RESPITE services for carers in the Edinburgh area are "well below the Scottish average and declining" according to a damning report on elderly care in the capital which also warned that staff shortages meant older people were being left to deteriorate before they qualified for help.

Inspectors rated health and social care services across Edinburgh as either "weak" or "unsatisfactory" in five out of nine quality indicators, with the remaining four categories found to be "adequate".

Delayed discharges from hospital for patients over-65 were "substantially poorer than the national average" due to a shortage of care home places or home care provision, with spending on emergency admissions for the same age group also higher than average.

The report by the Care Inspectorate and Healthcare improvement Scotland is the first time the performance of the new Edinburgh Health and Social Care Partnership - formed by NHS Lothian and Edinburgh City Council - has been reviewed.

Inspectors found that respite provision for older people and their carers was "well below the Scotland average and declining". Relatives needing a break from caring had to book respite "many months beforehand" and emergency respite was "particularly hard to find". The report added that older people were sometimes "admitted to hospital as a ‘social admission’ because their

carers had been hospitalised" and there was no provision to offer them care at home.

The report stressed that while the care services delivered in Edinburgh were "generally of a good quality", many older people and carers "were unable to get help unless their needs were critical".

Inspectors said the partnership had ploughed "substantial funds" into maintaining and expanding existing services "at the expense of investment in early intervention".

They wrote: "A serious concern was the difficulty experienced by older people in getting services before their conditions had deteriorated. Most frontline staff told us they could deal only with the most urgent cases and were unable to give attention to preventative work through early intervention. Priority had to be given to older people needing to be discharged from hospital, which meant people in the community missing out or having to wait much longer for services to meet their needs."

However, the report acknowledged that the timing of the inspection - from October to December 2016 - coincided with a "period of significant transformation" for the partnership.

Inspectors have made 17 recommendations for improvement.

Robbie Pearson, chief executive of Healthcare Improvement Scotland said: “Although the partnership achieved good outcomes for some older people and their carers, too many people had poor experiences and poor outcomes.

“The partnership needs to strengthen care at home. Our inspectors found examples of older people being admitted to hospital because their carer was unable to continue caring, when they could have been supported to stay living at home."

Rob McCulloch-Graham, chief officer of Edinburgh HSCP, said the partnership had already taken "significant steps" to improve.

He added: “After the preliminary inspection results, we established an improvement team which has already produced positive results, almost halving the number of people waiting for care within their homes and reducing hospital waiting times by around 20 per cent.

“This report pulls no punches and there are clear lessons to be learned – however, the inspection was carried out before we implemented a long-term reorganisation of care and we were pleased to note that staff remain positive and committed to the important work they are doing.”