IT SIMPLY cannot be right that someone is paid more for stacking supermarket shelves than for looking after our vulnerable elderly relatives. I fully welcome and support the Scottish Government’s introduction in October 2016 of the Scottish Carers Living Wage (SCLW) of £8.25 per hour for all carers in Scotland over 18 years of age. I genuinely believe that our hard working care staff deserve to be paid more for the excellent job they do. I am also hopeful that the introduction of the SCLW will help care homes to improve both staff recruitment and staff retention and that it will help reduce the requirement for expensive agency staff.
However, as generally 75 per cent of my care business’ residents are local authority funded and between 60-65 per cent of our fee income goes on staff costs, it is only fair that our main customer, the Scottish Government, properly funds (including acknowledgement of differentials) the welcome and progressive move that it has now made. Especially as, at some point this year it seems that the SCLW is likely to go up again to £8.45 per hour.
I feel very strongly that the independent sector provides good quality of care and very good financial value for taxpayer’s money. After several really tough years, however, there is simply no fat left in the sector to absorb the significant increases in costs involved in these increases in pay, even if they are welcomed and deserved. I remain seriously worried that we are now close to reaching a tipping point for the care home sector in Scotland.
If funding is not improved, and quickly, many more care homes will close in Scotland and fewer new care homes will be built. This will worsen the already growing net annual loss of care home beds in Scotland. This is causing increased NHS bed blocking, increased NHS costs and more cancelled operations. This is all happening at a time when the demographics are showing that there is actually a need for more elderly care beds, not less.
There are a number of other issues and problems that the Scottish care home sector is facing at the moment.
I am hearing from within my business, Renaissance Care, and from other operators, of increasing incidents of Scottish local authorities attempting to place nursing care clients at residential care fee rates with the placement going to the first provider to say yes. This is both very unfair to the clients concerned and to the care homes – and really unconscionable behaviour by the councils concerned.
In Scotland we currently have the National Care Homes Contract (nursing £649 – residential £559) which is negotiated annually between Scottish care, all 32 local authorities and the 32 new integrated joint boards (IJB), an arrangement which has to date served everyone fairly well. It is, however, increasingly creaking under enormous pressures from all sides. I hope that it does not fall away, but f it does then it would lead to 32 different negotiations and agreements having to be reached – a very backward step.
In April 2016 the new IJBs went live after a shadow year preparing but it is still too early to tell how effective they will be delivering their main task – the strategic planning of the provision of all health and social care services in Scotland – no small job!
The Scottish Government has also committed to abolishing all Employment Tribunal Fees for claimants as soon as it has the power to do so. This is a pity, as while I can agree the current UK-wide rates are too high for Scotland and should be lowered, getting rid of all of them is a retrograde step with the potential to increase frivolous claims and tie up already hard pressed managers.
I also have grave concerns about the new Apprentice Levy that is coming in this April. Although it is being raised as a UK-wide payroll tax of 0.5 per cent of total payroll costs above £3 million per annum, how this will be devolved is unclear, as is how companies can claw back their payments made towards qualifying training programmes. We have yet to find out what the Scottish Government intends to do with this money and how we might claim some of it back. Renaissance Care has greatly increased its training budget in recent years but I object to facing a stiff new tax – that might force us to actually cut our training budget going forward to meet the cost of paying this new tax!
The continued shortage of nurses is a UK-wide problem and the Scottish Government is trying its best to improve things by increasing training places and sticking with the old system of grants for nurse training as opposed to the recent switch from grants to loans for nurse training in England. Whichever system is used the fact is we are simply still not training enough nurses. The situation is further worsened by too many nurses leaving the profession completely, either retiring early or simply leaving and doing something completely different.
The Scottish Care inspectorate applies strict qualified and unqualified staffing ratios through ‘agreed’ staffing notices to all care homes in Scotland. They are, however, slowly agreeing to the use of SVQ3 and above qualified senior carers instead of nurses, in some cases subject to negotiation and certain conditions and on the quality grades of the care homes concerned.
To benchmark current costs and enable better targeting of scarce taxpayer resources the Scottish Government should carry out, as a matter of urgency, an extensive all sector ‘cost of elderly care review’ covering all NHS, local authority, voluntary and independent sector provision.