A man at the centre of a fatal stabbing in a flat was discharged to his family's care without a face-to-face handover by doctors treating his "delusional" behaviour.
Social Work Services 'Not Sustainable In Long Term'
Current ways of providing social work services are unsustainable in the long term, according to a report that found the annual bill has hit £3.1 billion in Scotland.
The Accounts Commission found council social work departments are facing "significant challenges'' due to a range of financial pressures.
It estimated social work spending will need to increase by up to £667 million by 2020, a rise of 21%, unless new ways of delivering services are brought in.
The local government spending watchdog concluded councils have coped well in recent years with the challenges they face but said the country was now facing a "watershed''.
It warned the time has come for "frank discussions and hard choices'' surrounding the social work services of the future.
The report, prepared by Audit Scotland for the commission, represents the first time it has looked at the whole range of social work services across the country.
It sheds light on the range and complexity of care provided by the 200,000 people working in social work and social care - a sector which supported and protected more than 300,000 vulnerable Scots in 2014/15.
About 70% of the people helped that year were aged 65. Meanwhile, the number of youngsters on the child protection register has increased by a third between 2000 and 2015.
The report stated: "In 2014/15, councils' net spending on social work services was £3.1 billion.
"Services for older people made up around 44% of this spending and services for children and families around 28%.'' Other services made up the remainder.
Social work spending has actually increased by 3% in real terms since 2011/12 and now accounts for nearly a third of overall council outlay, the report found. It said it comes as councils' total revenue funding has fallen by 11% in real terms since 2010/11.
Social work has largely been reorganised into new integrated joint boards (IJBs) with the NHS, resulting in a more complex set of roles and responsibilities.
"Current approaches to delivering social work services will not be sustainable in the long term,'' the document stated.
"Councils' social work departments are facing significant challenges because of a combination of financial pressures caused by a real-terms reduction in overall council spending, demographic change and the cost of implementing new legislation and policies.
"If councils and integration joint boards (IJBs) continue to provide services in the same way, we have estimated that these changes require councils' social work spending to increase by between £510 and £667 million by 2020 (a 16-21% increase).''
The analysis found local authorities have adopted various strategies to achieve savings, such as by reducing services and cutting costs, but that there has been "little in the way of fundamental change in the way councils deliver services''.
Councils now "need to instigate a frank and wide-ranging debate with their communities about the long-term future for social work and social care in their area,'' the study recommended.
Douglas Sinclair, chair of the Accounts Commission, said: "Increasing pressures on social work and rising expectations of what it should deliver can only intensify.
"Now is the time for some frank discussions and hard choices. It is vital that people who use and provide services - and the wider public - are actively involved in that debate on future provision.''
Councillor Peter Johnston, health spokesman for council body Cosla, welcomed the report's "recognition that councils have done a tremendous job of protecting social care spending ... through a prolonged period of austerity''.
He went on: "However, Audit Scotland are right that we have reached a tipping point whereby mitigating and managing cuts is no longer a sustainable approach to the challenges we face.
"Demographic change, increasingly complex demand for care and support, additional legislative requirements and national policy commitments like the living wage are impacting on budgets and social care provision right now, and drive the cost of social services up by over half a billion pounds in the next four years.
"It is in this context that Cosla is committed to working with the Scottish Government on the joint political agenda to reform adult social care in the knowledge that we need the right political, financial and operational conditions to enable transformational change.''
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Stefano Brizzi was found hanged in his cell around a month after being taken off suicide watch, an inquest heard.
iona McMaster, 41, was reported missing having last been seen outside Marks and Spencer in Morningside Road in Edinburgh at around 4.40pm on August 8.
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