Weekly Poll – Care Services Definitions (Week Beginning 17 May 2021)
Each week Disability Equality Scotland send out a poll question to our members on a topical issue. For the week beginning 17 May 2021, we asked a question about Care Services Definitions.
Question 1. Do you think the care definitions featured in the Public Services Reform (Scotland) Act 2010 are fit for purpose?
- YES – 39% (18 respondents)
- NO – 61% (28 respondents)
Question 2. Do you think the definitions need to change to meet future needs?
- YES – 70% (33 respondents)
- NO – 30% (14 respondents)
Iriss has been commissioned by the Scottish Government to conduct a review of the definitions set out in the Public Services Reform Act (Scotland) 2010 Act) to reflect changes in social care in the last decade. This is to ensure that service and role definitions reflect the understandings and expectations of commissioners, providers, workers, and people who access care and support. The majority of respondents (61%) answered
‘no’ and believed the current care definitions featured in the Public Services Reform (Scotland) Act 2010 are not fit for purpose. This is in line with the follow up question, whereby the majority of respondents (70%) think the definitions need to change to meet future needs. We provide verbatim comments where appropriate to illustrate strength of feeling or personal experience.
Respondents reflected on the current definitions featured in the Public Services Reform Act and whether they serve current needs, demands and delivery of health and social care provision in Scotland. Some respondents believed that the current definitions are too broad and open to inconsistent interpretation.
“There is a huge area to cover and groups need to be clearly defined.”
“The definitions are far too vague. They need to be far more specific because one authority’s definition of what is good enough to be considered a “service” may vary considerably from another authority’s definition. Also, if a fuller specific definition is included in a law, this reduces the government’s ability to change the definition as and when they want (usually depending on economic circumstances rather than public requirements) without the relevant discussions and agreements with the majority of the government. A wider range of services are required to enable people to maintain as independent a life style as is safely possible.”
“Care services are in many forms. Such a broad category of people to categorise together, could easily lead to one’s care needs having to be questioned further than perhaps necessary? For putting care/support in place, proof, financing to name a few. I fear that to categorise people with potentially contrasting care needs could exacerbate people who have difficulty expressing their care needs or even being aware that there’s a need for it. Understandably this pandemic will in turn, require more care/support services being readily available in the all to near future if not already presently. It seems a care service could be easily misunderstood and people may not receive the help, money or safety that other’s within the same “category ” may.”
“Personally I feel there would be too much room taking such an ambiguous approach, for inequity to occur unnecessarily. An offender accommodation service user could have conflicting needs for a day care of children. More judging members or less educated could find it offensive. Feeling grouped amongst people who made the decision to break the law whether they are repentant or not other’s within the “care category” could be subject to suspicion.”
“Condensing care into subsections doesn’t suit the future of care.”
Future Needs and Suggested Changes
A number of respondents highlighted the need to update the definitions featured in the Public Services Reform Act to meet existing and future needs. One respondent suggested that the definitions must incorporate a human rights based approach that values the ideals of respect, freedom, equality, dignity and fairness.
“For a long time we have moved away from the notion of care to one of promoting and prolonging independence. Definitions should change to reflect the dynamic quality of life a rights based service would deliver. The notion of care does not deliver the breadth of services required to meet needs.”
Another respondent believed that the definitions should make specific reference to kinship care. This is when a child is formally ‘looked after’ in terms of the Children (Scotland) Act 1995 by their extended family or close friends, if they cannot remain with their birth parents.
“Kinship care is currently not considered to be a care service and I believe it should be. Many of the children in kinship care are deeply affected by Adverse Childhood Experiences (ACES). Recent research has shown these children can be adversely affected by these experiences throughout the course of their lives. If it was not for kinship carers many more children would be looked after within the formal care system. Kinship carers save the government millions and are very often ignored within legislation.”
A further respondent highlighted the need for various organisations to be referenced in a fresh approach to care service definitions which recognises the evolving nature of care provision in Scotland.
“The use of third sector organisations like Third Sector Interfaces (TSIs) as well as nursing homes and any other organisation. The persons home needs to be mentioned as well as serviced employed under self-directed support etc and any future service should be mentioned as an overarching recognised progressing service.”
Monitoring Care Services
Respondents recognised that care services have gone through significant changes as a result of the COVID-19 pandemic. This has exacerbated existing inequalities which are not reflected in the current set of definitions. A proportion of respondents recommended that the legislation is monitored on a more frequent basis in order to reflect any significant changes. This can be furthered through meaningful and ongoing engagement with various stakeholders involved in the Scottish care sector.
“So much has changed recently around the world due to the Coronavirus pandemic and that includes the care sector. Unfortunately, it is extremely difficult to find or to work out what would be the best solution for so many of these points. What ‘person A’ might like ‘person B’ will not like. Maybe it would be a good idea to have a review every 5 years so as to be able to adopt more quickly to issues. I would also like to see something specific about pandemics.”
“Covid-19 brought a lot of issues relating to minority groups which may need addressing more directly to the forefront. Also gender related issues may need to be included in the definitions.”
“Social Services should monitor the providers to ascertain that they have the ability to work with clients in an identified area. Clients are being tendered for, realising that they cannot provide the right service from the outset. Bad timekeeping and short visits are common with my Care provider every day.”
“As time goes on changes must be made to reflect the new circumstances.”
“I think future decision and policy should listen to qualified groups. Those who have been at the chalkface and have invaluable real time experience.”
There was consensus among respondents on the need for care definitions to change in order to meet future needs. Respondents reflected on the broad nature of the existing definitions and how this is open to interpretation. Respondents suggested a number of areas that can be included in a revised set of definitions, including more explicit reference to human rights, kinship care and care service organisations. To ensure definitions continue to reflect changes to the care sector, respondents recommended that more frequent reviews take place which involve a variety of key care service stakeholders.