Policy Area 1B. Adult Social Care
Summary
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.
Indicators in this policy area
Indicator 1B.1. Care services for adults with additional needs
Adult social care policies for people aged 18 to 64 are built on a long-term legislative foundation, but accessing support remains difficult for many disabled adults. Eligibility rules vary between local authorities, charging policies can be complex, and women on low incomes are disproportionately affected by the financial and emotional pressures of navigating the system. While Self Directed Support is progressive in principle, in practice many people still struggle to exercise real choice and control.
View indicator +Indicator 1B.2. Care services for older people
Older people rely on social care to live independently and with dignity. While Scotland has long-term legislation and strategies for older people’s care, access remains inconsistent and often delayed. Women are more likely to be older care recipients, live alone in later life, and rely on support services, meaning gaps in provision disproportionately affect them. Delayed discharge, limited availability of care at home and persistent workforce shortages all contribute to a system under significant strain.
View indicator +Key challenges
- Access to adult social care is often difficult due to restrictive eligibility and complex processes
- Charging policies vary across Scotland with particular impact for those on low incomes between ages 18-64
- Significant unmet need exists but is poorly recorded due to limited national data
- Providers face fragile financial conditions and rising delivery costs
- Local variation results in inconsistent access and outcomes
- Limited preventative support leads to increasing pressure on emergency and crisis services
Key strengths
- Strong legislative foundation for rights based social care
- Long standing national commitment to free personal and nursing care
- National strategies set clear quality expectations
- Engagement with Disabled People’s Organisations and carers’ organisations provides valuable insight
- Clear ambition for system reform and preventative approaches