A care home sector actively managed by a national care service contract is one of the key recommendations for a new model of social care in Scotland.
Concluding the Independent Review of Adult Social Care, a new report calls for a ‘new deal’ for residential care, characterised by “transparency, fair work, public good, and the re-investment of public money in the Scottish economy”.
In terms of transparency, the review, which is headed by Derek Feeley, a former Scottish Government director general for health and social care and chief executive of NHS Scotland, calls for financial transparency on the part of providers. A national care home service would also demand a level of return that providers should re-invest in the service in order to promote service quality and good working conditions for staff.
This will include the introduction of skills-based national minimum terms and conditions as a key component of commissioning and procurement, with specific priority for pay, travel time, sick pay arrangements, training and development, maternity leave, progression pathways, flexible pathways and pension provision.
Other factors determining commissioning and procurement include the development of national minimum quality outcome standards.
Funding models are also discussed in the report, and it is accepted that individuals should make a means-tested contribution to their accommodation costs, although not to their care which remains free at the point of need.
Explaining the recommendations, Feeley says that a National Care Service will achieve the consistency that people deserve, will drive national improvements and strategic integration with the National Health Service, and bring national oversight and accountability.
The proposed changes also aim to shift the thinking on social care to a system that sees social care as an investment in preventative/anticipatory care, rather than a crisis-based burden, and a service that is collaborative rather than competitive.
Feeley concludes: “We have inherited 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. We also need to have an eye to the future.”
The review was launched by the Scottish Government in September 2020.