The service needs to adapt in a number of ways in order to meet the needs of more dependent older people.
The inspection of the service which is used by 88,000 people and on which over 100m is spent each year by local authorities, was undertaken by the Social Work Services Inspectorate at The Scottish Office.
James Douglas-Hamilton, minister of state at The Scottish Office said 'The Inspectorate's report 'A Service in Transition' shows that the home help service improves the quality of life of older people.
But the numbers of more dependent older people living in the community is growing. In order to meet their needs effectively, more flexible services are required which can work more in partnership with carers; and can link more effectively with the social work and occupational therapy services and with the community nursing service.
There is also a need for more specialist schemes to provide intensive packages of care so local authorities should promote the use of the independent sector which can offer flexible services and fill gaps in service provision. Home help organisers require more management support to deal with demanding workloads. These changes would enable the home help service to continue its excellent achievements in helping to support frail older people living in their own homes.'
The home help service is central to the community care objectives of assisting older people to live normal lives in their own homes and to retain maximum possible independence and choice. The policy aims to promote services which respond flexibly and sensitively to the needs of individuals and their carers and services which concentrate on those with the greatest needs.
The objectives of the inspection were to:
-- evaluate how well home help services meet the needs of older people and carers
-- to judge whether these services are effective, efficient, economic, equitable and accessible
The inspection was undertaken in two phases:
-- In March 1994 an independent research agency surveyed the views of 600 older people in six different areas Kelso/Jedburgh, North East Glasgow, Lanark, Falkirk/Grangemouth, Dundee and North and South Uist in the Western Isles
-- Between September and November 1994, inspectors visited these six areas interviewing 85 older people, 32 carers, home helps, home help organisers, social workers, occupational therapists and community nurses
Questionnaires were completed by GPs and independent agencies. The inspection team also studied documents about local authority policies and procedures, reviewed the literature on the home help service and analysed relevant social work and health service statistics.
The report contains 13 recommendations. Nine are addressed to local authorities; two to local authorities along with health boards and health trusts; and two to The Scottish Office. The recommendations are aimed at improving planning and co-operation between health and social work agencies; encouraging the development of independent home care agencies; improving the training of paid and volunteer home care staff in local authorities and independent sector agencies; improving the quality of assessment; and providing more effective support and involvement for carers.
The Inspectorate stated:
'We see the report as an important contribution to the new unitary councils in developing their community care plans. We shall ask local authorities, health boards and NHS Trusts to respond to the report and recommendations within three months. The recommendation addressed to The Scottish Office will be followed up with the Social Work Services Group. We shall also discuss the report with the Convention of Scottish Local Authorities, the Association of Directors of Social Work, the United Kingdom Home Care Association and relevant voluntary organisations.'