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11 January 2018, 06:41
More than 80% of independent home care services are concerned about being able to survive this year, a new survey has found.
The study by Scottish Care, which represents independent providers of social care, found 86% were concerned about their sustainability and survival in 2018 and 24% were "extremely concerned".
Half of home care services did not apply for local authority contracts in 2017 due to sustainability and capacity, while 40% handed work back to councils last year on these grounds.
The online survey, carried out the last month, represents 5,893 home care staff across Scotland caring for more than 12,000 people per week.
Scottish Care chief executive Donald Macaskill said: "We are not crying wolf when we stress the precarious nature of home care in the current climate, with the results of this survey emphasising how genuinely close to collapse we are in Scotland.
"It shows that half of the services we represent feel unable to compete for contracts because the rates and conditions at which they are set by local authority make the delivery of dignified care impossible to sustain. And of those who do try to make it work, 40% are forced to hand that work back because it is not viable to continue operating.
"It means we have a huge number of home care services willing and able to provide high quality care in people's own homes but who are stifled from doing so by a drive to the bottom by local authorities in terms of pay and conditions offered to those services delivering that care.
"The inability of services to recruit and retain staff and to pay them a good wage further cripples these essential services. We are faced with a reality where a quarter of services are not sure they will still be operating this time next year."
He called for urgent action for integration and funding of social care services.
Mr Macaskill added: "It is all very well to join up health and social care systems on paper and as structures. But real partnership which puts people at the centre needs to be worked at, not just spoken about.
"We need to work very hard in 2018 to ensure we still have a social care system able to care for our vulnerable older citizens. At the moment this survey suggests that there are worrying signs that we will not."
Concerns over the funding of social care were echoed by the local government body Cosla, with health spokesman Peter Johnston stating they had raised the issue with the Scottish Government as part of the 2018-19 spending review.
But he said: "It is wrong not to recognise that Scottish local government has driven up standards in relation to pay and conditions when we have promoted and supported, encouraged and negotiated contracts which include the Scottish living wage.
"There are other factors which affect sustainability in care at home including the current market configuration, individual business models and, critically, the ability to recruit and retain staff.
"We are facing a significant workforce issue in adult social care and this has the ability to get worse as more demand and further policies come into the system, things like extending free personal care to under-65s.
"The cuts to public funding and the dearth of care workers means that we all need to change our approach, service design and business models.
"We would look to providers to work with us to provide solutions which are sustainable for all. We would also look to Scottish Government and the Scottish Parliament to support us in this with an adequate settlement for local government."
A Scottish Government spokeswoman said: "This Government is taking action to protect care services, investing almost half a billion pounds of frontline NHS spending in the current financial year in social care services and integration.
"This will continue to support the delivery of the Living Wage for adult care workers. Our national health and social care workforce plan will also support our trained and dedicated workforce deliver new models of care.
"Meanwhile our draft budget will deliver record investment in the NHS as well as funding to increase payments for free personal and nursing care and further increase the care and support provided closer to people's homes, boost mental health spending and deepen the integration of health and social care.
"We are also working to provide support to health boards wherever they might need it, with the additional £22.4 million investment the Scottish Government has already made available for wider A&E and winter pressures."