The latest statistics from the care inspectorate highlight the fragmented nature of care services in Scotland and plenty of poor quality delivery.
There are now more than 62,000 people who receive some form of care in their own home in Scotland. These people are cared for by 814 different registered providers of services, including private firms, councils, the NHS and not-for-profit organisations. This is a level of fragmentation that Scotland has avoided in most other public services, unlike south of the border.
This fragmentation isn't doing much for the quality of service either. The latest report from the Care Inspectorate says: "There was a notable increase in the number of poorly performing services during 2012-13...... Services achieving these very concerning grades generally improve, but these improvements are not always sustained."
More than 100 home-care services for the elderly have been given low ratings for how they are run, one in ten have been rated adequate or below for care and support, 70 have been given low ratings for the quality of staffing. 5% of private companies were graded "unsatisfactory or weak for every theme".
Annette Bruton, chief executive of the Care Inspectorate, told The Herald that the failures should not be tolerated, She said, "We should have a zero-tolerance approach to the quality of care that the most vulnerable people get in our society. We should not tolerate that five per cent failure of service."
Failures include risk assessments not being in place for pensioners, or being carried out by staff who were not qualified. In others, "staffing levels which were clearly insufficient to meet the needs of the individuals" or staff not trained or qualified to carry out the tasks required. The administration of medicines was also found to be unsafe.
Kenny Campbell, a complaints team manager for the Care Inspectorate, said providers did respond to the Care Inspectorate's interventions. "The most common complaints that we see coming through the door are mostly about people not turning up, not turning up on time, not knowing who is going to turn up or the number of different people turning up to give care."
This all reflects the findings in UNISON Scotland's report 'Scotland: It's Time to Care', in which we asked care workers to describe the conditions they have to work in. A rigorous care inspection regime is fine, but what's really needed is a new approach to delivering care in Scotland. That needs proper funding and fair employment standards including the Scottish Living Wage. A less fragmented service would also be an improvement.