Shaping social care - What will the Social Services Bill need to do?

At an as-yet-unspecified point later this month, the Welsh Government will unveil the biggest shake up of social care in Welsh history when they announce their Social Services Bill.

If the tension is killing you, fear not. The number of trailers for the Bill will mean there are very few surprises – last year’s White Paper made the Welsh Government’s ‘direction of travel’ very clear, and more recent statements by the Deputy Minister for Social Services have also added flesh to the bones of the Bill.

Nevertheless, there are still some big questions over what is likely to be a radical set of changes. Today, the older people’s charity WRVS is setting out what we think are the biggest challenges which the Bill will need to address. If resources and political will are focused correctly, we believe the Bill can genuinely make life better for older people across Wales through the following three mechanisms:

  1. Setting the bar at the right level. Currently, there is a very clear discrepancy between the Welsh Government’s enthusiasm for preventative care services, and local government raising the threshold for care so that only those with the most critical needs receive help. When the Bill sets a national threshold for social services eligibility, the only way to enshrine prevention in the system is to set that threshold at ‘Low’; not doing so will inevitably result in relatively independent older people’s needs escalating. There is a strong consensus for this position, including from ADSS, the Welsh Government’s Pearson Review, and the Dilnot Commission in England.
  2. Helping local authorities to develop and signpost services which tackle loneliness. There is a very clear link between social isolation and physical ill-health – but loneliness can also be an easy and low-cost problem to address, through things like befriending schemes or good neighbour services. The challenge is ensuring that these services are properly signposted, and that more is done to help older people at risk of isolation. The simplest answer is to ensure that the proposed annual health checks for over-50s incorporate signposting towards social support where this is appropriate.
  3. Promoting wide-ranging ‘reablement’ services. Reablement services help older people to make the transition back to life at home after a stay in hospital. In Wales, the SSIA have identified that 60% of older people who enter a reablement service do not require further services after a six week intensive period of help and assistance. This not only makes a massive difference in improving an older person’s wellbeing, it also reduces costly hospital readmissions for the NHS. The Social Services Bill is likely to see a very welcome expansion of reablement services in Wales, and we would simply suggest that this includes social reablement services which are proven to bring significant benefits in terms of physical health. A lot can be learned by looking at the recommendations of those organisations already engaged in delivering reablement in Wales.

Although they may sound modest, these three suggestions would fundamentally alter social care in Wales by focusing on an older person’s quality of life rather than on ‘absence of illness’ healthcare. Getting preventative care right is the greatest challenge facing us – if we don’t change our approach, projections suggest that care services in Wales will need to increase by 24% to maintain the current level of service by 2020; this equates to around 5,000 care home places and 15,000 places for people seeking support in the home.

Properly-funded and effective preventative care services are in the best interests of older people and the public purse. Providing them will result in a care system which will make Wales a great place to grow old.

This article was first published at WalesHome

Posted by Dr Ed Bridges, Public Affairs Manager, Wales at 00:09 Wednesday, 07 March 2012.

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