Scottish Social Care in 2024: Sector Trends and Reforms

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Scottish Social Care in 2024: Sector Trends and Reforms

This white paper presents an updated overview of Scotland’s social care sector using the most recent data available (primarily 2024 releases). It examines key aspects of the sector – from care home capacity and workforce dynamics to regulatory performance, funding, and ongoing reforms – to inform care providers and decision-makers. All data and evidence are drawn from authoritative Scottish sources, including Public Health Scotland, the Care Inspectorate, the Scottish Social Services Council (SSSC), Scottish Government reports, and Scottish Parliament research. The aim is to highlight current trends, challenges, and policy priorities in 2024, providing context for strategic planning and quality improvement in social care services.

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Care Home Capacity, Occupancy and Demographics

Scotland’s care home provision for adults has contracted slightly over the past decade, even as the population ages. As of March 31, 2024, there were 1,020 adult care homes registered in Scotland, offering 40,079 places (beds) – representing an 18% reduction in the number of homes and a 6% reduction in places compared to 2014. The total resident population in care homes was an estimated 34,113 adults, about 7% fewer residents than a decade prior. This implies an average occupancy rate of around 85%, indicating that while capacity has shrunk, demand has remained high relative to supply.

Care home resident demographics are dominated by older people. About 91% of all adult care home residents are in establishments for older people. Within this group, the private sector is the principal provider: as of March 2024, an estimated 25,853 residents were living in private-sector care homes, while only 2,134 older residents were in voluntary/not-for-profit homes and 3,222 in local authority or NHS-run homes. This reflects a long-term shift toward privatisation of care home provision.

A high proportion of long-stay residents in older people’s homes are living with dementia. In 2024, about 30,170 long-stay residents were in older people’s care homes, with an estimated 63% having diagnosed or suspected dementia. Admissions of long-stay residents in 2023/24 were 6% higher than a decade earlier, yet respite (short-term) admissions have dropped by 69% over the same period. This trend, sharply exacerbated by the COVID-19 pandemic, suggests more individuals are receiving short-term care at home or that care home respite capacity has not recovered.

Workforce Numbers, Vacancies and Sector Trends

The social care workforce in Scotland is large and growing modestly, but staffing shortages remain a critical concern. As of December 2023, the paid social services workforce reached 212,780 people, accounting for approximately 8.1% of all employment in Scotland. In whole-time equivalent terms, the workforce was about 161,750.

The growth in 2023 was driven mainly by housing support and care-at-home services, along with nurse agencies supplying care. However, some areas, such as residential childcare and day services, saw more stable growth. The largest sub-sectors by workforce size include care at home/housing support, care homes for adults, and day care of children.

Despite modest growth, staff turnover and vacancies pose significant issues. The workforce stability index was 74.4% in 2023, and 48% of care services reported vacancies. Some service types, particularly care at home, housing support, and care homes, reported the greatest challenges in recruitment, primarily due to a lack of suitable, experienced, or qualified applicants.

The workforce remains predominantly female (around 84%) and ageing, with median ages of 46 in the public sector and 39 in the private sector. The private sector is the largest employer of social care staff in most parts of Scotland. Most staff are on permanent contracts, and around half work full-time hours.

Fair Work policies are being implemented to improve conditions and address recruitment and retention challenges. However, the gap between workforce size and demand continues to stress the system.

Regulatory Performance, Inspection Outcomes and Complaints

The Care Inspectorate increased its inspections in 2023/24, completing 4,583 visits – a 12% increase from the previous year. The regulator also issued 48 serious concern letters, 32 improvement notices, and cancelled four service registrations. These figures suggest active oversight, with a reduction in severe enforcement actions.

As of early 2025, 86.9% of all registered services were rated “good” or better. However, only 68% of care homes for older people met this standard. By contrast, adult daycare and childminding services had over 90% rated good or above. This reflects some improvement but highlights ongoing quality issues in older people’s care homes.

In 2023/24, the Care Inspectorate received 5,646 complaints, 4% fewer than the year before. About 73% of fully investigated complaints were upheld. Care homes for older people accounted for a disproportionate share of complaints, particularly in areas such as medication, nutrition, and basic care. These figures reinforce the need for continued focus on care home quality.

Funding Levels and Policy Priorities for 2024–25

The Scottish Government has significantly increased social care funding. Compared to 2021–22, spending has risen by over £800 million, with 2025–26 projections showing a total of £2.2 billion. The 2024–25 Budget prioritised funding for local authorities and health and social care partnerships.

From April 2024, the minimum hourly wage for adult social care workers rose to £12, as part of the Fair Work agenda. This aligns with the Real Living Wage and aims to tackle recruitment challenges. While welcomed, sector voices argue it remains a minimum baseline and advocate for further increases.

Policy focus continues on community-based care and preventative services. Funding for free personal and nursing care has been uprated for inflation. Targeted investments are aimed at reducing delayed discharges, enhancing home-based care, and introducing technological innovations such as Hospital at Home.

Local authorities have expressed concerns over ongoing funding pressures. Transparent allocation of social care funding remains a key scrutiny point as structural reforms evolve.

Legislative and Structural Reform Updates

Scotland’s National Care Service (NCS) proposal has been revised. Following widespread opposition to centralisation, the original NCS Bill was rebranded as the Care Reform (Scotland) Bill. This updated legislation, passed unanimously in June 2025, removes structural overhauls but introduces practical reforms.

Key reforms include:

  • Anne’s Law: Guarantees visiting rights for care home residents.
  • Carer Breaks: Statutory rights for unpaid carers to receive respite.
  • Integrated Care Records: Development of unified digital health and social care records.
  • Independent Advocacy: Strengthened access for care users.
  • Fair Work Principles: New expectations for ethical commissioning.
  • National Social Work Agency: To support training, leadership, and policy.

The structural status quo remains, with local authorities and integrated boards continuing service delivery. A new Social Care Reform Advisory Group has been created to oversee implementation.

Conclusion

Scotland’s social care sector in 2024 is in a period of cautious optimism. Despite pressures on care home capacity, staff shortages, and persistent quality concerns in some services, data show progress in inspection outcomes and pay improvements. Funding increases and legislative reforms aim to enhance the sector’s sustainability, support carers, and ensure high-quality care delivery.

Fulcrum Care remains committed to supporting care providers in Scotland as they navigate evolving regulatory standards, implement quality improvements, and address workforce planning. With adequate funding, strong leadership, and collaboration, Scotland has the opportunity to deliver a more resilient and equitable social care system in the years ahead.

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