National Care Service consultation: discussion events summaries

2 September 2021

• Theme of discussion: improving cae for people
• Time: 18:00-20:00
• Discussions leader(s): Gillian Barclay

Introduction

This is a summary of the key points raised by attendees at this session.  None of the points have been attributed to individuals as the purpose was to encourage broad and open discussion.  The summaries for all the national events will be provided to the independent contractor undertaking the consultation analysis.

Points raised at event

• Dementia group receives support from East Renfrewshire Council, a brilliant service. LA’s elsewhere not passing on the money. Whole proposal drawn by politics not in support of  people but for Independence. How much would it cost to start up the NCS under one service. What is the financial implications and proposals for saving money.
• Not intending to nationalise care services.  Care delivered by a series of providers.  Not intending to bring all services under the one roof.
• Funding - recognised there has been a lack of funding over time.  Will cost a lot of money, commitment to increase social care funding by 25%.
• Interested in proposal to upgrade the service.  Concerned about the unmet needs in children under 18 and children moving from childcare to adult care. Coming from HCIS, think there is a sub text about reorganisation of regulatory arrangements through the Care Inspectorate. Interested to know how going forward can ensure quality improvement and also regulatory aspects, Covid has identified gaps in arrangements.
• Care at Home Service:  NCS a fantastic idea.  Good we’re looking at care based on need and not money.  Preventable preferable than crisis care management.  Care at Home staff to be recognised as professionals.  NCS about care, not division. Qualifications/Training to be transferable.  Big challenge is care training, cost implications are.  A lot of experience. 
• Waste of resource not allowing carers into NHS training theatres to take skills into communities.  Also allow access to Shared Database to allow one database if dealing with the sae people and not duplicate work.  Risk assessments.  Unite. Take pressure of carers.
• Applaud the ambition for more consistent care and support.  National approach not an end result.  NHS is an example, variations across boards.  Structural change won’t necessarily cover all the gaps.
• NCS need to be alive to local priorities and circumstances. One size fits all won’t work.  Learn from Police Scotland.
• Concerned NCS not based on a medical model. Also, what NCS might mean for social work services as we know it.  More a transactional service compared to how it once was and not mentioned in Feeley.
• Welcomes the plan.  So much needs to be changed at local delivery level, agrees with person centred care.  Not convinced self-directed care offers that.  Should be looking more at a person’s individual needs. Particularly those who live alone.   It is very difficult to identify who contacts are around social care.  Without knowledge difficult to know who to approach for help.  Cross party engagement would be helpful.
• In the 70s/80s carers showed respect and treated people with dignity.  Today, needing support, surprised at the low level of training, poor attitude, low morale, carers don’t care, made to feel a nuisance.  Horrified and appalled at how social workers speak to people now.  In the past it was much more patient centred and supervised to ensure standards.  It’s now all in a downward spiral leading back to institutionalisation.
• Welcomes the note around prevention in the document. Needs a genuine shift of resource. Prevention also needs more consistency around any approach too.
• Workforce planning is crucial, in particular around recruitment and retention. Can’t lose people too soon due to their experience.  Best practice needs to be shared.
• Not much in the document about the basis and logic for including children and families, justice services etc. and how that will improve the current service.  Also structural change does not always make a difference to the provision and quality of service.  A bit more background around the proposals to what was and Adult Services Review would be welcome.
• Correct about the lack of detail in the consultation.  An issue highlighted across all LA areas is lack of consistency in service provision.   Through the IJBs some partnerships include children services some do not. Aim is to make sure all services are currently in or out are in.  However, these are proposals, no detail yet.  There will be more detail when we analyse the results of this stage of Legislation.
• The Feely report was prepared during the pandemic, we need to step back and be sure his recommendations are a good idea.  Half the country thinks this is about nationalising social care, when it is about centralising it and structural change.
• Don’t make the mistakes of setting up empires costing millions and holding up improvement services in Scotland as has been seen in other services.
• Has seen success in this service in New Zealand, in Canterbury.  They integrated services 10 years ago, key to success was the training of the staff, helping them understand the meaning of integration and involvement of service users.  Change was made from the bottom up, not top down.  Fear a top down  re-organisation will absorb resources needed for services. Biggest problem for social care in the last years has been underfunding.
• However this turns out a plea to stop time and task. LAs think of it as a cost saving measure, but demoralising to carers.  Ideally would like carers to be salaried with conditions of service similar to the NHS. 
• Sharing of Data to support care.  Happy to do if it makes jobs easier and everyone is working from the same database.
• Broadly in favour of the NCS.  Agree with the social model comments, vital and will give a challenge when interfacing with NHS and more medical models. In favour  of a lifespan approach.  Missing piece is education, needs to be connected with young carers and children with additional support needs. Social care needs of young people often overlooked, need to revisit what social  care means to different groups.
• Ensuring children and young people with severe disabilities are heard presents challenges  particularly communicating with groups of adults, especially if they are not confident at communicating.  Views can often be assumed or taken up by others who know them in some respect but not all respects.  
• Some third sector organisations aim to give children leisure activities they can enjoy.  Often volunteers know a lot about the child that would help the person centred support.