A DAMNING report into the state of health and social work services for older people in Edinburgh was published yesterday.

The Care Inspectorate and Healthcare Improvement Scotland report highlighted criticisms of practice, performance and the delivery of key processes at the time of the inspections late last year.

Health minister Shona Robison called the report “disappointing”, but with no administration yet formed at City of Edinburgh Council there was no local politician able to respond.

No fewer than 17 recommendations were made in the report and Edinburgh Health and Social Care Partnership said work was already well under way to implement them.

The partnership stated: “A comprehensive action plan has been developed and implemented to tackle the issues raised.”

The report did acknowledge that the partnership was at a crucial time of transition during the inspection process, but added: “Restructuring had involved a reduction in the workforce. Staff were working to capacity and were stretched and frustrated by inefficiencies and barriers to effective joint working.

"Many were anxious about what the changes would mean for them and for services.”

Recommendations included that the partnership should “further develop and implement approaches to early intervention and prevention services to support older people to remain in their own homes and help avoid hospital admissions” and ensure that “all unpaid carers’ needs are identified, assessed and met”.

People with dementia should receive “a timely diagnosis and diagnostic support for them and their carers”.

The report further stated: “More visible leadership and effective communication was needed to keep staff motivated and engaged throughout this period of change. When people received services, they were generally of good quality and made a positive difference. However, many older people and carers were unable to get help unless their needs were critical.

“It was not uncommon for older people to wait for lengthy periods before getting the support they needed.

“Performance against some important national indicators was poor. There was substantial work to do to improve access to services. We found important weaknesses in assessment, care planning, risk management and information sharing. Processes to identify and protect adults at risk of harm needed to improve.

“Quality assurance, self-evaluation and performance frameworks all required updating and improvement.”

Positive signs included “early indicators that the new team of service managers are working effectively together to shape services” and the fact that a range of community-based multi-agency services had been put in place with the aim of support older people at home, avoiding unnecessary hospital admission and supporting hospital discharge planning.

Rob McCulloch-Graham, chief officer of Edinburgh Health and Social Care Partnership, 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.

“Ensuring older people receive the care they need, both in hospital and at home, continues to be a top priority for us, which is why we have already taken significant steps to make improvements in these areas.

“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 per cent. This report pulls no punches and there are clear lessons to be learned. However, the inspection was carried out before we implemented a long-term reorganisation of care.”

Robison said: “The partnership has sought to assure me that they have a comprehensive plan in place to address these issues. However, I will be seeking further confirmation in the coming weeks and months that progress is being made.”