland, across a complex landscape of provision and practice.
The proposed vision for adult social care (including support for carers) paints an attractive picture: person-led, directed by human rights approaches and principles, and centred on quality of life. There’s an explicit statement that investment in social care support should match ‘its important role in this whole system of supports and services’. However, these aspirations must be viewed within the context of comparable policy and its implementation. SDS, the implementation of which is mentioned as a key ‘enabler’ for these reforms, is an obvious example.
Over the last six months, the ALLIANCE and Self Directed Support Scotland have been carrying out research (funded by the Scottish Government) into people’s experiences of accessing and using SDS. The initial findings from the ‘My Support My Choice’ project show close alignment between what people want from social care and many aspects of the ‘shared vision’. The reform documents make explicit statements about the need for ‘investment in Scotland’s people, society, and economy’. They focus on people’s quality of life and citizenship, including the ‘right to family life and for carers to have breaks and a life beyond caring’.
Yet these statements, although responsive to concerns within the care sector, are offered alongside consistent reductions in the budget for the SDS programme (this link will take you away from our website). Funding for SDS has fallen from £10.5 million in the 2017-2018 Draft Budget to £9.2 million in the 2018-2019 Draft Budget –an estimated real value of £8.99 million, allowing for inflation. The Scottish Human Rights Commission estimate that the latter equates to a 33.6% reduction in funding between 2015-2016 and 2019-2020 (this link will take you away from our website). This reduction took place while SDS was still being implemented across Scotland as the new mode of delivering social care. As such, detailed information on funding models is a key next step for the effective implementation of the reform of adult social care.
Similarly, the reforms state that ‘responding to crisis’ will be the exception rather than the rule in terms of how people first access social care support. Information will be provided for informed decision-making, and people will be treated with respect and kindness throughout. The reforms also respond to widely reported concerns about parity of social care experience, stating that people will ‘get the same quality and level of support across Scotland even if it is provided differently in different areas.’
These are admirable goals and match the ideals of SDS legislation and wider engagement with human rights. In practice, our research findings so far show that it’s increasingly common for people to only get help once they are in crisis, with eligibility criteria being tightened in response to budgetary constraints. Furthermore, there is significant variance in people’s access to social care across different local authorities (and even across different localities within a local authority area).
The reform of adult social care demonstrates engagement with many of the key concerns of people accessing social care and their families, care providers, and the public and third sectors. However, the sharp contrast between these ideals and current practice offers a significant challenge to effective implementation.
Concerns about a gap between legislation and practice have been raised repeatedly by respondents to ‘My Support My Choice’, and by our members. Going forward, the ALLIANCE will continue to highlight the realities of people’s experience of social care. We welcome the chance to facilitate public conversations and detailed discussion of implementation plans for the reform of adult social care, centred on people’s lived experience.