There Is Little Direct Monitoring Of Home Care Services By Councils, Says Unison Report
13th March 2017
Direct contract monitoring of service users is very limited and very few visits are made to check service users are receiving contracted levels of care, according to a report published today (Monday) by UNISON Scotland at a Community Sector Conference in Glasgow.
UNISON are calling for monitoring arrangements to be adequately staffed and include site visits to service users.
UNISON asked councils, under freedom of information, whether they visited service users in their homes to monitor if they were receiving adequate levels of care. Overall, the responses indicate that contract monitoring is limited to returns from the contractor and review meetings with them. There is very little monitoring of the actual service delivery.
Most councils have been unable, or unwilling, to answer whether they visited service users in their homes to monitor their levels of care, despite chasing them several times. Some confirm that they undertake no client monitoring at all. Some councils confirm they carry out restricted monitoring e.g. electronic monitoring systems such as ‘Callconfirmlive', a telephone logging system. While these systems confirm that a visit has taken place, they do not monitor the quality of the work undertaken. And councils who use this system do not generally undertake monitoring visits.
Direct monitoring is crucial to improving the quality of, and to tackling the current problems in, social care delivery in Scotland. Most providers are struggling to recruit and retain quality staff and therefore councils are finding it difficult to help move patients out of expensive hospital care and into community settings.
Dave Watson, UNISON Scotland head of public affairs said: "We know the difficulties the workforce face when delivering home care. They need better training, fair pay and the time to care for the vulnerable people they look after. They tell us how stressed they feel they are not able to provide the service their vulnerable clients deserve. And we know this happens far too often.
It is crucial that councils do spot checks, talk to those who receive home care and ask them if they are getting all they need, and that they speak to care workers to ask them if they feel their clients are being well served, and how the service can be improved. The fact there is so little direct monitoring of the actual service delivery cannot be good for those who rely on it."
UNISON will also highlight at the conference that new guidance has been published on social care procurement and fair work practices. The Scottish Living Wage is largely being paid to staff contracted to deliver adult care, but the weighting given to fair work matters in contract evaluation is low and inconsistent with the people centred nature of this work.
Dave Watson said: “For a service that is almost entirely dependent on people for quality delivery, it is not acceptable that contracts are awarded to companies on a basis of less than 20% weighting for staff. Many councils are awarding contracts on 5%. Councils' social care procurement strategy should ensure that a proper weighting is given to fair work matters and ensure that bidders are required to produce real evidence.”
We will also be calling on the Scottish Government to review the social care procurement guidance on this point.
1. Statutory procurement guidance sets out what is covered by fair work and each evaluation should allocate a percentage weighting to this factor. Self evidently social care is delivered by people, so this weighting should be significant. A number of councils did not answer this question because they haven’t evaluated a contract under the new rules or gave a very general response. This in itself speaks volumes for their approach. Those who did respond properly include: Aberdeenshire 40%; Inverclyde 25% ; Midlothian 20-30%.
Councils who gave an unacceptable response include: Edinburgh 15%; Clackmannanshire 10%; Orkney 10%; Perth 10%; South Lanarkshire 10%; Borders 5%; North Ayrshire 5%; Glasgow 5%; Highland 5%; East Lothian 5%; Renfrewshire 5%; and Dundee 4%.
2. See report briefing here: http://www.unison-scotland.org/2017/03/13/delivering-quality-social-care-procurement/