National Care Service: consultation analysis - easy read

Part 1 - What you told us about the National Care Service

Introduction

The Scottish Government had a consultation to ask people what they thought about plans for a National Care Service.

They want health and social care services in Scotland to:

• always give high quality care and support to every person who needs it across Scotland including better support for unpaid carers
• make sure care workers are respected and valued

Changes to health and social care services will happen by introducing a law called a Bill to the Scottish Parliament.

This would be a big change to public services.

The consultation was open from August to November 2021.

The Scottish Government has promised that there will be more chances for people to give ideas about how the new system will work.

Nearly 1 thousand and 3 hundred people and organisations answered the consultation.

Nearly all of them had experience of social care.

Organisations that answered represent or support:

• care workers and carers
• people who get care
• care providers – voluntary and private companies
• councils and health boards

Many people who answered the consultation thought:

• it was too long
• there was not enough time to reply
• there was not enough information about the plan
• some questions suggested a particular answer
• an Easy Read consultation was not available until long after the consultation had opened
• not everyone could take part
• there needed to be time to ask people what they thought as the National Care Service was developed

This easy read report says what the main themes from the consultation answers are.

You can see the individual consultation answers online here.

There was also an Easy Read consultation.

It had less questions that the main consultation so it was easier for people to fill in.

Sometimes people who answered the easy read questions said the same things as people who answered the main questions.

When people said different things, it has been added to this report.

Improving care for people

The National Care Service will be responsible for making community and health services better. What is good about this?

Most people thought:

• this would make sure there are high standards of care and support services and they are the same across Scotland
• this would help organisations work better together because there would be less rules and admin
• there would be more guidance for service users and staff
• Scottish Ministers should be responsible for the delivery of social care, through the National Care Service
• it should include prison services and children's services
• it should have human rights and equality at the centre of all work

People who answered the Easy Read consultation thought:

• it will share work that is going well
• it will make services more efficient

Efficient means the services are well organised and are good value for money.

The National Care Service will be responsible for making community and health services better. What may not work well?

People were worried that:

• people who get care and support or staff who support them may not have their voices heard
• it would change local services

People's needs change depending where they live especially people who live in remote and rural areas and on Scotland's islands.

• it is not clear what the role of local councils would be or if there would be local responsibility for services
• it would be difficult to move to one large service
• it would be difficult to keep staff
• there could be too many rules, admin and paperwork about how different parts of the organisation works
• it could change services that work well

People answering the Easy Read consultation said:

• it could be difficult to keep facts, figures and information safe and to share information
• there could be too much power at the top of the organisation
• politicians could influence how the National Care Service works
• it is important to learn from other large organisations like Police Scotland when they made big changes to the way they work

Access to care and support

This part of the consultation asked people how social care and support should be arranged and provided.

People wanted to do this by:

• speaking to their GP or another health professional
• speaking to a local voluntary organisation
• using a national phone helpline or online form

People thought it would be good to have one member of staff to coordinate care and support for each person

People were least likely to:

• speak to another public sector organisation
• use a drop in centre

People answering the Easy Read consultation thought:

• the supported person should be at the centre of making decisions
• they would ask their doctor about social care and support services

They said it was:

• difficult to know what was available to them other than their GP
• important to have accessible services

Support planning

Most people agreed that:

• they or their friends, families or unpaid carers should be involved in their support planning
• support with care planning could come from a voluntary organisation or a local community organisation
• decisions about support should make sure people can live a full life

People would like the right support depending how complex their needs are:

• if they need a little bit of support they could talk to a community support worker or someone from a voluntary organisation
• if they need a lot of support they could talk to a social worker

People thought the plan should follow the Getting It Right For Everyone National Practice model (GIRFE) with a single social care and health document or file.

People thought this would make things easier and they would not need to give the same information to many different health services.

Information would be shared more easily, staff would use the same words and work in the same way.

Equality and human rights would be at the centre of all work.

People were worried how information would be shared across different IT systems and if their personal information would be kept safe and secure.

In the Easy Read responses most people said the most important thing in their support planning was looking at support to live a full life and be as independent as possible.

People also thought making sure organisations work together would make it easier to get care and support services.

Right to breaks from caring

Most people said:

• everyone should have a right to a break from caring
• support should be what each person needs rather than the same support for everyone
• services should be flexible and change if needed
• preventative support – support that stops people getting to a crisis where things are difficult or dangerous

People who answered the Easy Read consultation thought:

• there should be a mixture of support that is what each person needs and support that is the same for everyone
• people can have very different needs for respite and this should be part of any support plan

Using facts, figures and information to support care

Most people wanted:

• information about a person's health and care needs to be shared across the services that support them
• new laws to make sure care services protect people's personal information

Some people were worried about:

• if online information and personal information will be kept safe
• the risk of starting a new large national IT system

People who answered the Easy Read consultation said:

• there would be less time and stress if they did not have to share the same information with different services

Some people thought not all information should be shared and consent should be gained from the supported person.

Complaints and putting things right

Most people thought:

• there should be a charter of rights and responsibilities that says what people can expect from care and support services
• there should be an independent Commissioner for social care to give people who get care and support a voice and to make sure complaints are dealt with

Many people thought how someone experienced the service should be used to check if the service worked well but this could be hard to do.

Most people who answered the Easy Read consultation thought:

• there should be one way to complain about health or social care services
• there should be clear information about what to do next steps if a complainant is not happy
• there should be clear information about advocacy services

Residential care charges

Many people thought that residents in care homes should pay some costs particularly for food and rent.

Less people thought residents should pay for:

• cleaning
• food preparation
• transport
• checking and repairing things
• furnishings and equipment

Most people and organisations think the means testing arrangements should be changed.

Means testing is the way it is decided how much a resident pays for their care, depending on how much money they have.

Less people who answered the Easy Read consultation thought residents should pay for:

• gas and electric
• leisure and entertainment
• cleaning

Children's Services

Most people thought children's services should be in a National Care Service and thought:

• it would make it easier for people to get care and support when they move from children's services to adult services
• children and adult services could work together and this would be easier for families

Some people said it could mean the loss of the link to education.

Community Health Services

Most people thought the National Care Service and the Community Health and Social Care Boards should make decisions about community health care services and be in charge of them.

Many people felt this would:

• make it easier for people to get support
• help to make sure people all over Scotland got the same service

Some people wanted to know if there would be enough money for services.

If Community Health and Social Care Boards were in charge of GP contracts people thought this would mean:

• health and social care services would link up better
• multidisciplinary teams would work better

People also said:

• it could be difficult for it to be clear who was in charge of what services
• there was a risk that health services could be split up

Social Work

Most people thought that social work being part of the National Care Service would give:

• make sure services are the same everywhere in the country
• give better outcomes for service users and their families

People said the risks were:

• losing local knowledge
• not knowing who was responsible for different services
• social work might not be as important as it is now
• it could change services and cost more

Nursing

Most people agreed that Executive Nurse Directors should have a leadership role in the Community Health and Social Care Boards.

The National Care Service should make sure:

• social care nursing staff get training
• there are clear rules and standards of care

Justice Social Work

Many people thought Justice Social Work should be part of the National Care Service.

Some people thought this would:

• make sure people get the same justice social work service in all parts of the country
• keep social work services together
• help to link offending behaviour with care and support needs

People also thought risks were that:

• the new service would be too big, have weaker leadership and everything would be centralised
• it may not show that justice social work is specialised
• resources would not be used well
• services would not be delivered in a way that was good for service users

Prisons

Most people thought social care services in prisons should be part of a National Care Service.

They thought it would:

• give better support for prisoners with mental health problems or learning disabilities
• make it easier for people when they are released from prison

People who did not agree said:

• different ways of working are needed in different local areas
• it could be more complicated
• it would need more money and staff
• there are no facts and figures to support the changes

Alcohol and Drug Services

Most people thought:

• Alcohol and Drug Partnerships organisations could work together well and give good outcomes for service users
• Alcohol and Drug Partnerships should be part of the Community Health and Social Care Boards

Some people suggested some alcohol and drug services could be better delivered through national commissioning.

Commissioning is how it is decided what services are needed, who will deliver them and how they are checked to see if they are working well.

Mental Health Services

Most people thought mental health services should be part of the National Care Service.

Some people suggested:

• there should be a quicker way to make a referral – to ask for a support service
• there should be multi-disciplinary teams – this means having different services in one team
• services should be better at sharing information

People said there was a risk:

• if there is not enough money for mental health services
• in getting new staff and keeping the staff we have
• needing better ways to move from children's mental health services to adult mental health services

National Social Work Agency

Most people thought that having a National Social Work Agency would:

• make training and professional development better
• help with staff planning
• make Social Work more respected

Most people thought that the National Social Work Agency should be a part of the National Care Service.

Most people thought that the National Social Work Agency should:

• be in charge of making social work better
• help lead social work education
• have a national framework for training and development

Some people thought that the risks could be:

• more paperwork
• less local knowledge
• moving to a new system