Health and Social Care Committee

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

RC3 ToR – Cymorth Cymru

To the Committee Clerk

Thank you for the opportunity to comment on the Terms of Reference.  Feedback from Cymorth members and their service users highlights some real concerns around issues that the Committee’s Inquiry will enable policy makers to consider in more detail. Based on the feedback we’ve received I would like to feed in the following comments:

· the process by which older people enter residential care and the availability and accessibility of alternative services

This is a really important question – often our members working with older people find that people are directed towards residential care when they could be more independent in another setting such as sheltered or extra care or by having floating support services delivered to their home.  We also find that residential care is sometimes used for younger people with disabilities again when they could, with support, have much more independence within an adapted or supported home of their own.  I wonder whether these specific issues could be picked up by the Inquiry as they massively limit the independence and quality of life of some of our most vulnerable citizens.

· the capacity of the residential care sector to meet the demand for services from older people in terms of staffing resources and the number of places and facilities.

We find people delivering/accessing other types of services often feel that there is sometimes a lack of awareness of different options in a given locality within social services that results in people being only offered residential care – leading to the situation described above.  We also often have reported to us that an issue with resources is the amount of surplus required to make it viable for some private sector businesses.  I don’t think that this is always the case but I think it is an issue that the Inquiry could explore – to what extent is WG happy in the current difficult financial climate for high profits or high chief executive salaries to be funded by public money when front line staff salaries in residential care are generally very low.  Third sector providers and ethically driven small private sector organisations would value recognition of this issue and a steer from government.

· the quality of residential care services and the experiences of service users and their families; the effectiveness of services at meeting the diversity of need amongst older people; and the management of care home closures.

These are crucial issues and link to the previous concern.  Cymorth has run a number of initiatives bringing people using services together with policy makers and elected representatives to have a voice in the policy making process and we would be happy to assist the Committee in this.  We also have concerns around the effectiveness of services to meet the diversity of changing needs amongst older people – particularly the most vulnerable and would be happy to discuss this further or assist in eliciting input on this issue.

· the effectiveness of the regulation and inspection arrangements for residential care, including the scope for increased scrutiny of service providers’ financial viability.

This is crucial in today’s context and we would suggest that there are two separate issues here – we would urge the Committee to consider how the service users/carers’ voice is heard in regulation and inspection – focusing on this in the terms of reference would provide a positive step forward in improving how inspection/regulation is improved in Wales.  On the second issue – we need to explore how the right expertise is utilised to adequately analyse the financial viability of a sector/particular organisation delivering services in Wales.

· new and emerging models of care provision

We would suggest that this in particular looks at emerging partnerships/practices between local government and the third sector.

· the balance of public and independent sector provision, and alternative funding and ownership models, such as those offered by the cooperative and mutual sector

Again, we would suggest that this also explicitly considers the role of the third sector.

I hope these comments are useful – please let me know if there is anything that needs clarifying or if there is anything further Cymorth can do to support the work of the Committee and this Inquiry.

Best wishes

Joy Kent

Director

Cymorth Cymru

www.cymorthcymru.org.uk