Edinburgh health chief faces calls to quit after care services slammed in watchdog investigation

Vulnerable people at risk of harm are being let down and support for unpaid carers is ‘inadequate’, inspectors found.

A Lothian MSP has called for the resignation of Edinburgh’s care chief after inspectors ruled too many people and carers in the Capital are not receiving social work services “at the right time or place.” The Care Inspectorate report found social workers were “constantly managing crisis situations” and that “urgent work was sometimes unallocated”. It said efforts to provide early support to people to prevent conditions worsening were "uncoordinated and inconsistent" whilst support for unpaid carers was “inadequate”.

A lack of support for unpaid carers in the community led to hospital admissions, while respite could only be accessed in private care homes and emergency respite was “mostly unavailable”. The watchdog found a large number of social worker vacancies and warned that the department's areas of weakness "could adversely affect experiences and outcomes for adults at risk of harm". People had problems from the start with assessment of their needs – with mostly no direct contact when people when they were first taken on by social care services.

Lothian Scottish Conservative MSP Sue Webber said: “Throughout my five years on the IJB, my colleagues and I repeatedly raised concerns about the quality of care being offered in Edinburgh and just as often those concerns were dismissed. The chief executive Judith Proctor has had long enough to put a proper improvement plan in place, but this report is as damning of a lackadaisical management culture as it’s possible to be. Vulnerable people and hard-working staff are being let down and enough is enough.

The report found a lack of support for unpaid carers among significant failures

“The City of Edinburgh Council’s chief executive must also shoulder responsibility too, and perhaps it is time for a complete clear-out because we simply cannot rely on current management to implement essential reforms the Care Inspectorate is calling for. But change needs to go further. The continued underfunding of local authorities by the Scottish Government means that delivering services is a constant battle to scrimp and save to make ends meet, and the plan to throw £1.9bn at a replacement national care service is just throwing money bat bureaucrats when this report is yet another illustration of where the greatest need lies."

Self-directed support, a system whereby those as having critical social care needs can request direct funds to arrange a personalised care package, had "not been implemented effectively," the report added. Inspectors recognised care staff were under "considerable pressure and sometimes overwhelmed" whilst "working hard" to deliver services. Significant delays in discharging people from hospital and waiting for care assessments had recently started to improve, the report said. But overall it was found there had been “insufficient strategic leadership and management oversight of key processes, meeting legislative requirements, policies, procedures and guidance.”

Care Inspectorate executive director of scrutiny and assurance Kevin Mitchell said: “Inspectors found significant areas for improvement in adult social work and social care services in the City of Edinburgh. Prioritised actions will be required to ensure the needs of people and carers are met, and their wellbeing improved, more consistently.”

The inspection of Edinburgh Health and Social Care Partnership (EHSCP) was ordered by the Scottish Government last year to provide independent scrutiny of its services. Social care services are overseen by the Integration Joint Board (IJB) with the City of Edinburgh Council and NHS Lothian.

Councillor Tim Pogson, chair of Edinburgh Integration Joint Board said: “I fully acknowledge the findings of the report, as well as the improvements we need to make for those in our care. Whilst the review highlights many of the challenges we’re already facing into, it was good to see our front-line staff highlighted as an area of strength. Their hard work continues to deliver vital services, often in difficult circumstances, and I want to put on record my thanks to them for their ongoing commitment and support.

“Our workforce deficit remain one of our biggest challenges, as does the need to address our partnership structures and governance, and we’ve long highlighted the need for urgent investment into our shared systems and processes. This is, of course, against a backdrop of ever-increasing financial pressures and without further support from our partners, including the Scottish Government, this will inevitably result in yet more difficult decisions. We desperately need further investment and I’ll make this point to the Minister when I meet him in the coming weeks.

“That said, we remain absolutely committed to driving forward the changes we need to make and work is already underway. This includes the recent appointment of a Principal Social Work Officer and the introduction of a strategic Inspection Oversight Group. This group will oversee and approve inspection improvement plans, ensuring actions are focused on outcomes to deliver a better service to those receiving our care, their carers, our colleagues and our partners. We’ll continue to report back on progress against these plans in the coming weeks and months.”