An investigation has uncovered "significant weaknesses" in the delivery of social care services in Edinburgh.
A damning report highlighted a "litany of failures" in the management of the city's social care system including "insufficient leadership" and an "inadequate level of support for unpaid carers" which has led to "too many people and carers not receiving services at the right time or place".
The wide-ranging inspection of Edinburgh Health and Social Care Partnership (EHSCP) was ordered by the Scottish Government last year to provide independent scrutiny of its services.
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The Care Inspectorate told the Partnership crucial action was needed to ensure the needs of vulnerable residents and their carers are being met to improve wellbeing "more consistently".
A collaboration between Edinburgh City Council and NHS Lothian, EHSCP works to deliver community health and social care for adults in the Capital whilst also dealing with issues such as homelessness and mental health.
The inspection report published on Tuesday (March 21) revealed "significant weaknesses" in the organisation and oversight of social care, including issues around the assessment of people's needs and in their case management.
It said efforts to provide early support to people to prevent conditions worsening were "uncoordinated and inconsistent" whilst unpaid carers were not being sufficiently supported.
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 said that care staff were under "considerable pressure and sometimes overwhelmed" whilst "working hard" to deliver services.
Conservative city councillor Phil Doggart described the findings as "appalling" for the city.
He said: "The care inspectorate report into adult social care just lists a litany of failures, particularly around the management of the organisation.
"We see throughout the report that we have willing staff who want to do the best for the people that they're working with but they seem to be let down by system failures, process failures and above all management failures.
"There has to be some responsibility for what has been going on within adult social care."
In an email to councillors addressing the report's publication, the Partnership's chief officer Judith Proctor said it highlighted "indirect consequences of broader pressures" and said shortage of social care workers "remain one of our largest issues".
Councillor Doggart added: "If you read the report and you read the email that went to councillors, you would think they were talking about completely different things."
Highlighting "structural weaknesses" in health and social care, inspectors said gaps in some services meant many were "not receiving services at the right time or place".
They said: “There had been insufficient strategic leadership and management oversight of key processes, meeting legislative requirements, policies, procedures and guidance and to ensure sufficient capacity and capability to deliver safe and effective services for vulnerable people. The pace of change was generally slow.
“Approaches to self-evaluation for improvement and quality assurance were not well-embedded.
“The partnership did not have effective social work governance arrangements in place. Strategic decisions were not always well informed by a social work perspective.”
Furthermore, they added the council's IT systems were "out of date and not fit for purpose".
And they said it could still be "several years before an improved system could be deployed".
EHSCP was told to draft an improvement plan setting out how steps will be taken to address the failures identified.
"We will discuss with the partnership the scale and nature of the improvements required, how it intends to make the necessary improvements and what support they will seek to do so," the report said.
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 focussed 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.”
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