SOCIAL CARE WALES — SHA @ LABOUR CONNECTED CONFERENCE.
- In seeking to Reclaim Social Care, we don’t have to start with a totally blank sheet of paper – there is already a lot of good practice and policy out there, not just internationality, but here in the UK. which we need to study and used a basis for progress.
- Social Care in delivered in the context of an older, sicker and poorer part of the UK.
- Social Care in Wales does not operate isolation, but it very much linked to a wider agenda which includes clear citizen focus and co-production – and with a strong emphasis on prevention and early intervention.
- Two crucial legislative frameworks:
Social Services and Well-being (Wales) Act 2014
Well-being of Future Generations Act (2015)
- Public service ethos of partnership and co-operation predominates policy formation but there is still a substantial and continuing legacy for domiciliary care and residential care provision by the private sector… dating back to the Griffiths report.
- The Welsh Government has placed a priority on protecting social care…. but the effects of austerity have been unavoidable.
- But it is still sadly the case that that the number of people who receive adult care has dropped but the amount of time they receive is increasing. This would suggest that the adult service is concentrating more on the more difficult and complex potential service users.
- In Children’s services – the Welsh Government is committed to working to the UN Convention on the Rights of the Child and has produced statutory guidance that the voice of the child and young people are part of the policy making process.
- Wales led the way in introducing free school breakfasts in 2007.
- Introduced the Foundation Phases – a Welsh adapted programme of kindergarten education through play.
- The EMA allowance has continued.
- It has maintained and enhanced the Sure Start programme under the Flying Start programme with provides for early years child care, parental support etc
- IFSS – for vulnerable family with drug and alcohol problems
- Despite that there has been in increase in children in care though there is some evidence more recently that the increase may be easing
- And a “close to care” grant has been provided to young people leaving care.
- In adult services the legal framework in terms for mental health remains the 1983 Mental Health Act but it is underpinned by specific Welsh guidance.. which is influenced a social model of care.
- As well there was supplementary Welsh legislation in 2010 which strengthened patients rights to statutory rights to care plans and a care co-ordinator as well as having a statutory right to independent advocacy if you are receiving in-patient care.
- The mental health budget is ring-fenced within NHS Wales.
- As elsewhere there is a very strong imperative to get adult services working with closely with health care. And early success was made in reducing delayed transfers of care which has been sustained for well over a decade.
- Since the Social Services and Well-being Act partnership is delivered through statutory Regional Partnership Boards
- Within the NHS the internal market was abolished and seven unitary health boards were established in 2009 and these health board areas provide the footprint for joint working with the 22 local authorities in Wales
- These boards have resulted in much closer working between the three sector and have produced some good results.
- The work has been supported by significant investment from the Welsh Government Integrated Care Fund which continues.
- Some of the ICF money is used for strategic infrastructure development across health and social care but much of this is project led. This in turn does create the problem of main streaming these projects as their funding ends and disseminating their learning work generally across Wales.
- And there is the issue of how successful a myriad on individual projects as a local level will deliver the strategic change which health and social care in Wales needs.
- In Wales the financial asset thresholds for access to care are much higher than in England – being set at £50k. And there is a £90 cap / week being placed on the cost for domiciliary care.
- Some work has been done on devising a social care levy ( Holtham) in Wales though it is not clear how the Welsh Government will take this forward as we wait for Boris Johnson’s big social care solution.
- The Welsh Government is pressing ahead with a fully registered social care workforce – a process that is due to be completed by 2022.
- Once in post for 3 months, care workers must be given the option of having a non-zeros contract with greater clarity on rota arrangements for care visits.
- It provided a £500 bonus to front line care staff in the Covid crisis but the UK government, to date, have refused to exempt it from taxation and NI.
- The response to the Covid Pandemic has been very much public service led through Public Health Wales, local health boards doing testing and local authorities doing the tracing work.
- During the period of the previous peak, Welsh Government has been proactive in ensuring that PPE has been regularly supplied to the sector.
- The level of deaths in care homes in Wales are of concern but they were below those of England and Scotland – there is now a two weekly testing programme for all front-line care workers with weekly testing in certain areas and the option of testing asymptomatic high risk, vulnerable groups in certain
- Overall the Covid crisis has exposed the vulnerability and fragility of most of the private providers in the sector and the Welsh Government is considering placing an new requirement on local councils to assess the stability of the sector on a regular basis.
All in all, the Welsh situation is a vindication of the public service model being pursued in the country and there is a fairly strong political consensus in support of this approach.
Even from Welsh Tories there is little enthusiasm to go down the English road.
The situation is far from perfect in Wales on many levels and SHA Cymru would like to move toward a National Care Service in Wales but that is a debate that is only just starting
- But equally we feel that compared to the situation in England, we have a lot to be grateful.
- And we all need to learn from each other if we are to successfully not only Reclaim but also Rejuvenate and Reinvigorate Social Care across the UK.