Social care support reform: summary of discussion paper responses

1. Introduction

1.1 Background

Scottish Government and COSLA (Convention of Scottish Local Authorities) are working together with people who use social care support, carers, and a wide range of local and national organisations, professionals and individuals to develop a national programme to support reform of adult social care. In this report, groups of people and organisations are sometimes called stakeholders.

As part of this, Scottish Government and COSLA wrote a discussion paper which set out some suggestions for what the national programme could include. The discussion paper was written after speaking with people who use social care support; with a range of key leaders and representatives in the social care sector in Scotland; and with organisations providing information, advice and support around social care for people and policy makers.

The discussion paper describes an overall approach to reforming social care in Scotland that is based on consensus and collaboration. It outlines some of the key opportunities for a national programme to support local reform. These include:

• increasing awareness of what social care is and its social and economic value;
• embedding self-directed support as Scotland's approach to social care;
• developing a shared vision for social care which uses the new opportunities of integrated health and social care services and support in Scotland;
• considering how social care is provided;
• considering the cost of social care support and how it is paid for;
• understanding and removing barriers to current and future reform efforts; and
• supporting strong and collective leadership around social care.

A list of the specific topics, issues and opportunities contained in the discussion paper is at Annex A.

The discussion paper and accompanying questionnaire were developed to stimulate thought and gather a large range of views from stakeholders. The aim was to gain a deep and rich picture of the key issues affecting social care in Scotland. They were sent to stakeholders including disabled people's organisations, other groups and organisations representing views and experiences of people who use support and carers, information and advice organisations, local authorities, NHS health boards, integration authorities, relevant public bodies, professional bodies, and social care provider organisations during October 2018.

The questionnaire (see Annex B) is a series of seven open questions. Using a questionnaire meant a large amount of information could be gathered in a relatively short period of time. Some stakeholders held workshops with their members to create their response. See Annex C for a summary of the range of experience, specialisms and functions of those who contributed to the 54 responses.

Qualitative analysis of the responses looked for themes, insights and explanation for what social care is like now and what needs to change. This method was chosen because responses were unique to the respondent. This was because the questionnaire was designed to gather people's specific knowledge, experiences, opinions, attitudes, feelings and perceptions.

It is important to note that:

• many responses were from organisations or membership bodies and collated the views of a number of people or organisations;
• the questionnaire asked for comment on topics not covered by the discussion paper, so if people agreed with what was in the discussion paper they may not have commented on or repeated a specific topic even though they felt it was important or relevant;
• responses are not fact but reflect views and opinions;
• responses are not necessarily representative of public opinion.

This report presents a qualitative summary of the analysis. It focuses on what people said regarding:

a) topics relevant to the national programme and adult social care reform;

b) collective leadership for the national programme; and

c) a shared vision for adult social care.

The analysis identified topics that were mentioned frequently. Within these frequent topics, different responses often focused on different things. Topics that came up less frequently are also included in this report, as they raised important issues and provide valuable insights.

It is important to note that in many cases, the themes and topics presented in this report are interconnected and have a direct impact on each other, or form part of one another. They should not be regarded as individual or isolated topics.

The analysis in this report therefore represents a range of topics which stakeholders responding to the questionnaire said were relevant to reforming adult social care in Scotland. Further investigation through discussion with stakeholders will take place to reach consensus on the priorities for the national programme for adult social care reform.

1.2 How this report is structured

Chapter 2 talks briefly about a refreshed plan to support the implementation of self-directed support as Scotland's approach to social care. It sets out how and why this plan is relevant to the overall reform programme.

Chapter 3 presents the topics that were identified as themes/prominent categories within people's views about what was relevant to reforming adult social care.

Chapter 4 presents the topics that weren't classed as themes, but were still discussed by some stakeholders as being relevant to the national programme and reforming adult social care.

Chapter 5 sets out stakeholders' comments on collective leadership for the national programme, and overall for reforming adult social care.

In Chapter 6, the report then focuses on what people said should be included in the shared vision for adult social care, how it should be developed, and how it should be achieved.