Adult social care in the Highlands is teetering on the brink of collapse as 112 days worth of care was unmet in one week in January
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Warnings that for months adult social care in the Highlands is teetering on the brink of collapse have been made explicit as in one week in January the equivalent to almost four months of care was undelivered.
Previously it was perceived the crisis was particularly concentrated within the care home sector but that now appears to have spread to other areas including those who receive support at home.
In a report to be presented at Highland Council by Fiona Malcolm, the council’s head of integration adult social care and Pam Cremin a chief officer at NHS Highland outlines how a variety of problems are really damaging the service.
They said: “Significant staffing pressures and fragility across commissioned care homes, care at home and support services in Highland, which continue to compromise service capacity and whole system flow from hospital.”
Regarding staffing recruiting and retaining staff continues to be a problem through “stress, wellbeing, and turnover” which now has to reckon with “competing seasonal and tourism employment; Covid absence; and accrued annual leave.”
That has led to a situation where there are “unmet mutual aid requests, and unmet in-house service demands” and those “staffing pressures have an impact on service delivery including both care homes and care at home.”
For the week ending on January 31 the total number of unmet weekly hours of care across the Highlands was 2700 – that is the equivalent to almost four months of care (112 days) without support.
The unmet hours was as follows 1014 in Inverness; 368 in Skye, Lochalsh and West Ross; 335 in East Ross; 274 in Badenoch and Strathspey; 240 in Mid Ross; 72 in Nairn and Ardersier; 44 Caithness; 28 in Sutherland; and 325 in Lochaber.
Another issue is delayed discharges as “there is a close relationship between unmet need across the system in terms of the availability of care at home and care home placements” which currently stands at 141 patients who cannot be discharged.
Underlying this all is a system that appears to be severely dysfunctional and totally inappropriate for the Highlands that is causing “significant sustainability and financial fragility issues across commissioned care home services.”
Ms Malcolm and Ms Cremin put it like this: “These pressures are considered due to: the higher number of smaller size and scale of operator in Highland; the National Care Home Contract fee being based on an average size of 50 beds (only eight of 66 care homes in Highland are above 50 beds).”
That means the amount that care home operators get to run their facilities, employ staff and take in residents puts them at a disadvantage because of the north’s dispersed population.
There is the added issue of “the age, condition, and lack of provider investment in care home stock” and the emerging “trend of larger providers divesting from Highland.”
The viability of care homes is now severely in question and has been supercharged by the cost crisis which put an end to at least six care homes since January of last year.
They include: Shoremill (Cromarty), Grandview (Grantown), Budhmor (Portree), Mo Dhachaidh (Ullapool), Castle Gardens (Invergordon) and Caladh Sonah (Sutherland).
Where there have been closures (recent and in previous years), these have been well managed but are becoming increasingly difficult to manage in terms of identifying alternatives.
And despite the World Health Organisation publicly announcing the end of the Covid pandemic the infection continues to present severe problems because as a result of ongoing outbreaks within care homes 12 were closed to new admissions.
