National Care Service - making sure my voice is heard: regional forums - findings summary

Next Steps

What’s next for Making sure your voice is heard

We are continuing our programme of co-design across the country and there will be an additional session focusing specifically on complaints and independent advocacy.

We will continue to write up and analyse what people have told us in the co-design sessions for Making sure your voice is heard. We will look to see if there are gaps in what people have told us about what is working well or not working well, and check for areas we need to explore further.

The focus of our co-design activity will shift towards gathering the suggestions people have made to improve people’s experiences and outcomes and testing out ideas for change to make sure they will work. We will also continue to work with key organisational stakeholders to further explore and understand what is currently happening, what is working well and not working well. We will work with them on taking forward people’s practical suggestions for improvement that can be implemented now.

It is important that we hear the views of as many people as possible during the co-design activities. We will speak to people from different walks of life and from

different areas of Scotland, including those from seldom-heard groups. We will look for gaps in who we have heard from and we will take steps to make sure we have heard from a diverse range of people.

Complaints – lessons learned

The feedback we have heard so far has flagged five broad themes for us to consider further to ensure the development of an NCS complaints service that is fair, effective and consistent. These themes are: integration; person-led complaints; complaints culture and leadership; workforce; and redress and outcomes.

We will continue to work with people to develop ideas for:

• how to improve complaints where people are transitioning between services and ensure joined-up complaints processes between different sectors
• how to ensure complaints processes are led by the needs of the person making a complaint and are accessible.
• how to embed a culture within the NCS that values complaints as opportunities for learning and improvement.
• how to support the workforce in handling complaints, such as training or guidance

We will work with people to understand more about what people are hoping to achieve from complaints, and what changes can be made so complaints are resolved more quickly and people get better outcomes.

Underpinning all of these themes will be our commitment to embed and promote human rights and equality throughout the complaints process in line with the NCS principles.

Independent advocacy – lessons learned

The feedback we have collected so far has flagged areas for us to consider further as we explore improvements to the provision of independent advocacy services for social care.

We will continue to work with people to develop ideas for:

• ways to improve the awareness of independent advocacy services and what independent advocacy services can do for people receiving or trying to access social care support
• ensuring that people are aware of independent advocacy services and that they can access them at the points in their social care journey when they can be most effective, such as through assessment or complaints processes.
• how to improve independent advocacy services availability and capacity. Particularly for certain groups, such as unpaid carers and those who live in rural and island communities
• ways to improve the consistency and quality of the independent advocacy provision across Scotland

We have heard that it is important for independent advocacy services to remain independent of the organisations that deliver social care services. We will keep working with people to make sure they have confidence in the support they receive from independent advocacy services with the transition to the National Care Service.

We will look in more detail at:

• how advocacy services are funded
• how advocates are trained and how to improve the training of advocates
• how services are evaluated to ensure that people have access to high quality advocacy services

Support planning – lessons learned

The feedback we have heard so far has flagged various areas for us to explore further in co-design to improve the initial access journey and support planning process.

We will continue to work with people on:

• ways to improve people’s awareness of where they can go to tell somebody about their social care support needs
• what types of information or support they should expect
• ways to help people who don’t think of themselves as unpaid carers know what support is available to them
• how we can provide a level of national consistency in the first access services that are available, but with flexibility in provision that reflects individual needs and local circumstances

We will work with people on ways to further develop and enhance delivery of a conversation approach to support planning that empowers people to be actively involved in decision making:

• exploring ways to standardise approaches, which still allow flexibility to respond to people’s individual needs
• ensuring support planning processes can reflect the fact that care provision will vary depending on different local circumstances
• looking at ways to make it easier for unpaid carers to get involved, both in conversations involving the people they care for and to speak about their own needs as carers

Looking at how access and support planning works we will explore with people:

• ways to improve how services communicate with people
• the idea of a single point of contact type of service The idea of a centralised advice service

Eligibility – lessons learned

We learned that the current system of using eligibility criteria to determine if an individual can receive social care support is deeply unpopular.

People described the system of eligibility criteria as unfair as the availability of social care support can be determined by budgets and resource availability rather than ‘need’ and that this could be discriminatory.

People expressed concerns about inconsistency in the application of eligibility criteria across the country. There was also dissatisfaction about the lack of portability of care support packages across local authority boundaries.

The interface between identification and assessment of need, support planning, the role of the professional social worker and eligibility to receive social care support was a theme throughout discussions.

The Scottish Government and COSLA are jointly committed to the “overhaul of the current mechanism of eligibility criteria to ensure an approach to adult social care support that is based on human rights and needs”. Together we are working with partners and stakeholder organisations to develop options for delivering this overhaul. The opinions gathered in these co-design sessions will form a key part of the evidence base for the development of these options and we will continue to co- design options on eligibility criteria with people with lived experience.