National Care Service Consultation

CARE ABOUT CARE   

Our care service needs to be improved.

It is urgent to

  • Take profit out of care
  • Improve pay & conditions for workers
  • Make care local & accountable
  • Ensure adequate funding
  • Make care a free service

At the moment there is a Scottish Government consultation about care. 

You can make sure everyone in Scotland is looked after properly by giving your input. 

A response can take as little as ten minutes. 

The deadline for this is 2 November 2021. 

The consultation is long & complex. 

If you are short of time just answer Questions 1 & 2  on page 15 – suggested answers below – you can copy and paste or copy and edit to personalise your response

Q1. What would be the benefits of the National Care Service taking responsibility for improvement across community health and care services? 

Tick all the boxes

Other – please explain below

A NCS would have the potential to bring these benefits, but only if partnered with  Local Authorities who  have the capacity  to work with their  communities to create local, flexible, inclusive services (and who are democratically elected and accountable to their populations). This would depend on the NCS  introducing National Sectoral Collective Bargaining to ensure good education, training, pay and conditions to social care workers.

Q2. This consultation and the National Care Service which will result from it may very well be superficial and not lead to real and sustained improvements in care provision.

There is a recognition that there is a need to improve community health and social care and that current structures are inadequate. If we are serious about good practice, ‘suggestions for significant cultural and systemic change’ have to be explored. This consultation does not allow for such an exploration.

For an effective care service we need to take profit out of care, improve pay & conditions for workers, make care local & accountable, ensure adequate funding and make care a free service.

This is the web address of the consultation  

https://consult.gov.scot/health-and-social-care/a-national-care-service-for-scotland/consultation/

If you have a bit more time to work on the questionnaire:

Click here for suggestions for responses to questions 1 – 8

Click here for suggestions for responses to questions 22 – 54

Click here for suggestions for responses to the ‘Valuing the Workforce’ section

For information and discussion about social care reform, see the Common Weal policy papers:  and news . 

Save Our Care Homes – Campaign News

The next critical date in the campaign is September 14th when the Edinburgh Integrated Joint Board is holding a special meeting to discuss the closure proposals. We understand that they intend to take a decision on closure at this meeting and then open a period of consultation which will run until the end of the year! Unison have organised a protest at the City Chambers to run at the same time as the board meets and Another Edinburgh is Possible are calling for the maximum possible attendance on the day. Please share with your friends and bring placards and banners. There’s a Facebook event that you can share.

Councillor Gordon Munro has received a number of written answers from Ricky Henderson on the care homes issue. You can see the details here.

Most revealing was of the answers is this:

‘ Throughout 2020/21, the Bed Based Review was ongoing and we deemed it morally unacceptable to admit into the care homes where the future of the home is under discussion.’


In other words they stopped admitting to the care homes over a year ago and then used their low occupancy rates as an argument for closure!

Save Our Care Homes – Protest Report

There was a lively Save Our Care Homes protest outside the City Chambers on Tuesday as the Edinburgh Integrated Joint Board met for its August meeting. 

Image by Pete Cannell – CC0 public domain

There were deputations to the board from Des Loughney and Kathy Jenkins from Edinburgh TUC, and from Unison and Unite the two unions that represent workers in the care homes. [Click on the links to read the deputation statements].

The board agreed to postpone a decision on the closure of five out the nine local authority care homes in Edinburgh until the end of the year and use the additional time to engage in consultation. Initially the board was going to make the decision at its’ June meeting.  There had been no meaningful consultation at that point.  So, the delay and the new interest in consultation is a real victory for the campaign.

The board’s initial rush to close the homes and the way they informed workers and residents only days before the June meeting was callous and incompetent.  The way the board has operated has highlighted the lack of democracy and accountability in the governance of social care.  And good quality people centred care seems to have been largely absent from their considerations.  No reference to the experience of Covid and none to the fact that the homes slated for closure have generally had much higher ratings for care quality than their private sector counterparts.

Saving the homes is the first priority of the campaign but in doing so we are also fighting for the future of care in Scotland.  We have written to the leaders of all the political groups on the council asking that their group makes a clear, public statement of opposition to the closures.

Here are some of the contributions made at the rally – first Councillor Gordon Munro

then Mary Alexander from Unite

Willie Black from Another Edinburgh is Possible

and a speaker from the City of Edinburgh Council Unison branch

Save Our Care Homes – Protest

Join the protest rally outside the City Chambers as the Edinburgh Integrated Joint Board meets on Tuesday 17th August. It’s likely that the board will hold a special meeting in September to make the decision to close 5 out of the 9 local authority care homes inn Edinburgh. We want to build a campaign that is so strong that when that meeting takes place the board has no option but to drop its’ closure plans. Three Edinburgh City Councillors sit on the board. We’ve written to the leaders of all five party groups on the council demanding that their group takes a clear and unambiguous public position in opposition to the closures.

Report from the Save Our Care Homes Public Meeting

A big thank you to everyone who advertised the meeting and all those who attended and helped make it a success. In the event 82 people registered for the meeting and 65 attended all or part of it.

This report includes video of the speaker contributions, a summary of the information, ideas, useful online links that were shared during the meeting, and a copy of the City of Edinburgh Council Unison branch’s newsletter on the Care Homes.

There are still a few things to add and if you spot anything that we’ve missed please email and let us know.

The meeting was chaired by Robyn Kane and in this first video you can hear Nick Kempe who is an active campaigner on social care. Nick was the first of the speakers.

Nick followed up after the meeting with some reflections on the overall discussion:

He suggested that if the Edinburgh City Councillors come out firmly against the closures then it will put the Edinburgh Integrated Joint Board in a very difficult place. However, he noted that if the recommendations of the recent Feeley report on social care go through then this element of local democratic control will be lost.

Nick also commented on the apparent lack of planning for the consequences of closure and the serious consequences for many residents with the likelihood that most would have to move into private care homes.

He also suggested that the Board is probably locked into Private Finance Initiative (PFI) arrangements with the private sector which may constrain their decisions and we may want to use a Freedom of Information Request to make this information public.

Following Nick we hear from Graeme Smith, chair of the City of Edinburgh Council Unite branch, which represents some of the care home workers.

Graeme was followed by Ian Mullen from Unison, which represents many of the care home workers affected by the closure proposals.

We also heard from family members of the residents who live in the effected homes. This video clip features Ray Whittingham.

Here are some of the suggestions for future action that were made during the course of the meeting – note that the next meeting of the Edinburgh Integrated Joint Board is on Tuesday 17th August.

  • Demo outside of City Chambers: identify suitable dates?
  • National campaign: UNISON is involved in campaigns against closures throughout the UK. Can these be joined up? This is a national issue. In Scotland, the Feeley report leaves the door open to private provision. The National Care Service is shaping up to be a commissioning body only. Our campaign should also address wealth retention. Outsourcing services means the outsourcing of profits generated by the community.
  • Identifying providers: Four Seasons and Equity Investors should be targeted for profiteering from public money and the elderly and vulnerable.
  • Reach out to residents and their families. Their voices must be prioritised.
  • Contact We Own It for support and joint action.
  • Allyson Pollock and Willie Black to get in touch with Paul Laverty – possibility of a short film to share on social media/future meetings (staff, residents and their families should be front and centre here).
  • City centre lightshow?
  • JIB is driving privatisation. This is about public provision and assets/community wealth. Save our Services should collate our case (again with staff/residents/families to the fore) and present it to the Board with media invited. What dates are they meeting? 

Many people shared online links that you may find helpful:

Please sign and share the Save our Care homes petition

Community Care page: human rights and family access

Edinburgh Integration Joint Board Proposals (PDF)

2021 Care Inspectorate report to Scottish parliament. Record of private care homes is always worse than those remaining in the public sector

Ferrylee report presented to Scottish parliament in March 2021

Integrated Joint Board meeting, June 2021.

Liberton hospital webpage

Care and Support Workers Organise! Facebook page

The CEC Unison branches newsletter on the care homes

Contact your councillor, MSP or MP about the Edinburgh care home closures

Here’s a draft letter for sending to Councillors, MSPs and MPs about the proposal to close care homes.  Please write to your local councillor’s, your MSP and your MP.  You can use the text below, but even better to adapt it and include your own thoughts and comments.  You should get a reply and if you do please forward it to the Another Edinburgh is Possible Campaign via edinburghjustrecovery@gmail.com

You can download this file to find out who your elected representatives are and how to contact them

You can find more information about the closures on the campaign blog https://anotheredinburghispossible.org

Dear                ,

I am writing to request that you join the council unions and the families of residents in making a stand against the proposal to close five publicly run residential care homes in Edinburgh.  

Currently the Edinburgh Integration Joint Board (EIJB) will meet in August to consider a proposal to close the five homes.  Fords Road, Clovenstone, Jewel House and Ferrylee homes are to be shut completely and Drumbrae is to become a facility for medically led care of the elderly. 

These closures will have a major negative impact on the provision of residential care in the city, on the care workers who work in the homes and on the lives of the residents who will be uprooted and scattered around the city.  Disgracefully, there was no public consultation before news of the planned closures was released tocare home workers, less than two weeks before the June meeting of the EIJB.

In the wake of the Feeley report, and in the clear knowledge that demands for residential care will continue to rise in years to come, the actions of the EIJB are indefensible.  Care homes are people’s homes, and the board has shown scant concern for the lives of the residents or the livelihoods of those who care for them.  Moreover, they show a contempt for local democracy and accountability.

As an elected representative I expect you to take the side of the residents and the care home workers. Please let me know how you plan to show your opposition to the EIJB plans.

Signed

Protesting as the EIJB meets to consider care home closures

As the board met at 10am today, we stood in socially distanced solidarity with the residents, the care workers and with the deputations to the EIJB from the Council unions and Edinburgh TUC.

Brian Robertson from Unite made his deputation from outside Ferrylea

Here is the text of deputations to the board from the Edinburgh Trades Union Council:

Bed Based  Care – Phase One Strategy

My name is Des Loughney, Secretary of Edinburgh Trade Union Council. My colleague is Kathy Jenkins who is a delegate to Edinburgh TUC. We would like to thank the Board for agreeing to hear our deputation. I will speak for five minutes and Kathy for the other five.

The reason we decided to seek a deputation is that the local trade union movement is very interested in the future of Scottish Social Care. We made a submission to the Feeley Review and participated in the Social Care debate that took place at the April Congress of the Scottish Trades Union Congress. This debate formulated a trade union policy on the future of Social Care in Scotland. When we learnt of the paper that is Item 7.1 we were curious  how that fitted into thinking about the future of Social Care. We are aware that the Scottish Government will be introducing legislation this year which will take up at least some of the Feeley recommendations.

It has been difficult to digest the whole paper as we only saw the final copy on Wednesday last week and became aware that recommendations of the paper will be amended. We were sent copy of the amendment on Friday afternoon. It has been difficult to fully digest the report in the time available.

We think that the actions proposed in the amendment are positive but we have questions about points (iii) and (iv).

Before I comment on the points I wish to say that Edinburgh TUC understands the concerns of the workforce and their trade unions about the way they were informed about the proposals contained within 7.1. After all their heroic efforts during the past fifteenth months of COVID, after enduring constant anxieties about protective equipment, putting their lives and their families lives at risk, the health and well being of their residents, they did not want added further anxieties about the future of their jobs. Staff had assumed that the rhetoric from politicians and senior management regarding their value now and in the future was meant. Their experience over the last couple of weeks has dismayed staff. We welcome point (ii) of the amendment in the expectation that engagement with trade unions will be real and that staff concerns about their future are fully addressed.

We think the paper for item 7.1 does not address the public’s main anxieties or concerns about the future of Social Care in Edinburgh (and Scotland). These main concerns are:

  • Have the lessons from COVID been learnt? Is the social care system going to be changed so that we are better able to deal with the remainder of this epidemic and future similar epidemics? How we are going to avoid, in future,  the alarming death toll in care homes which some people say were entirely preventable. How are we going to avoid resident isolation and associated distress and mental ill health? How is Social Care going to deal with the increasing challenges of Long Covid?
  • What will be the ongoing impact of austerity on social care plans. People are sceptical that any progressive plans will be delivered in full to all the people that need the service . Plans will be watered down in volume and content. Eventually a system of rationing will creep in. The EIJB needs to be very clear about whether or not the resources  will be available to implement their proposals.
  •  COVID revealed the problems that arise when you have to deal with an emergency having poorly trained, poorly managed and poorly paid staff, so bad that there is a 25% turnover of staff every year. We hope resources as mentioned in (v) can be identified. If not we hope that the EIJB will able to specify what is required from the Scottish Government.
  • What is the EIJB going to do about addressing the deficiencies of the private sector that were so clearly exposed by COVID? How does it happen that ten months into the epidemic the Care Commission has to issue a letters of serious concern to the Braid Hills Nursing Centre regarding COVID standards? On page 153 the paper allows the possibility that some residents of the homes proposed for closure may be offered accomodation within what is termed the private marketplace. What assurances can you give the public that the placements will be now and in the future safe and of good quality?

In looking at the points on the proposed amendment we consider that point (iii) should be amended. To (iii) should be added “and commissioning new build care homes to replace the places lost by the closure of the four homes to be run by the City of Edinburgh Council  and staffed by local authority employees”. Taking account of all that is stated in the paper we consider that there should also be plans to build new care homes to meet increasing demands and including replacing inadequate private sector homes/beds.  At the moment there seems to be an assumption that if the demand for care home places increase it will be solely met through the private sector. This , because of the problems of the private sector, is a poor and unwelcome strategy.

In relation to point (iv) I hope that there will be a thorough detailing of the investment that will be required to provide the service specified throughout Edinburgh; available to all who need the service, taking into account the impact of increasing poverty.

At the moment we are assuming that the Scottish Government will, in 2021/22 introduce legislation to set up a Scottish Care Service with a changed role for local authorities and Integration Joint Boards. I hope that in August there will be a discussion of how such changes might affect your strategy – that the possible changes will be part of an impact assessment.

Thank you for listening. I will happy to answer any questions clarifying what I have said.

Des Loughney

Secretary

Edinburgh TUC

EIJB ETUC deputation. 22 June 2021
Contribution from Kathy Jenkins

As Des has said, I am Kathy Jenkins.  I welcome the opportunity to speak to you today in response to your social care proposals.

Des has addressed some of the issues involved in the changes proposed for care homes.   I would like to concentrate mainly on recommendations 4 and 5:  investment for home care and community infrastructure; and workforce planning – the measures to be taken to support the recruitment, retention and development of staff.    

Before I do that, though, I would make a few wider comments.  First it seems to us that Liberton Hospital is being closed at a time when NHS hospitals are under severe pressure and that changes in social care provision in Edinburgh are to some extent being driven by a need for savings/income generation in the NHS. Second, we believe that what is needed, in terms of quality of care, working conditions and cost, is a reduction in reliance on the for-profit sector and an increase in public sector provision.   Third, we welcome plans to increase intermediate care and would confirm your statement that there is hidden need – known through the personal experience of people being discharged from hospital to unsuitable situations without assessment being done of their rehabilitation needs.  We also see as crucial that respite care services be retained and expanded to provide support for carers.   Fourth, you plan to increase the number of nursing homes through various changes including employment of nurses.   As these homes will be dealing with more complex needs, will there be changes to the training, pay and conditions of other staff in these homes? 

Coming to care at home, we welcome the emphasis in the paper on creating a social care system which will support people to stay in their own homes and communities for as long as possible.  But this will only work if it is well resourced.  Will this be the case for those over 65 as well as younger?   In my experience a cap can be put on expenditure if it is more than the cost of a care home bed for those over 65, meaning they cannot be given the home care they need.   Will night as well as day support be given?  If this is the case, proposals will need to include provision of suitable housing.   

We welcome your discussion of the 20 minute neighbourhood (and wider discussion in Scotland of community hubs), but if we understand them correctly this would need major changes in care at home provision.   At present our understanding is that care at home services in Edinburgh are given by a large number of providers.   This is inefficient, as different providers can be working in the same geographical area.  What is needed is a rationalisation of provision around the community hub/20 minute neighbourhood to enable those needing care and home care staff providing that care to integrate into the community and support each other.   Many of the current providers are in the private sector.  Again, we would argue for a reduction in reliance on the for-profit sector and an increase in public sector provision.   We believe this would have a positive impact on quality and know that it would have a positive impact on worker health, safety and welfare.     We have looked in some detail at both published and anecdotal evidence regarding the health and safety issues faced by social care workers, and particularly those employed on poor terms and conditions in the third and private sectors.  These include:

 *lack of rest and welfare facilities
*lack of adequate staffing and equipment for moving  and handling
*issues relating to the physical work environment, particularly for those providing care in other’s homes,  e.g. poor or overcrowded housing,  cleanliness,  waste and waste recycling, exposure to chemical and biological hazards;  slips, trips and falls
* physical environments that are not suitable for infection control, both poor or overcrowded housing and institutions like care homes
*hazards involved in lone working, including violence and aggression
*lack of sufficient personal protective equipment, e.g. appropriate grade masks, aprons, gloves, visors, goggles; and inadequacy of arrangements for dealing with contaminated PPE

And additional Issues that have direct implications for both mental and physical health through poverty and work related stress:*precarious contracts ( including zero hour contracts)
*lack of job security
*low pay 
*expectations of ever increasing flexibility by workers; lack of predictability of hours; the burden  of risk of unpredictable social care demand and cost being placed almost entirely upon the workforce
*long working hours; high levels of unpaid overtime;
*lack of support and supervision 
* growth in split shifts; shift patterns resulting in exhaustion, which then causes accidents e.g. care at home staff not paid for travel time so have to work longer hours to get basic pay; difficult  shift patterns in residential care; reductions in paid sleepovers
*issues with entitlement to sick pay and holiday pay
*underuse of skills
*little ability to contribute to decision making
*an expectation for home care workers to do what have been traditionally seen as nursing tasks but without appropriate training and support
*difficulties in accessing training and certification
*inadequate time to carry out required tasks in a way that respects the dignity and care needs of the user 
*administrative tasks having to be done in time designated for care, reducing further the ability to deliver quality care
*no paid time for travel between clients homes reducing further the time given to care
*the resulting low morale and  high levels of stress due unrealistic workload, not enough time for clients, lack of support, not feeling valued, and the absence of meaningful recognition of the importance of relationships in service delivery

I would close with two more comments.   We welcome the community mobilisation you describe but have concerns about how this will be supported given the cuts that have been made in community development staff over recent years.     The proposed Three Conversations model looks interesting and hopeful, but we would have concerns that too heavy a reliance could be put on unpaid, voluntary input.  This is important and valuable, but there must also be well resourced social care provision by paid social care workers alongside.   

Thank you for your attention.  

Kathy Jenkins
Delegate to ETUC
H&S officer, Unite Edinburgh Not for Profit Branch
sa

Save Our Care Homes

A few days ago the Edinburgh Integration Joint Board (EIJB) announced plans to close five publicly run residential care homes: Fords Road, Clovenstone, Jewel House and Ferrylee homes would be shut completely and Drumbrae would have a change the use to medically-led care of the elderly.If these closures go ahead they will have a major negative impact on the provision of residential care in the city, on the care workers who work in the homes and on the lives of the residents who will be uprooted and scattered around the city.

There has been no public consultation and news of the planned closures was released less than two weeks before the scheduled board meeting.

In the wake of the Feeley report, and the clear knowledge that demands for residential care will continue to rise in years to come, the actions of the EIJB are indefensible. Moreover, they show a contempt for local democracy and accountability.The EIJB is a partnership with representatives from Edinburgh City Council and from the NHS.

Another Edinburgh is Possible calls on elected representatives to vote against the plans and for the Board to withdraw its proposals forthwith.

Anger at the decision has already forced a postponement of the decision until the August meeting of the EIJB. To stop the closures we need to build the pressure on the board and on the council.

When the board meets at 10am on Tuesday 22nd June, we will stand in socially distanced solidarity with the residents, the care workers and with the deputations to the EIJB from the Council unions and Edinburgh TUC.Assemble for 10am Tuesday 22nd June at Ferrylee, North Junction Street, Edinburgh EH6 6HR. Bring placards and banners. Save our care homes!

Deputation to the Housing and Homelessness Committee

Hello – I’m Robyn Kane. I’m the chair of the Moredun Multis and Maisonettes Residents Association and a member of the Gilmerton and Inch community council. The resident’s association I represent has 6 high rises and two blocks of Maisonettes totalling over 500 homes. I personally have lived in the high-rises since early 2017 and have had to get in touch with repairs over the years for multiple reasons.  However, when I moved in, I had to ring for several different repairs as the flat was not in a fit state to move into when I first signed the lease.

The overwhelming issue myself and the tenants I represent are having is with the windows in the tenancies, and the surrounding problems because of the windows being in disrepair. This includes mould and condensation on, or inside the double glazing. The issue of mould, damp and condensation is causing damage to people’s physical and mental health. The overwhelming number of the tenants I represent are in fuel poverty, having to choose between food and heat, what makes this even worse is that because the windows are not airtight the cost of keeping the home warm goes up as the hot air escapes. 

Moredun Multis image by Kay Williams CC BY-SA 2.0

Reading the report, I was disappointed to read that a lot of the issues are being blamed on covid-19 as I am aware that issues have been going on longer than the pandemic. For example, paragraph 4.40, we have AOVs that where the wrong fitting in our Landings that are now being held open with a nail and some wiring. Another example is how the City of Edinburgh Council are passing the buck to Changeworks who themselves are over run to the point of non-communication for months as the waiting lists to get help are so long! 

Lastly before my time ends I would like to ask how the City of Edinburgh Council plan on actually bettering the system to help prevent the formation of mould, damp and condensation in tenancies, how the new resolution team are going to affect the complaints procedure and if this will make it even more difficult for someone to file a complaint with either the council or the ombudsman, and lastly I’d like to know how the City of Edinburgh Council plan on making these reports more assessable to the public and associations, as this report as well as the repairs report was passed onto me by a local Councillor and lack of transparency hinders my ability to best help the community I represent.

Our City: Housing and Homelessness

This is a report of the meeting on Housing and Homelessness in Edinburgh, which we held on 22nd April 2021. In our recent survey of how Edinburgh residents feel about councils services just under a half felt that housing services were poor and a similar proportions were unhappy with support for the homeless. In the rest of this post you can find a video record of all the contributions and then the outputs from the discussion groups.

The meeting was introduced and chaired by Robyn Kane

The first speaker was Gary Peden a member of the Unite City of Edinburgh Council Union branch

Gary was followed by Maddie Lou Barink who works for Shelter

Next up was Malcolm Fraser and Edinburgh based architect who talked about how we can build homes fit for people and fit for a sustainable future

Malcolm illustrated his talk with these slides.

Following Malcolm we heard from Willie Black. Willie is a member of Unite and a long-time campaigner in North Edinburgh

We then heard from council tenant Robin Ricci of her experiences of housing in Edinburgh

The final speaker was Pauline Nicol-Bowie from LIFT (low income families together)

We then broke into groups to share experiences and think about next steps. These slides summarise some of the points that were made. They are work in progress not the whole story. Please contact us by email to get involved in developing these ideas and helping take them forward.

We concluded by adopting this statement: