Dimension 1. Care Services
Intro
Care services include early learning and childcare, and adult social care. These services support people throughout life, enabling children to thrive and adults to live independently and with dignity.
Dimension snapshot assessment
Scotland has expanded access to early learning and childcare, but affordability, flexibility, workforce pressures and local variation continue to limit consistency and accessibility. In adult social care, persistent underinvestment, rising demand and difficulty accessing social care mean many people do not receive the support they need.
Summary
Care Services form the backbone of Scotland’s social infrastructure – from the childcare women, and families more generally, rely on, to the social care that supports disabled people and older adults.
Across this dimension, Scotland shows strong policy intent and established regulatory frameworks.
But the same pattern appears again and again:
- Policies are often ambitious, but access is difficult.
- Flexibility is low and availability varies across local areas.
- Underinvestment puts pressure on services and staff.
- Unmet need remains a major issue, particularly in adult social care, increasing levels of unpaid care, the majority of which is undertaken by women.
Childcare has seen major expansion through the 1,140 hours commitment, yet gaps for under-twos, limited flexibility, and a lack of a national school-age childcare system hold families back, impacting on the levels of unpaid care carried but women and, ultimately, gender equality.
Adult social care is guided by strong legislation, but inconsistent delivery, tight eligibility criteria, and financial pressures mean many people struggle to access the support they need.
Policy areas that influenced this score
Policy Area 1A. Childcare
Childcare is a vital service that supports children’s development and enables parents – particularly mothers – to work, study or train. It plays a central role in tackling women’s economic inequality and supporting long-term financial wellbeing.
Scotland has made meaningful progress in expanding Early Learning and Childcare (ELC), particularly through the introduction of 1,140 funded hours. Regulation and quality monitoring are strong, and targeted support exists for children who most need it.
However, accessibility remains a major barrier. Provision for children under three is limited, flexibility varies significantly between local authorities, and costs can be high for families who need full-year or wraparound childcare. Out-of-school childcare is not yet statutory, and current provision is inconsistent, leaving many families-especially those working non-standard hours or living in rural areas-without reliable support.
The sector also faces workforce and financial pressures, including rising running costs and fragile sustainability across providers. These challenges reduce families’ ability to access work, training or education and contribute to persistent gender inequality.
View policy area +Policy Area 1B. Adult Social Care
Adult social care supports disabled people, older adults and people with long term conditions to live independently, safely and with dignity. Most unpaid carers who provide support alongside formal services are women, and women also make up the majority of Scotland’s paid social care workforce. The effectiveness of adult social care policy therefore has a significant impact on women’s lives, financial security and wellbeing.
Scotland has a long-established legislative framework for social care. This includes the Social Work (Scotland) Act 1968, the Community Care and Health (Scotland) Act 2002, the extension of free personal and nursing care, the Self-Directed Support (Scotland) Act 2013, and the Public Bodies (Joint Working) (Scotland) Act 2014. In recent years the Scottish Government and COSLA have produced a range of strategies that aim to strengthen quality standards, integration and rights-based practice.
However, Scotland’s adult social care system remains under strain. Many people report that accessing support is difficult, slow and bureaucratic. Eligibility criteria and charging practices vary widely between local authorities. These issues create a postcode lottery for disabled people and older adults. Rising provider costs, workforce shortages and fragile service sustainability further limit consistency and quality. National data gaps mean unmet need is poorly understood, making it harder to plan or target resources.
Overall, current adult social care policy does not yet ensure equal access or affordability for those who rely on it. These gaps have a disproportionate impact on women, both those receiving support and those providing unpaid or paid care.
View policy area +Dimension assessment
Care services are central to a fair, thriving and caring Scotland. They support children’s early development, enable parents to work, tackle gender inequality, and uphold the rights, wellbeing and independence of disabled people and older adults.
Scotland has made meaningful progress in this area – particularly in expanding funded early learning and childcare hours and in strengthening regulation and quality standards across both childcare and adult social care.
However, the Scorecard reveals a consistent story across these services:
- Access remains a major challenge
- Early Learning and Childcare accessibility is limited and provision often inflexible.
- Out-of-school childcare is not yet statutory.
- Adult social care has long waiting lists and inconsistent eligibility rules.
- Many people experience unmet need, particularly in the most deprived areas.
- Consistency varies significantly between local areas
Local authorities deliver policies differently, leading to a postcode lottery in availability, flexibility and charges.
- Budgets are under pressure across both childcare and adult social care
Audit Scotland has highlighted fragility in the childcare sector, while social care services face rising costs and increasing demand.
- Workforce challenges affect quality and sustainability
Recruitment, retention and pay remain ongoing issues in both childcare and adult social care. Women make up the majority of those working in care.
- The impact of policies is limited by gaps in flexibility and inclusion
Families with younger children, parents who work non-standard hours, rural communities, and those with children who have additional support needs face the greatest barriers.