Adult social care and support in Scotland

Author: Anne Jepson

PDF Published: Thursday 03 Dec 2020 (SB20-78)

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Overview
Report

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Overview
Report
- Executive Summary
- Introduction
- Definitions of social care support
- Changing demography
- History of social care
- Social care is not organised like health care...yet
  - A brief aside: Social Care and Social Security Benefits
- Legislation and policy context
  - Social Work (Scotland) Act 1968
  - Part IV of the NHS Community Care Act 1990
  - The National Assistance (Assessment of Resources) Regulations 1992
  - The Regulation of Care (Scotland) Act 2001
  - The Community Care and Health (Scotland) Act 2002
    
    Free personal and nursing care in a care home
    
    Recouping payments made for personal and nursing care
    
    'Frank's Law'
  - Part V of the Public Service Reform (Scotland) Act 2010
  - Social Care (Self-directed Support)(Scotland) Act 2013
    
    The implementation journey of Self-directed Support
  - Public Bodies (Joint Working)(Scotland) Act 2014
  - Carers (Scotland)Act 2016
  - Other relevant legislation
- Accessing social care and support
  - Types of care and support
    
    Residential care (care homes)
    
    Changing provision of residential care
    
    Care at home
    
    Housing support
- How is social care organised?
  - How social care is funded
    
    Calls for reform of social care funding
    
    The challenge of costing outcomes
  - How social care is commissioned and procured
  - How social care is regulated
  - Staffing in social care
    
    Recruitment and retention
    
    Fair work and framework commissioning
    
    Workforce Planning
    
    Training
    
    Personal Assistants
  - Unpaid carers
- Scottish Government and COSLA Reform of social care
- Issues for social care (for twenty years and counting)
  - ...and proposed remedies in Scotland
    
    Reshaping care for older people
    
    Shifting the balance of care from hospital to the community
  - Scottish Parliamentary scrutiny and activity
    
    Committee scrutiny and third sector research: Social care and COVID-19
Sources

Note the reduction in children(i.e. birth rate) and working age adults and the near 4 percentage point rise in people of pensionable age.

Image: Figure 1: Estimated future proportions of working and non-working age populations

The charts above show us how many people, in different age groups and with different conditions, are receiving care and support.

Image: Figure 2: Age breakdown of people receiving social care support by condition

Most people getting support decide that they want the social work department to arrange it.

Image: Figure 3 How do people choose to use Self-Directed Support?

This diagram shows the 'journey' for a person who needs care and support. The journey starts (at the top of the diagram) with a social worker and the person deciding together what care and support is needed. This is a simplified version, and doesn't include all elements or considerations.

Image: Figure 4: Social care support pathway for adults

This chart shows that local authorities pay for most people to stay in care homes but that nearly a third of people pay for a care home place with their own money.

Image: Figure 5: How care home places are funded

These graphs shows the weekly cost of staying in a care home with and without nursing care. It also shows that the cost is higher for the people who have to pay for the care home themselves.

Image: Figure 6 Average gross weekly care home charges (cash)

This chart shows us that the number of care homes has gone down, except for those that are privately owned.

Image: Figure 7: Number of care homes over time

This chart shows the different groups who stay in care homes and how the number of care homes has changed over time.

Image: Figure 8: Change in numbers of care homes for all groups 2007-19

This chart shows that those most of those who receive care are over 75. This group also get the most help (more than 10 hours a week). But around 5000 people younger than 64 also get more than 10 hours help a week.

Image: Figure 9: numbers of people and hours of care and support provided in different age groups

This chart shows that most people who work in social care help people in their own homes. Each small circle equals 100 workers and the different colours tell us whether they work for a charity, a business or the local council.

Image: Figure 10: Staff employed in different aspects of social care in 2019

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