Scotland’s care regulator has warned of the “complexities and weaknesses” in care at home funding laid bare by the covid-19 pandemic.

The claim has prompted calls for an urgent investigation into links between a “disturbing” increase in excess deaths in the community and support reductions.

The Care Inspectorate today publishes the findings of an inquiry into responses to the pandemic in care at home and housing support services.

A majority of Scots in need of care and support are looked after in their own homes, but throughout much of the pandemic the focus has been on care homes.

Today’s report states that although care at home staff worked hard and tried to adapt to changing circumstances, the support on offer to service users and carers varied considerably across the country.

It says the challenge of responding to covid-19 “further exposed the complexity of and weaknesses in” funding for care at home and housing support services.

A survey last month revealing just half of care at home workers had been tested for the virus led to claims these services were being overlooked in favour of residential care and hospitals.

With the possibility of a second spike in covid cases during flu season, the report’s authors say health and social care partnerships must include care at home services in any PPE allocations, and engage more with carers and services users as they plan for the future.

People who use care services and their carers who voluntarily stopped their care to reduce the risk of infection earlier this year were found to have contributed significantly to enabling remaining services to keep running during lockdown.

But unpaid carers should have been provided with more support, the report says, to sustain such commitments.

As the pandemic hit, there were warnings people who receive care in their own homes were feeling “abandoned” over support being cut.

Social care in Glasgow was cut back to ‘life and limb’ cover at the peak of the crisis.

Responding to the findings, Scottish Care, which represents social care providers, says there is a real sense that the care at home and housing support sector continues to be the “Achilles heel” of Scotland’s pandemic response.

It says such services have been “regularly overlooked or insufficiently planned for nationally and locally”. 

“The report demonstrates that effective solutions have been reliant on good partnership relationships with the care at home and housing support sector at local level, but unfortunately the degree to which this happens and the sector is treated as a true partner remains extremely variable and often woefully inadequate.”

The representative body says the findings highlight the fragility of the care at home sector and its workforce in terms of how support is contracted and commissioned:

“It shows that – not just as a result of the pandemic but in line with what Scottish Care has called for for some time – we need to change how care is commissioned in Scotland and this report comes at an important time in contributing to the recently announced review of social care.

“It also highlights the lack of real choice and direct engagement with people accessing support when decisions are being made which impact their care.”

Earlier this month the charity Age Scotland called for an investigation into a steep rise in dementia deaths during lockdown.

Echoing such calls, Scottish Care says the links between a “disturbing” increase in excess deaths in the community and cuts to homecare support during the covid crisis must be examined urgently.

“There is clear evidence, highlighted in recent National Records of Scotland data, of a disturbing increase in excess deaths in the community and more work is required to explore the relationship between the removal or reduction of homecare supports as a pandemic response and the impact and experiences of people supported in the community," Scottish Care says. 

Today’s report from the Care Inspectorate highlights that “social isolation, disruption to daily activities, limitations on physical activity and the suspension of reablement adversely impacted on the health and wellbeing of people who experience care and carers.”

Scottish Care says that to date it has seen no sign of the extent to which care packages are being reintroduced and if they are, whether they will take account of the deterioration many people have “inevitably” experienced over the last six months. 

“Assessments must happen and must reflect the changes that have occurred in people’s lives.”

Peter Macleod, chief executive of the Care Inspectorate said: “We know there are ongoing challenges for care at home and housing support services that mean we need to continue to work together to drive improvement in this sector

“[This report] is intended to help inform future planning and improvement in services, and ultimately to support people experiencing care to live life to the full."

 

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