More core social work funding is needed to deliver needs-led services across Scotland, says UNISON Scotland as its latest survey reveals decisions are being driven by budgets.

Care managers have told the union that their jobs have become a ‘tick box exercise’ in many local authorities.

Rather than being led by the needs of people being cared for, UNISON has heard that the current system is driven by budgets and built on ‘gatekeeping’ care.

UNISON says the picture staff have painted is one of a ‘system on its knees’, cash starved, and crisis driven.

One survey respondent said: “We no longer work with people. Everything is based on finances.”

Others told the union that the solution is to better fund the bodies in charge of organising local community health and care in Scotland – not reorganising them within a National Care Service.

One of the report’s authors, Kate Ramsden of UNISON Scotland’s Social Work Issues Group, told healthandcare.scot:

“What our members are telling us is that the social work and social care system is creaking at the seams, and all the National Care Service Bill will do is impose new structures on top.

“Year on year cuts to Integration Joint Boards (IJBs) have resulted in a system which is crisis driven rather than needs led. What we need is urgent investment in social work and social care services.”

Crisis-driven

It comes after Scotland’s public sector watchdog explained that rising unmet need has created an ‘unprecedented crisis’ in community health and care which has been compounded by decreased funding to IJBs.

Just under half of the respondents to UNISON Scotland’s survey mentioned insufficient staffing and high caseloads meaning there is no time to build relationships or engage in early intervention.

It comes as discussions around the proposed National Care Service – focused on achieving a person-centred, rights-based care system – have become more fraught with tensions as stakeholders challenge government amendments.

Some referred to this crisis as a recent development brought on by funding cuts, with one seeing their team reduced by half in the past 18 months, now struggling to cover initial assessments, never mind building meaningful relationships.

Other respondents shared that staffing has been “chronically low” for years, but now teams are dealing with crisis-level issues more and more.

Although a small number in this survey said they felt able to practice in a person-centred and needs-led way, others shared that constant “firefighting and plate spinning” limits meaningful relationships.

The majority of respondents spoke of difficulties in meeting need worsening in recent years.

One outlined how this leads to losing staff and vacant posts being left unfilled:

“Ever increasing demands, more complex cases and reduced resources/funding places a huge strain on social work teams and has resulted in many workers leaving and unable to fill vacant posts.

“Soul destroying when you constantly feel that you are letting clients down and working over and above your hours with no additional pay.”

This follows a parliamentary review of self-directed support found that it is delivered ‘inconsistently’ across local authorities, and often practiced in a way that ‘contradicts its aims’.

UNISON Scotland also heard that bureaucratic processes mean that opportunities to save money are being missed and people are often not supported until reaching a crisis point.

One respondent said this limits staff “when we should be intervening early to avoid crises.”

It also comes as social work leaders have told MSPs that they fear the National Social Work Agency will lack the authority needed to deliver for the sector.

UNISON Scotland is calling for increased resources and staff for the people receiving support by helping create manageable caseloads that support person-centred, preventative care.

Respondents also identified more time for relationships-based practice and needs-led assessments with less bureaucracy and paperwork.

As council leaders have withdrawn support for the National Care Service, UNISON Scotland has said it will ensure it relays these messages as it continues to engage with the government development a National Care Service.

Read more: Council care failures echo Shakespearean tragedy; Scheme for GPs to help lost patients extended; Health and care workforce to be bolstered over winter

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