Health and Social Care Committee

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

RC5 ToR – Parkinson's UK Cymru

To examine the provision of residential care in Wales and the ways in which it can meet the current and future needs of older people, including:

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

Parkinson’s UK supports the evidence and analysis that indicates people may be entering residential care too soon, particularly at the transition from hospital and for self funded residents who don't get the advice and info they need on alternatives. Therefore, Parkinson’s UK in Wales encourages the welsh Government to ensure that this analysis should also look at the cost effectiveness of this process and whether there is variation amongst councils in the comparative use of residential/homecare which can't be explained by demography of the area alone). The TOR should include an analysis of availability of good quality financial advice to help people plan for entry into a residential setting.

-          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. (Parkinson’s UK in Wales agree but need for TOR to analyse commissioning behaviour see below)

-          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. (agree)

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

-          new and emerging models of care provision (agree)

-          the balance of public and independent sector provision, and alternative funding and ownership models, such as those offered by the cooperative and mutual sector (agree but could combine with above)

- In addition, Parkinson’s UK in Wales calls for an examination of the distinction between experiences and issues facing self funded care home residents and those of publicly funded residents. For self funders the process should look at both information and guidance in choosing care, third party top ups for care and cross subsidising by self funders to sustain low rates of payments for council funded residents. For publicly funded residents there are the issues of choice and control over the care package and also placement, as well as how much LA are prepared to pay for that person's package of care.

- Parkinson’s UK in Wales would urge the study to look at commissioning of care as authority's approaches to commissioning have a wide ranging impact, from the level of funding in the system, the experiences of individuals, the ability for providers to invest in new service models and the level of pay and training available to staff. It even has a knock on effect on self funders just from the fact the fees they pay are often effectively subsidising publicly funded residents. Commissioning behaviour is a strand that runs through each TOR above but its important that it is analysed in its own right.

Parkinson’s UK recommends that the study looks at the relationship between health services and residential care, from access to GPs, to therapies, dental care, assessments and funding for nursing care and NHS continuing care. The decision on the latter can be life changing in terms of the older person being able to retain more of their savings/income from the sale of their home but if the person is a self funder there is no incentive on either social services or NHS to alert the person to the possibility of applying for NHS CC.

 Aileen Napier

Country Manager, Wales

Parkinson's UK Cymru, Maritime Offices, Woodland Terrace, Maesycoed, Pontypridd CF37 1DZ