Since 2014 councils have been responsible for implementing Self-directed Support (SDS), which offers people more choices around their support and how it is managed. This is now largely provided by the new local health and social care integration authorities drawn from councils and the NHS.

Today’s report for the Accounts Commission and the Auditor General says while many people have benefited from SDS, integration authorities still have a lot to do to provide this for everyone.

Councils spend £3.4 billion a year on social care supporting more than 200,000 vulnerable adults and 18,000 children and their families. Assistance ranges from everyday tasks such as dressing and preparing meals to helping individuals live more fulfilling lives at home, at work and in their communities.

Most people rate social care services highly and the majority of staff are positive about the principles of SDS. The report highlights areas of good practice such as giving front line staff powers to spend small amounts that can make a big difference.

On the ground, however, not everyone is getting to choose and control their social care the way they want to and staff need more support to try new approaches. Providers also face challenges in offering flexible services, particularly in recruiting and retaining social care workers.

The Scottish Government, councils, health boards, the new health and social care integration bodies, third and private sector organisations, and individual people carers and families, are all involved in making SDS happen. This is set against a backdrop of increasing demand for social care and tighter budgets.

Ronnie Hinds, acting chair of the Accounts Commission, said: “There is a growing body of evidence that SDS is helping many people with support needs to live more fulfilling lives. However, there is no evidence of the transformation required to fully implement the policy.

“Radical change of this kind is never easy but we are in the seventh year of the 10-year SDS Strategy, and it’s been three years since the legislation was introduced. Authorities must respond more fully to provide services that make choice and control a reality for everyone who needs social care.”

Auditor General Caroline Gardner said: “SDS is clearly working well for some people but many more people can and should benefit from it. The Scottish Government has invested £70 million in SDS and needs to work with its partners to boost progress and develop its full potential.”

Councillor Peter Johnston, COSLA’s health and well-being spokesperson, said: “COSLA welcomes Audit Scotland’s report which highlights the scale of the challenge councils and Integration Authorities are facing and acknowledges we are being asked to deliver transformational change against a backdrop of increasing demand and tighter budgets.

“Shifting to new models of care and support inevitably means facing the dual running costs of continuing, or slowly winding down, existing services until new models are fully in place. The squeeze on local government funding has undoubtedly impacted on the pace at which some areas are able to progress this.

“However, despite these challenges, Audit Scotland also found that most people rate their social care services highly – evidence that councils and Integration Authorities are continuing to deliver for our communities in the most difficult of circumstances.”

Scottish Conservative shadow health secretary, Miles Briggs, said: “The change to allow people to have more control over the support they received was welcome.

“However, the Scottish Government has been sluggish in ensuring this option is available to everyone.

“It would appear from the Audit Scotland findings that, having made this change in legislation, the SNP has taken its foot off the gas.

“As the auditors note, we are now seven years into a 10-year strategy, but it’s a strategy which – as it stands – is leaving far too many people behind.

“It’s clear the Scottish Government needs to do more to support these vulnerable people.”

Scottish Labour’s social care spokesperson, Colin Smyth MSP, said: “This report shows that the SNP government has failed to deliver real progress in the delivery of self directed support, meaning few Scots are taking advantage of the options available to them.

“It is worrying that the report states that the government has seriously underestimated the levels of investment required to fully implement the self directed support strategy.

“This is compounded by the fact they have yet to offer any assurances about the amount of support, or in fact if there will be any support to further support SDS implementation from 2018/19 onwards.

“The SNP government must come forward and clarify what support will be provided from next year as soon as possible.”