Pressures On The Care Home Sector

Dementia Care
November 30, 2017


At a recent conference of Scottish Care and care service providers, serious concerns were expressed about the future of care home services. Providers expressed concerns about the workforce, and about funding issues.


The existing pressures on staff came from low staffing levels, the increased dependency of an ageing population, and uncertainty about the future. These were having a harmful effect, causing increased stress and worry. This was affecting adversely the mental health of people working in the sector.

There was also an increasing difficulty in recruiting new staff, and in retaining those already in post. Combined, these meant an increasingly vulnerable and reducing workforce facing increasing pressures at work. It was said that one-third of the overall workforce had been lost over recent years.

The conference also highlighted a perceived lower level of mental health support for elderly people. It was said that this was possibly due to an inherent ageism in society’s attitudes to older people, and poor resourcing of relevant support and care services. A call was made for society to do much more to protect and support the mental health of our more vulnerable elderly in our communities.


Continued reduction in funding meant services had to cut back on what was previously seen as essential items. These include staff training, providing sufficient time for visits to clients, and reduced staffing levels. The sector was facing a major crisis, with the danger of many care homes having to close and the loss of these vital services to the country. The report concluded that :

‘The current national care home contract runs out at the end of March.  As yet there is no clarity about what will take its place. Local Councils and partnerships need to urgently engage care home providers on what provision they require going forward and what the funding arrangements in each area will be.  The current uncertainty threatens to further destabilise the sector at a point when more providers are looking to exit and very few are looking to come in … The security and well-being of over 33,000 residents and over 46,000 staff depends on getting it right.’

The Future

There was a recent mass closure of care homes in Scotland, by the Bield Housing association. This had been, and is, a well-respected provider. Perhaps that event points to evidence for what this conference was seeking to convey, the serious concerns and risks about the years ahead. But it may also point to a brighter, more diverse future. Bield has intended to develop alternative provision and new ideas to support and care for people. The Scottish Government is consulting on the effect of these closures, and some Councils have commented on ways of coping with reduced funding resources. These include more support at home, better use of technology, and more person-centred commissioning of services.

I believe that is the way to go. While preserving the quality of care already delivered, more individualised services need to be developed with a creative approach. Not only has the dependency of the elderly increased, but increased choice and individual solutions are now expected. Perhaps the present crisis can move authorities to develop, fund and commission more effective and individualised solutions for community need.

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Tony Clarke

Scottish Care Inspectorate Specialist


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