Review of care service definitions: challenges and recommendations

1. Executive summary

The Scottish Government commissioned Iriss to help review the current care services definitions (section 47 and schedule 12 of the Public Services Reform Act (Scotland) 2010 Act), by engaging with key stakeholders in the sector. Iriss interviewed 55 stakeholders representing organisations from across the social services, health, and education sectors and local and national government (see appendix 2 for the stakeholder list). The following report provides feedback on key areas of changing the current care definitions: challenges the current definitions pose, the changes the sector wants to see, the implications of any suggested changes and approaches to consider for taking forward recommendations from this research.

Challenges

Some stakeholders felt that the current definitions of care services posed a range of challenges to the sector. Some challenges were around service provision. Stakeholders argued the definitions hindered person-centred care, exacerbated the current challenges of integration and created barriers between social work and social care. Stakeholders also felt the current care definitions complicated the practical operation of the SSSC Register for social care workers and further challenged professional roles in this sector. Similarly, those using services cannot always access the support they need and some stakeholders showed transitions are a crucial area missed by the schedule for care definitions.

Changes

Stakeholders wanted to see a range of changes to the current definitions. Some argued for specific changes to each definition (see appendix 1). This included the creation of new categories, using more appropriate and updated language that reflected the culture of the sector, developing further guidance to support the current schedule, and broadening the definitions of care services. Others argued for wider transformational changes focusing specifically on person-centred care and providing holistic support.

Implications

Stakeholders were mindful of the potential implications of changing the current care services definitions. Many reflected on the pressure this might put on service provision, as services could become over-regulated. Some also considered the positive implications on public attitudes towards some areas of the sector which currently carry stigma and negative connotations. Stakeholders were also concerned that any changes to the definitions would negatively impact social care workers in the sector by creating new regulatory barriers and by threatening flexibility and autonomy for workers. Stakeholders, however, felt that changes to the definitions would lead to better quality of care for those accessing support services.

Iriss recommendations

This report concludes with Iriss' recommendations for development with references to systems change and health and social care redesigns.