THE pandemic exposed a “creaking and fragile” care system and infection control failings that require radical change under a new National Care Service, experts have said.

An independent review of adult social care, which was commissioned in response to the catastrophic impact of Covid on care homes, calls for urgent improvements in workforce planning, pay and conditions and a re-think on charging policies.

Social care staff spoke of the lack of support and training opportunities, which had led to “serious consequences for those who use services”. 

The authors of the report were also frequently told that workers “could earn more in a supermarket”.

Care homes that successfully minimised outbreaks of Covid-19 tended to be “smaller, locally run and staffed services”.

READ MORE: 'It's really positive': Self-funding care home residents to benefit from significantly higher financial support 

The report, which was commissioned by the Scottish Government and led by former NHS chief executive Derek Feeley, found there were problems deploying care home staff quickly during the pandemic and calls for a national advisory body to oversee workforce planning in a similar way to the NHS.

It makes more than 50 recommendations, including the appointment of a Minister for Social Care to oversee improvements.

Henry Simmons, chief executive of Alzheimer Scotland, said the charity was “delighted” that the report calls for all an end to all “non residential” social care costs. It means those with advanced dementia in care homes would not be required to foot the bill for nursing care.

The report said: “It does not make sense for people to have access to health care free at the point of need but, in circumstances that are equally related to their health and wellbeing, to be charged for support.”

Mr Simmons said: “We would like to see further details on this particular recommendation, as it is our main objective to bring an end to this inequality.” The charity’s Fair Care campaign is backed by The Herald.

The working conditions of social care staff form a major part of the review with with the gender imbalance – 83 per cent of staff are female – cited as a reason for inequalities in pay and conditions.

READ MORE: Th e pandemic blamed as care home residents face monthly fee rises of up to £240

“Were it 83% male, it simply would not be marginalised and undervalued as it is.” It calls for all frontline staff to be paid the real living wage of £9.50 an hour.

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

The review estimates that the cost of implementing all the recommendations would be an extra £0.66 billion annually but said the expenditure was justified on human rights grounds and investment in the workforce and economy.

“There is clear evidence that social care support is not a drag on our resources; it creates jobs and economic growth. It enables people who access care and support, and their carers, to seek and hold down employment themselves.”

Most people who contributed to the report 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.

The report said: “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.”

It cites as good practice, schemes in Moray, the Borders and South Lanarkshire, which combine private housing space with communal facilities, onsite care and dedicated nursing support and homeshare initiatives that involve a young person staying with an older person in exchange for low-cost accommodation.

The report recommends that the free personal care and nursing allowances for self-funding care home residents should be increased in line with those who do not pay, which would cost an additional £116 million annually. It found that those who pay are facing shortfalls of  around £191 and £230 per week.

READ MORE: Scottish Government urged to scrap 'unfair' contributions system for nursing care home costs 

The Health Secretary announced last week that it is to fast-track an increase of 7.5 per cent  by April, with local authorities given £10.1m to cover the rise, which Alzheimer Scotland said was an important “first step”.’

Labour’s Monica Lennon said: “Scottish Labour and the trade union movement has long campaigned for a National Care Service.

“The workforce has been undervalued and underpaid for too long and unable to collectively bargain for improved pay and conditions.

Mr Feeley said:  “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.
“If we want a different set of results, we need a different system.”

The Health Secretary Jeane Freeman said the Government is considering the review and would respond in due course.