Scottish Care, the umbrella body for independent care home providers, and local authorities’ body Cosla are often on opposite sides of the negotiating table.
They don’t always see eye-to-eye over the amount councils are willing to pay for care. Care home providers also resent the fact that councils often ask private providers to deliver care for far less money than they are willing to provide to their own in-house services.
So it is unusual to see them on the same side of growing tensions over the Scottish Government’s Safe and Effective Staffing in Health and Social Care proposals. Ministers want to enshrine in law the procedure for planning and recruiting nursing staff to meet demand.
This is widely supported in the NHS. But problems arose when someone in the Government thought the law should also apply to social care, as services are increasingly integrated.
This sounds logical. But it isn’t just Scottish Care and Cosla who have concerns. Critics of the approach, also include the Scottish Social Services Council (SSSC) and the Care Inspectorate – both say social care should not be included in the new law.
There are various reasons for that. Some have objected to the emotive title of the bill, implying that services at present may not be safe. In fact, there already are ‘safe’ staffing rules in place for care homes, overseen by both the SSSC and the Care Inspectorate.
That is why the Care Inspectorate says the rules don’t need to apply to the care sector. Applying workforce planning measures designed for health to social care settings is “neither helpful... nor necessary,” their response adds.
The inspectorate doesn’t agree with the proposal on the basis that legal staffing levels are already established in regulations.
The SSSC says the law needs to recognise the diversity of approaches in social care. It also claims the wording of the proposals is confused, referring throughout to improving outcomes for patients. “Some people accessing social services are patients some of the time. People living in care homes may be viewed as residents,” it says.
The Scottish Care response too refers to the “vastly different contexts” for social care, while Cosla warns the move could destabilise the whole system and describes the whole policy as potentially “burdensome without being beneficial”.
Some do buck the trend. Healthcare Improvement Scotland aregues safer staffing rules should apply to social care, because anything else risks unintentional “skewing” of resources.
However the Government’s own analysis of responses admits that while individuals generally supported its plans, “Health and Social Care Partnerships and other public bodies were the only respondent types in which the majority of those answering the question did not agree.”
‘Only’ is a strange choice of word. The key public agencies responsible for social care do not agree. And that surely means pressure is building on ministers to reconsider.
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