Health and Social Care Committee

HSC(4)-17-12 paper 1a

Inquiry into residential care for older people – Additional evidence from Care Forum Wales

Mark Drakeford AM

Chair

Health & Social Care Committee

National Assembly for Wales

Cardiff Bay

Cardiff

CF99 1NA

Friday 1 June 2012

Dear Mr Drakeford

Enquiry into Residential Care for Older People in Wales

We would like to thank the Committee for its invitation to give evidence on Thursday 14 June and we would like to take this opportunity to submit additional evidence following on from our written evidence submitted in December 2011.

Our three significant concerns outlined previously still stand:

· The development of a two tier system for residential care and the inability of those who cannot self-fund to choose residential care. The perception is too often that care in a residential home is a choice of last resort, despite the fact that many residents do choose it in order to have the reassurance of 24 hour care and escape the social isolation that many experience in their own home. Information should be made available to explain the advantages and disadvantages to individuals of both home care and residential care.

· Local authority planning and commissioning arrangements, including fee setting, which in too many areas do not adhere to the principles of the Welsh Government’s Commissioning Framework Guidance and Good Practice Fulfilled Lives, Supportive Communities or the Memorandum of Understanding Securing Strong Partnerships in Care. This has led to a lack of appropriate planning, and fee levels which are unsustainable and do not permit the investment needed to maintain provision let alone improve it.

· The lack of sufficient incentives to encourage providers to meet the needs of increasing numbers of older people with dementia.

In our earlier submission in relation to staffing and training we mentioned the potential for reviving the Academy of Care Practitioners after a successful pilot.  This was re-launched in May with the backing of both the Health Minister and the Deputy Minister for Children & Social Services.  It is the first professional organisation of social care workers anywhere in the UK.  The aim is to promote, support and develop Care Practitioners and raise standards in social care provision - and raise the status of this undervalued profession.

The Academy of Care Practitioners has three major objectives:

Provide a reference point for Care Practitioners

o Provide value, status and influence by belonging to a professional organisation

o Promote consultation and representation at a local, regional and national level

o Provide communication channels and support between Social Care Practitioners

Support members by offering advice and providing information

o Provide regular publications, via hardcopy and using ICT and other technology

o Hold Care Practitioner seminars, workshops and conferences

o Provide access to research and reports and links to professional and statuary bodies

Encourage and promote continual professional development

o Promote career progression via structured horizontal and vertical career pathways

o Provide careers, learning and development advice and guidance

o Provide information about local and accessible training courses and events

o Empower members through recognition via celebratory Care Awards

The Academy has been set up as a company limited by guarantee with the aim of it becoming a charity and Glyndwr University, in Wrexham, will be its main base for the foreseeable future.

We have also seen significant developments in terms of the consultation on the draft Social Services (Wales) Bill.  This includes a number of positive developments: a stronger voice and more control for those needing social care, and an end to doing things 22 different ways. Overall we feel the draft Bill provides a great opportunity to refocus social care in terms not just of clinical and personal care needs but emotional well-being.

However, we do have one significant concern regarding the proposal to time-limit the registration of social care providers. As things stand, the regulator is able to de-register providers where necessary in cases of exceptional bad practice.  We believe time-limited registration would have a serious adverse impact on the sustainability of social care provision in Wales.  We are most concerned about the potential financial implications for providers.  In light of these proposals providers have consulted lenders and investors, who have indicated that they would view a business that only had a time-limited registration significantly less favourably than one with a permanent registration.  This is likely to lead to higher interest rates, and a pressure to pay back any loans and make a return on investment more quickly.  There will be an adverse effect on both access to and the cost of credit making existing provision more expensive to maintain and new provision or improvements to provision prohibitively expensive.

We have a number of other concerns with this proposal:

• Instability in the workforce: when a provider was nearing the end of its registration period it might find it impossible both to retain and recruit staff. 
• A deterrent to providers considering entering the market in Wales thus leading to a lack of sustainability of provision.
• The bureaucratic burden taking time and money away from front-line care.

There may also be a threat to the continuity of care for people using services. We would see such a model as particularly unsuitable for organisations requiring capital investment and/or significant staff numbers, such as care homes.  Overall our view would be that the system isn’t broken and doesn’t need fixing.  

Our members wish to provide flexible, innovative, professional services which are properly funded.  We hope that Wales will lead the way to a country where providers are properly engaged by commissioners through the Memorandum of Understanding, where there is meaningful partnership working and vastly improved outcomes for those in need of social care, where care workers are appropriately professionalised through the Academy of Care Practitioners and where those using care services receive the best outcomes possible. 

We look forward to the opportunity to give evidence to you.

Yours sincerely

Mary Wimbury

Senior Policy Adviser

Care Forum Wales