IN the weeks leading up to lockdown, Sophia Latif, who runs Milan – a senior welfare organisation working with the South Asian community in Edinburgh – noticed that people gradually stopped coming to its day care services.

“We started to see fear spread in our groups and numbers dwindled,” she says. By the time Nicola Sturgeon announced that it needed to stop running its drop-in, where transport, lunch and activities were provided, the charity was already thinking about how else to meet needs.

Because at a time when people were seeing support packages they considered essential cut from all directions, that need was growing by the hour.

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Latif moved fast, finding restaurant kitchens, getting staff trained and delivering lunch to their community as well as offering support and advice on the phone. The charity started off delivering to 20 people, but as demand increased numbers have soared and it now has 150 older people on its books.

The 10-strong team has put in extra hours and teamed up with other local charities such as Unity to reach right across the city but Latif still worries that some are falling through the gaps.

The need to support older people through this pandemic – over three-quarters of deaths in Scotland have been of those over 75 and 52% in care homes – has been put back in the spotlight this week, with calls emerging for a National Care Service.

At First Minister’s Questions, Nicola Sturgeon said she was sympathetic to the idea, claiming that though it came with complexities, now was indeed the time to look at reforming Scotland’s social care offer.

Yet while attention has fallen on care homes, many are now also pointing to the chronic under-investment in social and home care in the community. There is frustration too from some who have been calling for reform and investment for years that this is “easy rhetoric”.

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Donald Macaskill, chief executive of Scottish Care, puts politicians’ failure to act until now down to “selective amnesia”. He adds: “It has cost of thousands of lives to give them back their hearing.

“We have been calling as an organisation for the reform of the social care system for years and now everyone is jumping on a bandwagon of using an easy phrase.”

Social care is different from health, he argues and it is not a “one-size fits all” system. As an organisation representing the third and independent care sector, he also has concerns about how nationalising care will impact on the choices older people should have the right to make about how they receive care. That includes care and support at home.

“Home care is the forgotten front line in this pandemic,” he says. “What we have seen around the country is local authorities have written to people to tell them they are removing their package and then three months later write back to say: ‘Because you haven’t needed this we are assuming you won’t need it in the future.’ In fact, these people are being cared for by families who are on furlough, for example. They do need that support.”

He claims action, not rhetoric is now needed, paying carers who are still waiting to receive the living wage promised by the Scottish Government back in April, banning “unacceptable” 15 minute home visits, re-instating essential packages and putting proper investment in place.

Tressa Burke, chief executive of Glasgow Disability Alliance, whose membership includes many older people, is emphatic about the need for investment. She says: “Our social care system was hanging by a thread before Covid hit. Chronic underfunding leaves huge numbers of older and disabled people struggling with unmet needs, and no choice and control in their lives.

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“This was already a national scandal, and the devastating impact of Covid-19 on Scotland’s care home residents, as well as the thousands of people in Glasgow alone, whose vital care and support was cut under lockdown, reveal that our fragile, over-stretched system is not fit for purpose.”

She is convinced by the idea of what she calls a “National Health and Care service” but stresses choice and control must be embedded. Had there been proper investment in social care, she argues that many care home deaths could have been avoided. “Social care would have more aligned quality of care and standards,” she says. “Sufficient numbers of staff, proper PPE available from the outset alongside NHS peers would have been in place, for example.”

Change is also urgently needed to allow people the choice to stay at home for as long as they are able, she adds. “Eligibility thresholds go up and up as budgets shrink, and bureaucracy spirals, making it impossible for older people with changing needs to access timely support to live well and safely at home.

“The upsurge in community volunteers must not be taken as a ‘big society’ solution to fundamental rights and needs. Communities and families are vital for our health, wellbeing and social connections ­– but no-one should be forced to rely on a neighbour to come and wipe their bum.”

DON Williamson, chief executive of Shared Care Scotland, a charity representing organisations offering support and respite to carers, says it hears many of the same fears.

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“Scottish figures from a Carers UK survey showed 80% of carers have taken on more responsibility since the start of lockdown,” he says. “We also know about 40% have had services either reduced or cut completely. It’s of major concern the longer this goes on.”

He claims while the third sector in particular had done “a fantastic job of rapidly and creatively” finding ways of putting services online, new issues are arising as they consider emerging from lockdown.

“It’s a complex affair,” he adds. “People are nervous about starting up again and inadvertently being part of the problem in terms of a second spike. Families need to be reassured that it will be safe. Staff need to have reliable access to PPE in sufficient quantities and access to testing. There is a real eagerness to get back to business. But these are the concerns that services are raising to us.”

There are structural issues here too. “Third sector and not-for-profit organisations provide so much of our health and social care services,” he says. “But they are saying there is a perfect storm coming in terms of increased demand and reduced income. The sustainability of the third sector is a huge concern.”

Transition funding must now be made available, he argues.

Meanwhile in Edinburgh, Sofia Latif has noticed a change creeping in. “What we have found is that people are getting very disturbed now,” she says. “They are getting very emotional. They are telling us they just want us to come and see them.”

In response the charity has applied to the Care Commission, and its staff are now allowed to visit, wearing PPE. And they continue to act as a lifeline to many.

It has arranged rescue flights for people stuck in Pakistan, India and Bangladesh and provided essential food and medicines when they were instructed to quarantine. “We are supporting people with dementia,” Latif says. “Some of our clients are staying in a hostel. They are not even able to cook. So you can imagine how much they depend on us.

“These are the kind of things that nobody recognises.”

And now that need has been exposed, those who support older people across Scotland claim we must not look away.