Three need to die before one person can get care home bed they require, MSPs told
Scottish Care said providers face ‘some of the most significant challenges in a generation’
Care homes are under so much pressure that "three people need to die before one person gets the bed they require," MSPs have been told.
Scottish Care said there is "growing concern about the ability of people to access residential care when they need it".
In evidence to a Holyrood committee, it highlighted "constrained availability and increasing occupancy pressures" as well as growing financial strain.
The Scottish Conservatives said the submission was a “damning indictment of the SNP’s failure to properly support local care services”.
John Swinney has promised to reform social care as part of a wider shake-up of public services, including slashing the number of NHS boards from 14 to two and reorganising local government.
The First Minister said the current social care arrangements are "overly complex".
The SNP scrapped its flagship plan to create a National Care Service last year due to a lack of support.
MSPs on the health, care and sport committee will take evidence on the key issues facing the sector on Wednesday.
In a written submission ahead of the meeting, Scottish Care, which represents the largest group of social care providers across Scotland, said the sector "faces some of the most significant challenges in a generation".
It said the immediate reality is "characterised by increasing difficulty accessing care, growing complexity of need, workforce pressures and rising concerns about financial sustainability".
It added: "One of the clearest indicators of system pressure is not found in hospital statistics but in the experience of individuals attempting to secure care and support.
"Across Scotland, providers report increasing delays in accessing care at home support, growing waiting lists and significant challenges in matching available capacity to assessed need."
Scottish Care said recent intelligence had highlighted examples where individuals were waiting months for appropriate support packages.
"Providers report that capacity is often unavailable not because staff do not wish to provide support, but because workforce shortages and commissioning restrictions mean that assessed need cannot immediately be translated into actual care," it told MSPs.
"Similarly, there is growing concern about the ability of people to access residential care when they need it.
"One provider described the current reality by saying that 'three people need to die before one person gets the bed they require'.
"Whilst anecdotal, this statement reflects the underlying issue of constrained availability and increasing occupancy pressures across many localities.
“In care at home services, Scottish Care has also gathered evidence that in some areas fewer than half of available hours or packages are effectively repurposed and reallocated when capacity becomes available.
“This represents a significant inefficiency within a system already struggling to meet demand.”
Scottish Care said the profile of individuals receiving care and support had changed significantly over the last decade.
"People are entering services later in life, often after years of managing multiple long-term conditions and increasingly complex health needs," it said.
Meanwhile, providers consistently report recruitment and retention difficulties.
Scottish Care said its immigration survey found international workers represented 26 per cent of the workforce within responding organisations.
"Changes to immigration policy have therefore had a disproportionate impact on social care," it added.
The body said financial sustainability has become the dominant concern for providers, while wider cash pressures in the public sector are also having an impact.
“Alongside provider challenges, health and social care partnerships are themselves operating under significant financial pressure,” it said.
“Across Scotland, projected financial gaps approaching £500 million are affecting local planning and decision-making.
“This matters because financial pressures within commissioning organisations increasingly translate into operational pressures for providers and delays for individuals requiring support.”
It said there is a “widening gap between what Scotland expects social care to achieve and the resources, workforce and infrastructure available to deliver those expectations”.
The Coalition of Care and Support Providers in Scotland (CCPS) said the sector is “facing sustained and increasing pressure from rising demand, workforce shortages and escalating costs”.
It told MSPs: “Scotland's social care system is not only underfunded but is also characterised by complex and fragmented funding and commissioning arrangements, that undermine sustainability and the implementation of policy.
“Without reform, providers will continue to struggle to recruit and retain workers, limiting their ability to deliver high-quality support and threatening wider public service outcomes.”
It said urgent action is needed “both to stabilise the sector in the short term and to deliver the long-term reforms required to secure its future”, and urged the committee “to recognise social care as a strategic national asset and to support reforms that will ensure its sustainability for years to come”.
Cosla, the council umbrella body, said integration joint boards, which are responsible for planning services in health and social care, face a £475 million budget gap in 2026-27. It said longstanding pressures had resulted in service reductions, including in care at home provision and care home placements.
“Alongside financial pressures, demographic change is a key driver of rising demand for social care across Scotland,” Cosla told MSPs.
It added: “Across Scotland, people are living longer and increasingly require support for multiple and complex conditions, often over extended periods of time.
“This is contributing to growth in demand for both community-based and residential care services, as well as an increase in the intensity of care required.
“These pressures are largely demand-led and unavoidable, yet the resources available to local authorities and integration authorities have not kept pace with the increasing volume and complexity of need.
“The result is growing pressure on already stretched budgets and difficult decisions about how limited resources are prioritised.”
Miles Briggs, the Scottish Conservative health and care spokesman, said: "This evidence is a damning indictment of the SNP’s failure to properly support local care services during their two decades in power.
“Despite their promises to eradicate delayed discharge over a decade ago, they have hit record levels under the SNP.
“That means patients who are otherwise fit and healthy are stuck in hospital for longer and unable to go home, or to be seen further by local care providers.
“SNP ministers should be ashamed it has reached this situation which has a deeply damaging impact on patients and their families.
“Having spent years squandering millions on their doomed plans for a National Care Service, SNP ministers should use this tale as a wake-up call to finally give local authorities and care providers the resources they need to meet demand.”
Outlining his programme for government last week, Mr Swinney said he could not see Scotland resolving the fundamental challenges facing social care “without a single line of decision-making, accountability and funding, with the NHS taking the lead”.
A Scottish government spokesperson said: “Local authorities are responsible for the provision and delivery of social care, however we are clear that the current status quo is not good enough.
“It is vital that we use public service reform to address the issues we see in people accessing the support they require and it’s why the Scottish government will engage in intensive consultation with local government over the next three months to develop potential solutions.
“We have provided record investment of £2.3 billion in social care but we recognise some of the specific challenges social care faces – including the burden placed on the sector from the UK government’s employers’ national insurance hikes and its closure of the health and care visa for international workers. This has been devastating for the recruitment and retention of workers.
“We have continued to engage with care providers and they will play an important role in shaping our plans for reform of the NHS and social care services.”
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