Health and Social Care Committee

Consultation on terms of reference for inquiry into residential care for older people

RC18 ToR – Dr Angie Ash

Dear colleagues

Thank you for the opportunity to comment on the draft terms of reference for the inquiry into residential care for older people.

In making these comments I draw on a range of professional and personal  experience that includes:

Working with health and social care services in Wales and the UK as a consultant onprojects that have included: setting quality standards for residential care[pre Care Standards Act]; drafting the national  social care regulator’s induction framework for staff working in care homes; undertaking serious case reviews of the care of individual older people; staff training and development programmes for care staff; engaging older people in the design and delivery of the services they receive from a local authority.

Long distance, long-term care, over a number of years, of my late mother, who lived in a nursing home prior to her death.

Published doctorate research on safeguarding older people from abuse.

Turning to your draft Terms of Reference, I suggest the following:

ToR bullet  2 – I suggest this para includes a statement about the demand – or rather expectation - of the quality of care. There may well be a defined number of staff and beds, but if the quality ofcare delivered is poor, the staff numbers are unlikely to be of any consequence to the older person.

I suggest this bullet point is rewritten to state: …'the capacity of residential care to meet the demand for services of quality from older people in terms of staffing resources…

ToR bullet 3 – I suggest issues of quality and experience from the point of view of the older person are separated out from market and money matters in your ToR.

Hence, this bullet should exclude 'and the management of care home closures'. This should instead be placed in a discrete bullet point that is concerned with money and the market.

ToR bullet 4 – in the same way, I suggest the last phrase ‘including the scope for increased scrutiny of service providers' financial viability' is removed from this bullet point, again to a separate the matter of money and the market.

In that way, the point about ‘effectiveness of regulation..’ etc will not be not lost in market considerations.

In addition, I suggest this bullet point is rewritten to emphasise the quality and life experience of the elders who use the residential sector, with market and money matters being the means by which that end can be secured.

I suggest the bullet point reads: ‘the effectiveness of the regulation and inspection arrangements in the delivery of high quality residential care to older people ‘

ToR bullet 5 – to include diversity, so that it reads ‘new and emerging models of care provision for the diversity of needs of older people’

Last Tor bullet point: add here ‘the funding of residential care’. It would be faint-hearted of the Committee to duck the opportunity to consider the overall funding of residential care inthis inquiry.

This bullet point, which is concerned with the market and cash, could include also issues I suggest earlier are not tacked onto quality of care issues: ie, care home closures and financial viability of providers.

In summary, I would urge the committee to be bolder in including quality of life and the experience of the older person in its ToR and subsequent deliberations, and allow regulation and funding to follow, and not drive, that primary purpose.

I hope these points are helpful.

Kind regards

Dr Angie Ash
Angela Ash Associates