Transforming social care: Scotland's progress towards implementing self-directed support 2011-2018

Conclusion

The development and embedding of large scale approaches to choice and control across an integrated health and social care landscape is underway.

This has been a complex task both in itself and in the context of the significant changes to social care and related systems since 2010. These wider changes have included legislative changes, structural changes, financial pressures and increasing levels of demand and expectation. Despite the challenges, valuable progress has been made and stakeholders are keen to both showcase the advances made in their local areas, and to hear about and learn from the ways that implementation is being approached in other areas.

The challenges in implementing self-directed support are being recognised and tackled at all levels, and there have been substantial changes across the policy landscape to support transformation. The Health and Social Care Delivery Plan is a platform to embed person-centred approaches across a range of policies and achieve greater policy cohesion. The recommendations in the joint Scottish Government and COSLA Health and Social Care Workforce Plan part 2 bring a renewed focus on professional values and on improving recruitment and retention outcomes.

The shape of our population is changing, and health and care needs will continue to evolve as medical, social, and technological advances push the boundaries of what was possible in the past. Our system must adapt to more people accessing support, and often with more complex needs. The Scottish Government and COSLA are jointly developing a programme of reforms for adult social care, working closely with individuals and stakeholders with different experiences and expertise.

This process is taking a whole-system approach in considering the activity required to comprehensively reform the way in which our adult social care system operates and is understood so that it can best support an integrated health and care experience for people, and so that we can ensure that access to quality support is sustainable for the future. This will include aligning current activity to a common goal for adult social care and designing and taking forward new reforms.

This report marks a significant milestone in the journey towards the full implementation of self-directed support as Scotland’s mainstream approach to social care. The impact and learning of the last seven years of investment evidence the beginning of a clear shift towards social care that offers genuine choice and control to supported people and their families.

"…actually you can do more if you think in a different way and work in a different sort of way, and to some extent are prepared to take risks and let people take responsibility for their own lives."
Social Work Scotland research participant