'Crippling' shortages of care workers in Scotland

The data compiled by Scottish Care, which represents the independent care sector, found more than three-quarters of care homes have current staff vacancies and 90 per cent of care-at-home services said they have difficulty in filling job positions.

The private sector provides the majority of care home places in Scotland and just over half of home care hours for older people.

A separate survey carried out among care workers in the private sector by the GMB Scotland union also paints a picture of a workforce under increasing stress, with more than two-thirds considering leaving for another job.

And almost one-in-five workers said they felt under pressure every day to cut corners in their work, with many pointing to increased staffing levels as one thing which would improve care for residents.

With predictions that the number of elderly people requiring some form of care will increase by two-thirds over the next 25 years, experts are warning there is an urgent need to examine how it can be sustained in the future.

Dr Donald Macaskill, chief executive of Scottish Care, said that behind the statistics was a story of someone who was not being cared for to the fullest possible extent because of staffing shortages.

He said: “The trends are showing that we are not only finding it difficult to attract workers, but we are increasingly finding it difficult to hold onto workers. Frontline workers are saying to us is what we have become is virtually automatons and they don’t have time to be with people.

“One of the things we are calling for is a return to a relationship-based care in home care services, which is time flexible and which is also preventative.

“It is those times where you have conversations and form a relationship with an individual which enables the worker to recognise somebody is changing their behaviour, when someone has altered the way in which they are responding to medication, somebody is less mobile than they used to be.

“You can’t do that if you are in and out in 15 minutes.”

Scottish Care carried out a survey in January and February this year which showed that 89 per cent of care-at-home services have vacancies and 58 per cent of respondents stated it was harder to recruit this year compared to last year.

One third of total staff leave every year and nearly one staff member in 10 is from the EU – raising concerns over the impact of Brexit on the sector.

There is an equally worrying picture for care homes, with 77 per cent reporting vacancies and 25 per cent reporting greater difficulties in recruitment compared to last year. The average rate of staff turnover is 22 per cent and more than four out of 10 care homes rely on recruiting support workers from the EU.

Macaskill said: “If we all hope to live longer and to enjoy that life, we are going to have more and more people supporting individuals who need that support, and I don’t know where they are going to come from.

“If you speak to frontline carers they will talk about how rewarding it is, how fulfilling, and they can’t imagine themselves doing any other job.

“But at the end of the day people have bills to pay and it is continually going to be a struggle to keep that sense of vocation going when people have not surprisingly, mortgages to pay.”

Between 2006 and 2015, the number of older people in residential care run by the private sector increased by five per cent to 25,700, according to a recent report from Audit Scotland.

Over the same period the numbers in local authority or NHS residential care fell by almost a quarter, to 3,747. Residential care provided by ‘third sector’ organisations – such as charities – also dropped by 14 per cent to 3,324 older people in this accommodation.

Around 61,500 people also receive home care services in Scotland and the independent sector provides around 55 per cent of home care hours for older people.

Councils currently spend around £1.6 billion a year on outsourcing all types of social care services – with roughly two-thirds to the private sector and a third to charities.

Macaskill said there was a gap between the requirements of social care and the funding made available to providers and called for an analysis of the true cost of care in Scotland to take place – similar to the Dilnot Commission in England, which examined the future funding of care and support services in 2011.

He said: “We recognise the public purse is much tighter than it used to be, there is always going to be that drive to ensure we get the best value for our buck, but the problem is we are not dealing with purchasing paper clips, we are dealing with people who are spending their time enabling people to lead more fulfilling lives.”

He added: “We see no other profession which is so critical to the lives and wellbeing of so many, but which is so under-recognised and under-valued. If this doesn’t change, the future of care provision looks very bleak indeed.”

The Scottish Living Wage of £8.45 per hour for care workers was introduced by the Scottish Government in October last year.

GMB Scotland pointed out that over the next 25 years the number of people aged 75 and over is predicted to increase by 86 per cent and the number of people requiring some form of care will increase by two-thirds over that time.

The union wants to see care workers treated as a skilled profession and has called for all bodies – including employers, government, and trade unions – to work together to improve the terms and conditions for workers in the private sector.

The GMB Scotland survey of care workers found 98 per cent said they felt passionate about their work, but 71 per cent said they did not feel fairly rewarded for the work they do.

Nearly three out of ten – 28 per cent – said they were subject to verbal abuse on a daily basis at work and one in five received state benefits to subsidise their pay.

When asked what could be done to improve care comments in the survey included: “We as carers are constantly expected to work short-staffed. It is on an almost daily basis. I would like more recruitment and at least some more support at work.”

Another respondent said: “More staff on duty to reduce pressure on all carers.”

Keith Robson, chief executive of the charity Age Scotland, said the shortage of staff was a “worrying situation”.

He added: “The Scottish Government has introduced a living wage for care staff but the fact that so many care providers have vacancies and are struggling to recruit shows that further action is required.

“The fact so many of our carers come from EU countries also shows the importance of this issue for older people in negotiations over Brexit.

“Recruiting the care staff we need represents a problem that needs tackling now before it becomes a crisis.”

Health Secretary Shona Robison said: “Raising the status of social care as a profession, and attracting and retaining the right people, is key to delivering quality care. That is why we have taken action to protect care services, including paying the Living Wage to adult care workers, boosting the income of up to 40,000 people.

“In the coming year there will be almost half a billion pounds of NHS investment in social care and integration, underlining that we are treating this as a key priority.

“We are also working with COSLA and care providers to deliver a major reforms to adult social care, which will consider workforce issues and new models of care and support.”