Whilst searching through the attic recently I came across a Swansea Borough Council Diary for 1963/4. The Borough Council was the equivalent of unitary authorities today. In the diary was a list of committees which included a children’s service committee dealing with adoption and children in care but not one dealing with services for the elderly.
How times have changed today elderly care services are the major component of Social Services in all Welsh Councils.
We have had an ageing population for several years with a huge increase in the number of over 80s and 90s and with many more people reaching the age of 100.What we need to see is not only people living longer but also having a good quality of life which is something social services alone cannot achieve.
Probably the one initiative that has improved the lives of people above pensionable age is free bus travel which has allowed many people the freedom to travel that they would not otherwise have.
So whilst social services need transforming we must not forget the positive impact that a whole range of other services can have a positive affect on peoples lives.
Also two key facts need to be remembered
- Over a third of the population are over 50 and the percentage will continue to increase
- Whilst many people do not want to grow old they prefer it to the alternative
The strategy for older people 2013-2023 identifies some key issues.
- The importance of social participation. When people retire they often lose contact with their former work colleagues and there becomes the risk of social isolation. Social isolation and loneliness can lead to deterioration in mental and physical health and also to a huge increase in alcohol consumption.
- Lack of public toilets or seating or their being situated in unsuitable areas can lead to many elderly being unwilling to venture away from their home
In my view, the Social Services and Wellbeing (Wales) Bill is a very welcome and progressive piece of legislation, particularly as it represents a major step forward in the process of changing the way people in Wales receive social care and support.
It’s no secret that over the years, social services in Wales has been faced with a number of fundamental challenges, especially as we have an aging population leading to an increase in service demand.
I’m pleased that the Welsh Government recognises this in the form of this ambitious Bill, which aims to transform the current system to better meet the needs of service users as well as deliver a sustainable, high quality social care system for the future.
I’ve had the chance to reflect r on the Bill and come up with some potential suggestions and ideas that I believe would strengthen this legislation to further benefit both those that receive and those that deliver social care services in Wales.
One of the major themes of this Bill relates to prevention and early intervention. The Bill introduces a duty on local authorities, facilitated by Local Health Boards, to provide information, advice and assistance to help people understand what is available locally, how they access help and, where necessary, to be assisted to access care and support.
Firstly, I believe that there needs to be more clarity on what is meant in terms of prevention; this will be essential in getting the Bill right in terms of achieving individual outcomes and objectives. In particular, more clarification is needed around preventative services, along with how they will interact with assessment, eligibility and charging for services.
Although I strongly welcome the inclusion of preventative services in the Bill, I do believe there is concern among some organisations and bodies that it is not currently clear enough as to who would have access to preventative services. For instance, at what point a person will be deemed to have ‘care and support’ needs, and how this will promote real prevention and early intervention.
I feel that the legislation needs to identify more clearly the steps that are envisaged to provide proportionate support to people, and the relationship between preventative services, assessment and the eligibility framework. Once this is clear, I believe that it will be possible to identify when eligibility and charging can be applied, as well as ensuring there are no unfortunate unintended consequences. After all, the proposals for preventative services will not bring benefits to service users if the threshold for accessing them is set too high.
It’s my view that an indicative definition of preventative services on the face of the Bill would help to ensure provision of both general universal prevention and more targeted individual-level prevention.
Despite positive intentions, I do think that the wording of the Bill could be strengthened on the need for a person centred approach; this could, for example, be done through provisions that require the active involvement of people throughout their experience of care and support services, co-production of care plans and outcomes, and promotion of options that are available to exercise voice and control.
A further comment I have relates to the provisions in the Bill that allows local authorities to charge for information, advice, assistance and preventative services. There is some concern about these powers, particularly as there is a strong belief that information and advice should be free, independent and accessible. This is a basic principle that I would wholeheartedly agree with. I therefore hope that the Welsh Government will be providing local authorities in Wales with guidance and advice over charging for such services.
On a final note, there is some concern that the role of service partners (such as Local Health Boards) remains unclear, and there is uncertainty over whether the Bill extends the role of partners beyond that already in place.
It’s my belief that without a meaningful relationship between local authorities and the health service, there could be potential conflicts about charging. Although the Bill provides for local authorities to be able to charge, LHBs will be unable to charge. This could possibly cause conflict in terms of joint working between health and social care rather than encouraging cooperation. It’s therefore advisable for the Welsh Government to consider implementing guidelines, or developing a strategy, towards resolving any potential issues that may arise as a result.
Despite my suggestions, I’ve no doubt that this Bill will make a significant and positive difference to the lives and well-being of people who need care and support, as well as carers who equally need support. It’s likely that all of us, at some stage in our lives, will come into contact with social care services, whether it be for our own needs or for the needs of loved ones and friends; that’s why it’s reasonable to want this ground-breaking Bill to be the best it can possibly be in order to meet our needs and desires as a civilised society.
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