What this indicator measures

This indicator assesses the funding, availability, accessibility, affordability and quality of social care services for disabled adults and adults with long term conditions. It considers eligibility criteria, charging practices, consistency across local authorities, and the extent to which services support independence, dignity and participation in daily life.

Key findings

• Accessing adult social care is often difficult due to complicated processes and limited support in navigating them
  
• Eligibility criteria differ across Scotland, leading to inconsistent access and outcomes
  
• Financial charges for non-residential care services disproportionately impact those aged between 18-64
• Self Directed Support is inconsistently implemented, limiting real choice and control for many adults
• Local authorities report significant pressure on budgets, reducing their ability to meet demand
• Lack of robust national data makes it hard to understand the true scale of unmet need
• Audit Scotland identifies workforce pressures, rising costs and sustainability risks across the sector

Impacts on families

Many disabled adults and their families report long waits for assessments and support. Women providing unpaid care often reduce paid work or leave employment entirely due to gaps in formal care. Uncertainty about eligibility and inconsistent delivery across areas creates stress and financial pressure, particularly for women in low-income households.

Accessibility considerations

Accessibility varies between local authorities. Disabled adults in deprived areas are more likely to experience unmet need. Charges for non-residential care can be a barrier for those living on low incomes. Lack of clear national data on unmet need makes it difficult to identify and address inequalities affecting groups such as disabled women, people from minority ethnic communities and people in rural areas.

Budget context

Budget allocations for adult social care have increased in recent years, but this sits against a backdrop of long-term underfunding and rising service delivery costs. Integration Joint Boards face financial uncertainty, limited capacity to invest in preventative approaches and growing demand for care. Financial pressures contribute to inconsistent implementation of Self-Directed Support and reduced availability of local services.

Lived experience

“It should not be a fight to get the support I need, nor a fight to keep the support I have.”

Quoted in the Independent Review of Adult Social Care

Overall interpretation

While Scotland has long-standing legislation and clear ambitions for rights based social care, the system is not yet delivering consistent, equitable or accessible support for adults aged 18 to 64. Barriers to access, financial charges and variation between local authorities continue to undermine quality and reach. These issues have a significant gendered impact, particularly for women who provide unpaid care or rely on support to participate in work, education and community life. Strengthening implementation, improving national data and investing sustainably in services are essential steps toward meaningful change.