An independent review that was prompted by the catastrophic impact of the pandemic on care homes has called for the creation of a National Care Service on "an equal footing with NHS Scotland".

Derek Feeley’s report makes more than 50 recommendations for radical changes to adult social care which include national improvement programmes to raise standards in care homes and the appointment of a Minister for Social Care to oversee improvements.

The report recommends that the National Care Service should also ensure enhanced pay, terms and conditions for the social care workforce and provide better support for carers.

It recommends an end to charging for non-residential services, so that social care can be free at the point of need for those receiving care in their own homes or community settings, and a re-opening of the Independent Living Fund, which provides funding to enable disabled people to live in their communities.

Families who contributed to the report described the process of accessing social care as ‘notoriously difficult’, ‘over-complicated’ and ‘bureaucratic’.

The report said: "This is not a humane response to people living with disability or ill health, or who are simply getting older and are no longer able to live their lives without some support."

Social care staff spoke of the lack of support and training opportunities which had led to "serious consequences for those who use services." while the authors of the report were told frequently that people ‘could earn more working in a supermarket’.

Employers said a lack of training and career development opportunities made it difficult to attract and retain staff, which lessens their ability to establish rapport and trust with those accessing care.

Care workers said they felt "policed rather than supported" as a consequence of current registration arrangements under the Scottish Social Services Council.

The Care Inspectorate is also criticised for paying too much attention to "procedural and process issues" and not enough to individuals’ experience of care.

Most people said they would like to live in their own homes for as long as possible but reported that there is still an "almost automatic default" to care home care in some areas, particularly for frail older people. 

"We are concerned that at times the emphasis on residential care for older people is counter to that fundamental right to choose and is sometimes suggested because care at home can be more expensive. Alternatives exist."

The Herald revealed last week that the Scottish Government is planning to fast-track a 7.5% increase in the allowance given to those who pay their own care home fees, with local authorities allocated an additional £10.1m to cover the rise.

Health Secretary Jeane Freeman said the higher than usual increase in personal and nursing care contributions was recognition of the increasing cost of providing care, particularly for those with dementia and was welcomed by Alzheimer Scotland.

Mr Feeley said:  “This is a time to be bold and radical. Scotland needs a National Care Service to deliver the high quality, human rights-based services people need to life fulfilling lives, whatever their circumstances.

“Scotland has ground breaking legislation on social care but there is a gap, sometimes a chasm, between the intent and the lived experiences of those who access support.

"We have a system that gets unwarranted local variation, crisis intervention, a focus on inputs, a reliance on the market, and an undervalued workforce.

“If we want a different set of results, we need a different system. That’s why I want to see a National Care Service, delivered in partnership with the people who rely on it and with the workforce, which provides the opportunity for everyone in Scotland to flourish.”   

Claire Cairns, Network Coordinator, The Coalition of Carers in Scotland said: ““We are particularly pleased that the review has recognised the role of carers as the cornerstone of social care support and has recommended that carers have a right to respite, alongside recognition as full partners on key decision making bodies”.

Pat Rafferty, Scottish Secretary of Unite, added:: “We have repeatedly called for a mechanism which offers a route to collective bargaining for all carers not covered by existing and agreed bargaining processes.

"This is essential if we are to ensure that standards are met, regulated and every carer receives the best pay and conditions. 

"The creation of a National Care Service is essential to this process and to ensuring the highest standards are met across the whole social care sector but it’s not a silver bullet in itself.

"The system must be properly funded by government, and in light of the past 12 months, we need to move forward with urgency.”

Other members of the review include the former minister for health, Malcolm Chisholm, the former auditor general between 2012 and 2020, Caroline Gardner, and Ian Welsh, the chief executive of the Health and Social Care Alliance Scotland.