Care firms that let elderly down blame cost-cutting by councils

Private providers of care for the elderly have blamed Scottish councils for many of the problems revealed by a Herald investigation.

The body representing 60% of Scottish independent homecare providers said councils were building failure into contracts and claimed the public would be shocked if they knew how elderly care is commissioned by some local authorities.

The investigation into the provision of care at home services showed nearly all the main companies providing such care for councils had faced criticism from regulators, including complaints and negative inspection reports.

Many of the problems were repeated across the country and across companies, including failure to attend appointments, ill-prepared and inexperienced staff and excessive turnover of carers.

Care providers say many are trying hard to improve. But they are also angry at being criticised for failings they say are caused by local authorities and the way they tender services.

Scottish Care at Home (SCAH) is an umbrella body representing 88 companies providing care at home for elderly people in Scotland. SCAH chief executive Gloria McLoughlin said: “Most local councils are awarding contracts based on lowest costs, which results in issues around lowered quality, consistency, training and a lack of time to deliver care.”

She said the approach was in danger of driving good providers out of the market when, with a rising elderly population Scotland needs more high-quality care companies.

And she claimed Herald readers would be shocked to learn that many councils now ask companies to deliver 15-minute visits for personal care, saying: “This practice is increasing, with providers powerless to prevent it.”

Responding to complaints about visits being cut short or staff appearing to be rushed, Ms McLoughlin said this too could sometimes be caused by contracts. A common feature of them was a refusal to reimburse companies for travel time, she said

“Workers are forced to reduce time spent with clients, or arrive late for appointments. These poor outcomes for service users, and stressors for providers and their staff, are built into tenders from the outset, and result from the current approach to procurement and the commissioning of services.”

Ms McLoughlin also called for a review of the care-sector workforce, which she said was characterised by staff receiving not much more than the minimum wage for increasingly complex work, often in isolated settings.

She welcomed the “increased visibility and debate” generated by the Herald’s campaign on elderly care.

A spokesman for Cosla, the Convention of Scottish Local Authorities, said Scottish Care at Home’s comments were “not an accurate reflection of the true picture,” and added: “Councils are committed to working with a full range of providers and comments such as this are divisive and unhelpful.”

Meanwhile some companies have pointed out that services have been improving rapidly, especially with the introduction of new electronic monitoring systems which enable better control over staff visits to elderly clients and cut missed appointments.

Lynn Laughland, ­managing director at HRM Homecare, said there had been a staff restructuring programme and investment in a new electronic system since service failures flagged up in the firm’s last Care Commission report from January 2009, which reported on 2007 to 2008 performance.

She said: “This investment in electronic staff rostering, a call monitoring system and training is to ensure the best care and support for our service users and our workers.”

Others have praised the Herald’s campaign for highlighting other issues including abuse of the elderly. Harriet Dempster, president of the Association of Directors of Social Work, said: “Community care policy means that far more frail older and vulnerable people are now being supported in the community. Heightening awareness of the risks of elder abuse will be key to safeguarding vulnerable people from all forms of exploitation.

“It is likely to result in an increase in referrals and it will be difficult to determine whether this rise is in fact a rise in abuse or awareness and knowledge.”

She added: “There is a link here with the important role played by informal carers and a recognition of the support they need to continue caring and continue caring safely. Caring for someone with dementia can be very, very stressful.”