Health and social services are continuing to let down elderly people and their relatives and carers in Edinburgh according to a new report.

A devastating report in May last year by Scotland's care watchdogs said the city's services for older people were barely adequate, and warned substantial work was needed to improve them.

However an updated report by the Care Inspectorate and Healthcare Improvement Scotland says only limited progress has been made and that services have "deteriorated" in other important areas of care.

The review warns that older people and their families are not getting the support they need when they need it and large numbers are facing a lengthy wait before they get any support at all.

The city has seen an increase in delayed discharges – what is sometimes known as bed blocking – as people who are fit to return home remain in hospital, because Edinburgh hasn’t made the necessary progress towards providing care for more people in the community.

A spokeswoman for the city's Health and Social Care Partnership (HSCP) said the report – based on a visit by inspectors in June – reflected services as they were in the spring, but that improvements had been made since.

The latest review looks at the HSCP's efforts to meet the earlier report's 17 recommendations, in order to address "significant weaknesses" in services across the city.

Inspectors say rather than delivering an overall programme of improvement, the HSCP's response has been "reactive and short term".

Progress has been made in the help offered to elderly people who have suffered falls or are at risk of falling and other aspects of assessing and managing older people at risk.

However the biggest improvements have been delivered because of the dedication of frontline staff and the partnership itself has not addressed key areas of concern.

The report says: "The commitment of front line staff and some managers had been a substantial strength at the time of the original inspection. This remained the case at the time of the review. Where we could see where improvements had been made, these were usually initiatives taken forward by front line staff and middle managers."

However, too little had changed in the year since the previous report: "Many older people and their carers did not have the appropriate support when they needed it. It was still not uncommon for large numbers of older people to wait for lengthy periods before getting the support they needed.... the partnership’s performance in important areas of service delivery had deteriorated."

Gordon Weir, interim chief executive of the Care Inspectorate said: “People want to experience care that is consistently high quality, with health and social care staff working well together to support people in a way that promotes their rights and choices.

“The review found that the health and social care partnership has significant progress still to make to deliver the right care at the right time and in the right setting.

“Prioritised action will be required across services to ensure that older people and their carers are protected, their needs met and their wellbeing improved."

The watchdogs will now work with the HSCP to make clear the scale and nature of the improvements expected, he added. "Given the limited progress in important areas of service delivery we will follow up again with this partnership to report further on progress.”

Alastair Delaney, Director of Quality Assurance for Healthcare Improvement Scotland, said: “There is clearly still much work to be done to give the people of Edinburgh the services and quality of services they need”

A spokeswoman for the HSCP conceded the report had highlighted key areas for improvement.

She said the HSCP would consult on a new carer's strategy in the new year and added|: "The Partnership has set new trajectories for improvement in reducing delayed discharge figures which are showing early signs of improvement."

The report warned of a lack of strategic leadership, but a new chief officer and operations manager appointed in May 2018 had "taken strides in changing the leadership and organisation structure" she said, including the appointment of a new head of strategic planning and head of operations.

Judith Proctor, Chief Officer, Edinburgh Health and Social Care Partnership, said: “We are committed to making the improvements required ... and will continue to work with the Care Inspectorate and Healthcare Improvement Scotland in our action and improvement plans.

“The report is a fair snapshot of where the service was in Spring of this year. Since then, early signs of improvement are encouraging. We fully expect to be in an improved position when the inspectors revisit next year."

The report is based on inspectors' meeting with 30 older people and carers and around 200 staff from health and social work services, charities, private companies and other organisations.

Its findings came as new figures showing a rise of six per cent in delayed discharges across Scotland were described as “disappointing and embarrassing” by Age Scotland.

Brian Sloan, Age Scotland’s Chief Executive said: "Far too many older people are stuck in hospital far longer than they need to be which is just not good enough.

Each of these people stuck in hospital are at risk of infection, psychological distress and loss of strength and mobility. As you age, the longer you stay in hospital the less likely you’re able to leave it," he said.

"The Scottish Government and NHS Scotland should treat this as a priority, and ensure social care is properly funded and staffed in order to turn this around.”