New care model not yet achieving its full potential

24 August 2017
Self-directed support

New ways of offering people more choice and control over their social care can make a real difference but further work is needed to ensure everyone can benefit, says a report out today.

Since 2014 councils have been responsible for implementing Self-directed Support (SDS), which offers people more choices around their support and how it is managed. This is now largely provided by the new local health and social care integration authorities drawn from councils and the NHS.

Today's report for the Accounts Commission and the Auditor General says while many people have benefited from SDS, integration authorities still have a lot to do to provide this for everyone.

Councils spend £3.4 billion a year on social care supporting more than 200,000 vulnerable adults and 18,000 children and their families. Assistance ranges from everyday tasks such as dressing and preparing meals to helping individuals live more fulfilling lives at home, at work and in their communities.

Most people rate social care services highly and the majority of staff are positive about the principles of SDS. The report highlights areas of good practice such as giving front line staff powers to spend small amounts that can make a big difference.

On the ground, however, not everyone is getting to choose and control their social care the way they want to and staff need more support to try new approaches. Providers also face challenges in offering flexible services, particularly in recruiting and retaining social care workers.

The Scottish Government, councils, health boards, the new health and social care integration bodies, third and private sector organisations, and individual people carers and families, are all involved in making SDS happen. This is set against a backdrop of increasing demand for social care and tighter budgets.

Ronnie Hinds, acting chair of the Accounts Commission, said:

"There is a growing body of evidence that SDS is helping many people with support needs to live more fulfilling lives. However, there is no evidence of the transformation required to fully implement the policy.

"Radical change of this kind is never easy but we are in the seventh year of the 10-year SDS Strategy, and it's been three years since the legislation was introduced. Authorities must respond more fully to provide services that make choice and control a reality for everyone who needs social care."

Auditor General Caroline Gardner said:

"SDS is clearly working well for some people but many more people can and should benefit from it. The Scottish Government has invested £70 million in SDS and needs to work with its partners to boost progress and develop its full potential."