'Substantial improvements' needed for OAP care in Edinburgh
Substantial improvements are required in some health and social work services for older people in Edinburgh.
It follows a joint inspection of services by the Care Inspectorate and Healthcare Improvement Scotland.
It looked at how well health and social work services by the Edinburgh Health and Social Care Partnership delivered personal outcomes for older people.
Across nine "quality indicators", four were found to be "adequate", four were "weak" and one was "unsatisfactory".
Inspectors looked at how services work together to deliver services to older people, and how far they help people to be independent, safe, as healthy as possible and have a good sense of wellbeing.
Inspectors said the way services supported people was "very complicated" which "staff and older people struggled to understand and navigate".
Performance against some national indicators, for example how quickly people ready to leave hospital can do so, was poor, although new teams had been introduced to assess people's needs and support them better.
Inspectors found that when people received services, they were generally of good quality and made a positive difference. But too many older people and carers were unable to get help until their needs became critical.
Although inspectors found ambitious plans in place to improve the experience for older people, they said there was "substantial work to do to improve access to services.
It was not uncommon for older people to wait for lengthy periods before getting the support they needed.
They added: "There were weaknesses in the ways older people had their needs assessed and in the way their care was planned."
Inspectors said the ways in which adults at risk of harm were protected needed to improve significantly.
The report makes 17 recommendations.
Rob McCulloch-Graham, Edinburgh Health and Social Care Partnership's chief officer, said: "We accept the contents of the report, but also acknowledge the inspection was carried out just prior to the partnership completely reorganising its services based on four localities across Edinburgh.
"Many of the concerns highlighted within the report had been previously identified by the partnership and work was already being progressed to address through the partnership.
"After the preliminary inspection results, we established an improvement team which has already produced positive results, almost halving the number of people waiting for care within their homes and reducing hospital waiting times by around 20%.
"This report pulls no punches and there are clear lessons to be learned."
Karen Reid, chief executive of the Care Inspectorate said: "This report lays out clearly what is working well and what needs to improve.
"Where older people and carers did receive services, these were generally of good quality and made a difference.
"However, older people are not getting the right support at the right time, delivered by the right people.
"We know new strategies are being put in place to help people leave hospital more quickly, but the partnership needs to support older people much earlier on, preventing them having to go into hospital wherever possible.
"The leadership team must plan and deliver services in an integrated way, ensuring people's needs are understood early and met well."
Robbie Pearson, chief executive of Healthcare Improvement Scotland said: "Although the partnership achieved good outcomes for some older people and their carers, too many people had poor experiences and poor outcomes.
"The partnership needs to strengthen care at home. Our inspectors found examples of older people being admitted to hospital because their carer was unable to continue caring, when they could have been supported to stay living at home.
"We now require an action plan detailing how the partnership will take the necessary steps to improve experiences for people. We will continue to work with them to sustain and embed improvement and will return to the partnership in 12 months to review progress."