Two firms providing care at home for older and vulnerable people in the Capital have been barred from taking on new clients after poor reports from inspectors.
The companies are two of seven contracted by the city council to deliver vital support services in thousands of homes across the city. A third care company has stated that it is unable to take on any new clients needing support packages at present. The moves mean more people are likely to face longer waits for care packages when they are ready to leave hospital or have been identified as needing help to continue living independently.
The city council has not identified the two firms which it has suspended from taking on new clients until the issues identified in Care Inspectorate reports have been resolved.
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However, two firms, Avenue Care Services, which covers the Almond district, and 1st Homecare, based in West Granton, have been scored “weak” in the crucial “care and support” category by the inspectorate in recent weeks. This rating usually leads to an automatic temporary suspension for firms from taking on new clients.
The inspectorates’ findings, based on unannounced visits, do not necessarily mean that the general standard of care being provided has fallen below acceptable standards and is often linked to staffing issues. Temporary suspensions are often used to prevent overstretched firms from taking on new clients until staffing issues are addressed.
The council has said it is committed to working with the firms to resolve the problems.
The latest meeting of the Edinburgh Integration Joint Board revealed that the city is still in the grip of a crisis, with 157 people delayed in hospital waiting for packages of care and places in care homes.
The board, who are responsible for providing health and social care in the Capital, admit that the number of people whose discharge from hospital is delayed continues to exceed target levels and continued pressures are also evident in the community, with the number of people waiting for a package of care increasing.
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The main challenges are the lack of availability of care packages and of local authority funded care home places at the national contract rate.
The board report also states that infection has prevented admissions to certain care homes.
Care homes work to make sure that infections like flu or norovirus do not spread from resident to resident, but such outbreaks can and do happen.
These spread very easily and when they do care homes need to delay admissions until the outbreak is resolved, in case new residents are also infected.
Labour MSP Daniel Johnson said: “This has all the hallmarks of a crisis in care. The system clearly is not operating as it should, there are long waiting lists for care packages, disappointing recruitment and retention figures for care staff, and the suspension of admissions to some care homes due to poor inspections. The extra money going to tackle this problem announced at the end of last year can’t come soon enough.”
A scathing Care Inspectorate investigation last May into the quality of care provision found five out of nine factors of care that were rated “unsatisfactory” or “weak” while the projected deficit for health and social care costs rose to £9 million in September.
Crucially, inspectors said the ways in which adults at risk of harm were protected needed to improve significantly. Inspectors looked at how services work together to deliver services to older people, and how far they enable people to be independent, safe, as healthy as possible and have a good sense of wellbeing.
Inspectors said the way services supported people was “very complicated” which “staff and older people struggled to understand and navigate.”
Overall, the report made 17 recommendations for improvement including ensuring all unpaid carers’ needs are identified, assessed and met.
The joint board have come under fire after admitting the city regularly has the highest number of delayed discharges in Scotland.
This led health chiefs to allocate a £4.5m emergency fund to tackle the “immediate pressure” caused by the delay of having people waiting in hospital to be assessed. Bosses were also considering a one-off spend on additional care home placements and plan to reduce the backlog over the next seven months.
Shadow health secretary Miles Briggs MSP, said: “It is deeply concerning that NHS Lothian remains the lowest performing region in Scotland on delayed discharge and is showing no sign of improvement.
“This crisis is due to SNP Ministers’ mismanagement of NHS Scotland, failing to recruit and also failing to retain the necessary social care staff.
“The cost to the NHS of delayed discharge is enormous. It also has a knock-on effect for other areas, such as increased waiting times.”
The Evening News revealed in September how the city is facing an unprecedented recruitment crisis in social care with thousands of jobs lying vacant and people being paid more to walk dogs and stack supermarket shelves than work as carers.
Competition for scarce labour continues to intensify and numbers of new hotel, leisure, retail and call centre developments are adding to the pressure. At any given time care jobs are the most single advertised position in the Capital.
A spokesperson for the Edinburgh Health and Social Care Partnership said: “The number of people whose discharge from hospital is delayed continues to be a challenge across the country.
“The rate of delays varies but in Edinburgh we have seen a sustained downward trajectory from 215 in January 2017 to 157 in December.
“Reducing delays is a top priority for us all and the Partnership is working hard with home care providers, care homes and hospitals to address these delays and to support people to either get home or to move to the right specialist provision as quickly and safely as possible.”