6. 4. Statement: The Social Services and Well-being (Wales) Act — One Year On

– in the Senedd at 4:06 pm on 4 April 2017.

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Photo of Ann Jones Ann Jones Labour 4:06, 4 April 2017

We'll now move on to item 4 on our agenda, which is a statement by the Minister for Social Services and Public Health, ‘The Social Services and Well-being (Wales) Act—One Year On’. And I call on Rebecca Evans, as Minister for Social Services and Public Health, to move that statement. Rebecca.

Photo of Rebecca Evans Rebecca Evans Labour

Thank you. It’s now a year since the landmark Social Services and Well-being (Wales) Act 2014 came into force and we are seeing the way care is being delivered on the ground being transformed to meet the needs of the individual. People have a stronger voice in improving their well-being and deciding what support they need to help them live independently. Care is being co-ordinated with the person at the centre, recognising that they, and their family, know the situation best; they live it every day.

The Act has provided the opportunity to focus on the things that matter to people and to organise the support that is needed through real conversations that build on the skills, strengths and abilities of the individual. The Act was the culmination of many years of hard, collaborative work following the 2011 publication of the Welsh Government White Paper, ‘Sustainable Social Services for Wales: A Framework for Action’.

The White Paper highlighted a number of challenges faced by public services in Wales, including an ageing population and increased demand on services, as well as considering the continuing harsh economic reality. It set out a new vision for the sector, which offered the best possible outcomes for those who need care and support, while also making social services sustainable for the future.

From the very beginning, the Act was developed and delivered in true partnership with local authorities, the third sector, care providers, and health. Its implementation is further strengthening this integration.

Seven regional partnership boards are now leading the change in services, undertaking their own area population assessments to enable them to plan tailor-made solutions based on firm evidence of what the people in that region want and need. As well as multi-agency representation, the citizen voice is increasingly present in the decision-making process, ensuring solutions are being co-produced with input from all of those involved.

The population assessments will set out the range and level of preventative services necessary to meet the care and support needs of differing population areas. To support this, last September I allocated £15 million from the intermediate care fund to provide a range of preventative services in communities, and we will continue to develop these types of services, as well as others required by the changes made through the legislation, through the rebranded £60 million integrated care fund.

Recently, I visited the Bridgend community resource team at its base, the Trem-y-môr residential care facility in Bettws in Bridgend. Through bringing staff together from reablement, physiotherapy, nursing, social work, and the occupational therapy teams, integrated services like this one are making a real difference to the lives of people in the area.

It’s these types of preventative, integrated services in the community that can address people’s needs and intervene earlier to help and support individuals before their needs reach a more critical stage. They can keep people out of hospital and in their homes, living the life they choose safely and independently for longer.

It would be impossible to describe all of the strides being taken in the sector under every part of the wide-ranging Act in this statement today, but to give the Chamber a flavour of the real benefits we are seeing as a result of the social services and well-being Act, I’d like to highlight the success of the National Adoption Service for Wales, established under the legislation. Since its inception, we have seen the waiting time for looked-after children to be placed for adoption nearly halved to 13.5 months from 26 months.

We are proud also that the Act has given enhanced rights to carers. As a Government, we recognise the vital role that carers play across Wales. Now, for the first time, thanks to this legislation, carers have an equal right to assessment and support as those who they care for. We have always made it clear that we will monitor the progress of the Act and the difference it’s making to help people who need care and support achieve well-being. The national outcomes framework was published in March 2016, listing 50 national indicators to measure the well-being of people in Wales who require care and support and carers who need support.

We’ll be setting a baseline through our first annual report, which will be published following the release of the national survey data, this autumn. This report will then be produced annually every autumn from 2017-18 onwards. An independent long-term standalone evaluation will commence in the third year of implementation of the Act, with a stakeholder evaluation group to inform the specification for the evaluation and steer it.

At this first anniversary point, we are only at the end of the beginning of the transformation of social services in Wales, but it is already clear to see that the sector is rising to the challenge to support people who need it by doing what really matters to them. As a Government we will continue to support our partners to deliver this ambitious agenda to its full potential. The journey also continues through the implementation of the Regulation and Inspection of Social Care (Wales) Act 2016, the companion Act to the 2014 Act, which brings regulation into line with the principles of its sister legislation and strengthens protection for those who need it. Yesterday, and as a result of the regulation and inspection Act, the Care Council for Wales became Social Care Wales. Social Care Wales will build on the work of the care council, continuing to be responsible for workforce regulation and development, but also taking a lead role in improvement of the care sector, which we recognise as a sector of national strategic importance.

This spring, after extensive stakeholder engagement, I will also be putting the second phase of regulations and associated guidance under the 2016 Act to full public consultation. It will include the requirements on providers and responsible individuals in domiciliary and residential care, and also now the requirements in relation to secure accommodation for children. A third phase will follow, focusing on fostering services, adoption support, adult placements, and advocacy providers. At the end of this process we will have a regulation and inspection system at the forefront of making sure that care and support in Wales is the best it can be. I look forward to working with our partners to further deliver real differences to the lives of some of the people in Wales who deserve it most. Thank you.

Photo of Rhun ap Iorwerth Rhun ap Iorwerth Plaid Cymru 4:13, 4 April 2017

(Translated)

Yes, 12 months have passed since the legislation came into force, but, in reality, a large part of the Act related to giving powers to the Government to make regulations over a period of time in various areas. So, there’s been less than a year of action in a number of different areas, if truth be told.

In order to retain focus, I want to concentrate on carers, because the Act took the place of the carers Measure, and we heard you mention there that the Government recognises the crucial role that carers play across Wales, and that, through this legislation, there is a right to have an assessment and support for those carers. The Government, you say, wants to monitor how improvements are being made as a result of this Act, and the difference it’s making to those people who need care, but there is still no mention here of the kinds of outcomes of any monitoring. Carers Wales have published their own performance monitor since the Bill, and I will remind you of some of the things that they found: 17 of the 22 local authorities can’t provide any data on the number of carers that contact them over the phone; the majority of councils don’t know how many carers they’ve referred to other organisations; 16 of the 22 local authorities can’t provide figures as to how many people they had referred to other organisations, and so on and so forth.

Now, simultaneously, I will highlight the 24 per cent reduction in the number of nights of respite care over this period. Eighty per cent of those people that completed the Carers Wales survey stated that they hadn’t been offered a needs assessment. Now, the question in my mind, a year on, is: has there been a real practical and measurable change, or is the Government still declaring a year on what they aspire to happen as a result of this piece of legislation, which has already been in force for a year?

So, in response to the concerns raised by Carers Wales—and I’ve raised them also in this Chamber—you said that you’ve written to every local authority in Wales on the issue, and had asked officials to look in more detail at the findings. Can you give us an update on what actions local authorities will take as a result of your letter, and also can you express your view on the findings of Carers Wales, which are quite striking in terms of what has happened in the past 12 months?

You also said that you were discussing a national model in terms of dealing with the issue of respite care with the third sector. Can you give us some details as to when we will see that national model developed, and whether you will aim specifically at overturning the reduction that we have seen in the number of nights of respite care provided? Because my constituents, and I know the constituents of Members across this Chamber, will hear a great deal from constituents on the impact of those lost nights of respite care.

Photo of Rebecca Evans Rebecca Evans Labour 4:16, 4 April 2017

I thank you for those questions. I’m very familiar with the Track the Act campaign from Carers Wales, and I actually really welcome the input and the constructive challenge that they are providing us, and the positive engagement of the third and voluntary sector in the whole co-productive approach that we have through the social services and well-being Act, working in partnership with us and with local authorities to improve particularly outcomes for carers, and also those who are cared for.

I think it is early days yet, and I do acknowledge there is variation in data collection across Wales, but also I recognise that there is also some excellent practice developing. As part of the developing performance management framework for the new Act, a lot of effort is going in to ensuring that there’s a consistent approach to the use of data on a national basis as we move forward. ADSS Cymru has dedicated a specific work stream to secure a national consistency in the implementation of the performance management framework, because I do recognise the importance of having comparable data right across Wales.

With regard specifically to the report that Carers Wales provided—and I do acknowledge it has been useful—the data was generated through a freedom of information request in relation to the first six months of implementation, so we have moved on a further six months from that. But local authorities and, indeed, Carers Wales themselves recognise the variability and inconsistency of reporting against this particular freedom of information request, and that is disappointing. So, in order to get some stronger and more comparative data in future, I’m pleased to update you that local authorities and Carers Wales have agreed to work together in partnership to better shape the request in order to secure more consistent and robust information, as we move forward in the coming months. I would expect improvement in both recording and reporting and, certainly, this work will help inform the implementation of the Act.

So, in terms of my response to the report, I do think it’s difficult to draw firm conclusions from it because of the quality of the data, and it’s worth noting as well that the chief exec of Carers Wales has stated that carers and wider individuals concerned don’t always necessarily recognise that they’ve participated in an assessment as well, so we’ve certainly got some work to do there. And carers are more likely to respond positively if they’ve had or participated in a ‘what matters’ conversation, which is our way of taking forward the social services and well-being Act.

So, to summarise on that, the data do not demonstrate that carers are being denied their right to assessment, but what they do demonstrate is that engagement through the information and advice service isn’t being recorded effectively and consistently across Wales. So, further work is definitely needed in order to embed that consistency. I’ve set out proposals to evaluate the short, medium and long-term impact of the Act as well. Mark Drakeford, the previous Minister, actually set out the process for the evaluation and monitoring of the Act in a statement on 31 March back in 2016, and it will be explicitly linked to the work that’s already been established on the national outcomes framework, which I referred to in my statement as well, which has 50 different outcomes that we will be measuring against. So, the intention is that we will have some really robust data to demonstrate not only where we are now but actually to demonstrate improvement over time in a way that’s consistent right across Wales as well.

I just reiterate the commitment to the national approach to respite. Work is ongoing with that with partners in the voluntary sector particularly, also looking at models that are in place elsewhere. Of course, I am completely open to views and ideas and input from Members in the Chamber on this issue as well.

Photo of Suzy Davies Suzy Davies Conservative 4:20, 4 April 2017

Thank you for your statement, Minister. This legislation, of course, was supported by us and we want to see it succeed. I was pleased to hear the good news on adoption as well, because that was actually a model with which we were pretty sceptical, if I’m honest, so I’m pleased to say that we may have been persuaded otherwise on that now that we have the evidence.

I think we do agree that an ageing population increases likely demand on social services and so we look forward to an indication of the milestones thta the parliamentary review on health and social care integration may have reached. I’m wondering if perhaps you can exercise some influence there about when we might hear about some of those milestones.

You claim in the statement that you’ve given today that the implementation of the Act is strengthening integration further. Now, bearing in mind the points that have already been made on data capture, can you at least give us a flavour of the type of evidence you’ve already had to support the expectation that the seven regional partnership board assessments have begun to improve prevention, rehabilitation and care in their regions, and the evidence that the citizen is in fact leading the way, contributing to the design of their care? I suppose, in short, what I’m asking is: what do you think co-production currently looks like, and what can you do to reassure me, if you like, that the duty to promote social enterprises and co-ops, and the duty to promote the involvement of the person for care or preventative services, are to be provided, which was imposed on local authorities by the Act? Those two duties—are they actually being observed?

We support your investment in the intermediate care fund—that £60 million and now the additional £15 million. However, I am a bit surprised, especially as you’ve indicated that you hope to develop those services further, from your statement, that you’re not really willing to publish the new independent report you commissioned on how to identify good practice and effective use of funding. Now, that’s not just useful for the regional partnerships. That’s actually useful for us as an Assembly to scrutinise and, of course, support you in making good decisions. But I think it’s also useful for those social workers who, at a conference in Swansea last month, were concerned that they were missing clear indicators of what practice actually looks like. So, if you would be prepared to consider releasing that report, I think I’d be very grateful, because I don’t really see why I should wait three years for a full report on what the intermediate care fund is looking like.

I’m happy to acknowledge the potential of the multifaceted care centre and share your interest in Trem-y-môr. I’m not sure why its success would lead to Bridgend council cutting the social care budget by £2.2 million as a result, but I am keen on hearing more about other successful, locally relevant models. I appreciate this is additional work, but if you are prepared to perhaps produce another written statement with some good examples, I think that might help those of us who are trying to scrutinise you.

Carers—I don’t need to repeat what Rhun ap Iorwerth said—but that refreshed strategy is now overdue, I would say. Again, accepting this issue of data capture, can you give us an indication now about how many carers have been told they are eligible for assessment? I’m quite astonished that some might have been assessed without their knowledge. I really wonder how that was allowed to happen. But then on the back of that, do you have any idea of the proportion of those who’ve been told that they could be assessed who have actually exercised that right; the approximate proportion of those who are still waiting to exercise that right; and again, roughly the proportion of carers who have exercised that right and been assessed and had a statement of their needs who have actually had those needs met? For this to work, it’s got to be more than about smiley faces and frowny faces. There’s got to be some realistic and firm measure of whether those needs have been met.

And then finally, even though I could ask you loads more, I’m afraid, the Act introduced an obligation on local authorities to have due regard to the UN Convention on the Rights of the Child and the UN principles for older people. Now, my party believes that all local authority activity should pay due regard to those, but this is a start. So, how are you monitoring the observance of the due regard obligation, and how do you intend to monitor compliance with various codes being issued under the Act, not least that they’re in compliance with those due regard obligations? Thank you very much.

Photo of Rebecca Evans Rebecca Evans Labour 4:25, 4 April 2017

Thank you for those questions. I’ll start by recognising, as you did, the great, important strides that we’ve made in terms of improving adoption services in Wales. Also, just to update Members, the National Adoption Service, as one of its priorities, is seeking improvements in life story work and adoption support as well, because we know that those are things that are really important and have a really significant impact on children who’ve been adopted, and the families who adopt them, as well. So, it’s undertaken a root-and-branch review of life story work, leading to an action plan to improve the quality and number of completed life journey stories that children have. Also, we’ve provided significant grant funding to the development of the new framework for adoption support as well, so there’ll be an action plan setting out how this framework will be delivered later on this year, as well.

I’m also glad that you recognise the difference that the intermediate care fund is having. I gave the example of Bridgend, but there are many more and I’m more than happy to share them with Members. Suzy might be interested—particularly in the Western Bay area, the ICF funding supports a specialised nursing team that has consistently improved hospital admission avoidance. So, this year, the service has resulted in 70 admissions being avoided. Other examples are the Pembrokeshire intermediate voluntary organisations team, which improves opportunities for independent living in the community, reducing social isolation for individuals. And, to date, 1,090 bed days have been saved to the NHS and 109 hospital admissions avoided. Just one more, although I do have others: the Cardiff and Vale regional partnership board has implemented a variety of services provided to support independent living, including the health active partnership and the independent living services schemes. To date, the health active partnership has enabled 365 people to remain in their homes and the independent living service has provided 350 interventions, removing 83 people from a life of isolation, as well. So, lots of great examples. Behind every one of those numbers, as well, there’s obviously a story to tell.

One of the things that excites me most about the figures that we’re seeing at the moment is the delayed transfers of care. We’ve had four months now of declining figures, and our figures at the moment are some of the lowest we’ve ever had in Wales, which is absolutely fantastic, especially as we’re in the winter period, still, at the moment. Our figures are now more than 20 per cent down on where they were last year—for the latest figures. It’s too early, really, to make that link completely, but I think it’s certainly a positive sign that the intermediate care fund is making a real difference.

In terms of setting out, I suppose, an understanding of where we are—our starting point—well, under the Act, all of the regional partnership boards have been required to undertake a joint assessment of the care and support needs, including those of carers, within their population areas, and there are regulations that provide for the production of combined population assessment reports on that health board footprint. So, the first of those reports have been published on 1 April, and they provide some real clear and specific evidence bases on which to inform a range of planning and operational decisions for the future, as well. So, I’ll be exploring with Social Care Wales how we can use these regional assessments of population needs to actually create a national assessment of population need as well. I think that’s going to be really important in terms of helping us understand where we move forward with our preventative services, particularly.

The Act also requires the production of area plans, so setting out the range and the level of preventative services that will be put in place in response to those population needs assessments. So, in the first year of the Act, there has been a lot of work going on to try and understand the level of need, and the next phase now is to complete those plans in terms of meeting those needs. And it’s been made very clear in legislation and the guidance, as well, that we have to be focusing on integrated services in terms of meeting the level of those needs.

The citizen has always been at the heart of this legislation, and the citizen is leading the way right across the piece, really, from the individual conversations that the person will have with the people undertaking the assessment, right through to the whole co-production of things on a larger scale. The principles of co-production are actually set out in the code of practice relating to the Bill, and these are: seeing people as assets, building on capabilities, developing mutuality and reciprocity, investing in networks to share information, and blurring distinctions between providers and people who need care and support, and also facilitating rather than delivering the services as well. We’ve put our money where our mouth is by providing funding for the Wales Co-operative Centre to lead on this work, particularly with some work to help local authorities with that duty to promote alternative models of care. I think that there’s a lot to be excited about in terms of not-for-profit organisations, co-operatives and so on, and how they can start meeting the needs of people across Wales as well. Because I do think the more diverse a market that we have in terms of provision, probably the more healthy it is, given our starting point from where we are at the moment, as well.

I’ve dealt with data capture. So, with regard to the UNCRC and the other obligations as well, there’s regular reporting mechanisms from the regional partnership boards to Welsh Government, and obviously we’ll consider all of the duties that the regional partnership boards have, both under that legislation and their wider duties as well, in that reporting mechanism.

Photo of Lynne Neagle Lynne Neagle Labour 4:31, 4 April 2017

Can I thank you, Minister, for your statement today? This is a landmark piece of legislation and I think it’s good to have these reports, and I hope that this is something that you will commit to doing regularly for Assembly Members. I would associate myself with a number of the concerns raised by Rhun ap Iorwerth around adult carers, and I do pay tribute to Carers Wales for the work that they’re doing on Track the Act, but I am also really pleased to hear what you’ve said this afternoon about there being a much more in-partnership approach now between Carers Wales and local government. So, I wanted to ask specifically, really, about the impact of the Act on children.

You will remember, because you were a member of the committee at the time, that a lot of concerns were raised with us that the people-focused nature of this Act may lead to a weakening of support for children. That was in general terms, but also in relation to the repeal of section 17 of the Children Act 1989, which came about as a result of this legislation, and I do have some concerns in that area that we are already seeing some evidence of less support perhaps being provided to children as a result of the Act. I know that Carers Wales, as part of their Track the Act work, have identified a possible problem with carers of disabled children not being recognised by all local authorities as carers, and I’d like to ask whether you have any evidence of that and what you were doing to communicate to local authorities that they most certainly are. I know that you are aware of my concerns about the impact of moving the family fund money into the sustainable social services grant. There’s also been a cut to funding for Contact a Family. Those are two important mechanisms to support disabled children and their families. So, I wanted to ask: the evaluation you’ve referred to of the Act is very, very welcome, but how specifically will you ensure that the needs of disabled children and their families are taken into account in that evaluation?

Finally, I wanted to ask about safeguarding, which I know falls under the responsibility of the Cabinet Secretary for children, but the decision to put adult and child safeguarding together came as a direct result of this Act, and I know that there is a lot of concern that we are still waiting for the all-Wales child and adult protection procedures to be disseminated in Wales. I understand that a statement is expected very soon, but I wondered if you would be able to comment on that, but also whether you could explain how the relationship between yourself and the Cabinet Secretary for children works on this vital area of safeguarding, with you being responsible for the Act, but the actual delivery of the policies on safeguarding falling under a different Minister. Thank you very much.

Photo of Rebecca Evans Rebecca Evans Labour 4:34, 4 April 2017

Thank you very much for those questions, and I’ll start on safeguarding. Carl Sargeant and I work really closely on all aspects where our portfolios do have crossover, and there are quite a few, particularly with regard to the Act. But on safeguarding particularly, I most recently met with Carl Sargeant last week to talk about safeguarding, particularly, actually, within the sporting field. We had some discussions on that, and also safeguarding children in the home environment, as well. So, we did have some regular contact and regular discussions on those issues.

I think the Act did take a big step forward in terms of safeguarding, especially with that duty to report, so if, as you know, a professional in various fields has a concern about a child, they have a duty to report to the local authority, and the local authority then has a duty to investigate. I think that is a huge step forward in terms of what we’re doing to safeguard children in Wales. You’ll know about the national independent safeguarding board as well, which takes a Wales-wide look at safeguarding issues and advises both myself and Carl Sargeant on the adequacy and effectiveness of safeguarding arrangements in Wales, and I had a very good meeting with them recently as well.

Our officials do meet regularly with the safeguarding board’s business unit managers to review progress as well. Volumes 1 to 4 of ‘Working Together to Safeguard People’ have been published, and they’re available on the Welsh Government website. Volumes 5 and 6 on handling individual cases are currently out to consultation, and that ends on 25 February.

I’ll have to write to the Member with the date in terms of the production of the child protection procedures, and the adult protection procedures for practitioners, because I can’t give you an exact date on that at the moment.

You mentioned several issues in terms of whether or not the Act is truly delivering for children. I was concerned when you said that you were aware of evidence of less support for children. So, I’d be really keen if we could share that information, because I’m really keen, at this very early point in the Act, to find out if there are any barriers or any unintended consequences that we can actually get on with and deal with now, rather than getting to a point where it becomes something that’s ingrained within the legislation. So, whenever issues are brought to my attention, either I or my officials will liaise with the appropriate authority to try and break down the barriers that we are finding in the early stages of the Act.

I know that we are hearing that the Act is making a real difference to many families, particularly those of looked-after children. I’ve been told that families who have been known to social services for quite some considerable time, both in and outside social services, have found that ‘What Matters’ conversation really empowering and refreshing. For the first time in a long time, apparently, some of the parents have really opened up about the family situation and have been much more open to receiving support for the family as well. I think that it’s having remarkably better outcomes for those families, and that’s certainly what the Act is designed to do.

Part 6 also sets the framework for improving outcomes for looked-after children and young people at the edge of care, and it seeks to safeguard and promote the well-being of looked-after children as well, and make sure that they’re able to achieve their personal outcomes. So, those aspirations are very much the same as the aspirations that we have for adults under the Act as well. The Act also has a real focus on diverting children from care in the first place and putting support in place so that families can stay together when it’s in the best interest of the child to do so.

Another feature of the Act that is consistent across adults and children is the individual’s voice being at the centre. It’s so important to listen to children in terms of what kind of well-being outcomes they want to achieve. They need to have advocacy, and we had a debate, just yesterday, on the importance of advocacy and taking a national approach, as well, so I think we’re taking good steps in terms of advocacy.

It’s important to us that looked-after children have the same life chances as any other child, and that’s got to be a priority for all of us across Government, which is why I’m really glad that Carl Sargeant has asked David Melding to chair the improving outcomes for children ministerial advisory group, and I know that that group is taking forward quite a challenging programme as well. But I would say that, at this early stage within the Act, if there are issues that you or any other Member are aware of that might be unintended consequences or barriers to the Act fulfilling its potential, then please let us know and we’ll work together to find solutions.

Photo of Caroline Jones Caroline Jones UKIP 4:39, 4 April 2017

Thank you for your statement, Minister. The social services and well-being Act was the biggest shake-up in social care in decades, intended to put the people receiving care and their carers at the heart of the system. These changes were absolutely necessary. Social care has been hugely under-resourced and is likely to be put under increasing pressure in future decades as our population ages. So, therefore, additional funding is welcomed.

I welcome this Government’s commitment to improving social services, with care being totally focused on the individual’s needs, rather than the needs of service providers. I look forward to reviewing the annual report later this year, so that we can ensure the delivery is meeting its intentions. The national survey for Wales found that, last year, just over half of the public thought that their local authority was delivering good social services. So, I would like to see a vast improvement when the national survey results are published again in the autumn.

I have just one or two questions for you, Minister, and I recognise that we are at the start of the journey of transforming social care delivery, but to those waiting for care assessments or home adaptations, we can’t simply tell them that change is coming. So, what is your Government doing to reduce waiting times for home adaptation? And, Minister, you mention you’re proud that the Act gives enhanced rights to carers, so what is your Government doing to ensure that the funding and facilities are in place to deliver those carers’ rights?

Minister, your statement highlights the fact that the Act is a partnership approach between carers and providers from all sectors. And your predecessor was keen on the co-operative model of direct payments, so what success have you had in encouraging people with care needs to set up and operate co-operatives to make better use of direct payments?

And finally, Minister, the Regulation and Inspection of Social Care (Wales) Act will go a long way to put an end to appalling abuses in care, and I look forward to working with you to ensure the social care regime in Wales is as safe as it possibly can be. I would be grateful if you could update us all on the work undertaken to ensure that all of those undertaking care work are suitably trained. Thank you once again for your statement and for the positive way you are working with all parties in this Chamber to improve social care in Wales. Thank you. Diolch yn fawr.

Photo of Rebecca Evans Rebecca Evans Labour 4:42, 4 April 2017

Thank you very much for those questions, and I’ll deal with the last issues you raised first, in terms of what we’re doing to ensure that social care in Wales is safe, and that has to be absolutely the starting point in terms of ensuring that care is safe. CSSIW does a series of inspections and undertakings in all care settings across Wales, and they do a very good job in terms of ensuring that the care and support that people receive are safe and of a good standard, and they provide an annual report, which I would recommend Members read in terms of understanding the issues in the sector. It’s very important that we have a workforce that is well trained and well paid and well motivated, and one of the exciting things that we’re doing through the Regulation and Inspection of Social Care (Wales) Act is registering the domiciliary care workforce by 2020. Not only will that give those workers the kudos and the recognition that they deserve, but it will actually give them the opportunity to have a career structure as well, and Social Care Wales is doing some excellent work in terms of looking at the future for domiciliary care. They recently published a five-year plan, which I recommend to Members who are interested to have a look at, as well. That looks right across the homecare system and what we can do to make improvements, both in terms of quality, but also in terms of ensuring that the workforce is much more stable. Because, as we know, the turnover in the workforce can be around a third in some providers, which obviously is bad for business, but more importantly is bad for the individual receiving the care as well, because we know people like to have consistency in terms of the workforce that is looking after them.

You mentioned direct payments, and direct payments are really important in terms of giving people autonomy and giving people choice, and I think there’s a lot of potential there. We have actually seen the numbers of direct payments increasing, because they can be used to meet any eligible need that is a care and support need under the Act. It does give people that voice and choice and control that the Act is all about as well. Local authorities are embracing the concept, but I think it’s fair to say that there is some variation across Wales, and so, to ensure that we maintain the momentum, I’ve asked officials to bring together a cross-sector group of practitioners from local authorities, as well as service providers and direct payment recipients, to look at what more we can do to promote uptake across the sector as well. And there are co-productive models that we can use to encourage people who might be nervous or might not want to take on an employer kind of role as well. So, there is some work going on in that sector, or in that field, as well. That new group will also further raise the profile of direct payments and explore alternatives to the traditional solutions of meeting people’s care and support needs as well.

I think it’s also important to say that we have removed a number of the historic restrictions limiting the use of direct payments. So, now, we permit direct payments to be used to pay a relative living in the same household for the provision of care and support, or to help in managing the payments, if appropriate, for promoting the well-being of the recipient as well. So, direct payments are much more flexible and responsive to people’s needs than they have ever been before. I think that’s to be welcomed.

You mentioned co-operatives. As I’ve said before, I think this is one of the really exciting parts of the Act, in terms of giving new impetus to the sector, looking at different models, different—you know, models that can be really responsive to society and to the different needs of different communities. I do have some good examples of those, which I’m more than happy to write to you about—different things going on in different parts of Wales within that kind of work as well.

Photo of Ann Jones Ann Jones Labour 4:46, 4 April 2017

Thank you very much. And, finally, Mark Isherwood.

Photo of Mark Isherwood Mark Isherwood Conservative

Diolch. Thank you. You might recall that in the last Assembly I brought forward a private Bill proposing a community care (direct payments) (Wales) Bill. The then Minister, your predecessor, Gwenda Thomas, said that, if I withdrew it, she would work with me, because there was much common ground. And reference to, for instance, the co-operative care she referred to, came from my Bill, which, in turn, had come from lobbying from the sector, and also reference or agreement that there would be the need to acknowledge the need to promote and support direct payments. That wasn’t on the face of the Bill, but I was told it would be put into the codes. How, therefore, would you address concern raised with me as recently as Sunday, at a World Autism Day event, that not only are some people still not receiving the promotional support, but people who receive care are still, in some local authorities, being told they can’t have direct payments, even when they ask for them? This is managing expectations, managing understanding, and ensuring that local authorities’ officers at a senior level understand this is no longer an option; it’s Welsh law.

Secondly, and finally, the social services and well-being Act places a specific duty on local authorities to promote the involvement of people in the design and delivery of care and support services. Code 2 to the Act

‘recognises that disabled people can achieve their potential and fully participate as members of society, consistent with the Welsh Government’s framework for Action on Independent Living’, which expresses the rights of disabled people to participate fully in all aspects of life. Your statement says,

‘the citizen voice is increasingly present in the decision-making process, ensuring solutions are being co-produced with input from all of those involved.’

However, in north Wales alone, since this has come into play, and over recent months, I’ve had members of the deaf community saying they’ve had their British Sign Language support and wider support taken from them; a haemophiliac being denied employment by the local authority after a medical; a person with Down’s syndrome not being involved in the decisions over their supported living; wheelchair users being denied access to public footpaths; and people on the autism spectrum facing officers who don’t have the basic autism awareness needed to understand them. As chair of cross-party groups on neurological conditions, disability, autism and others, I’m aware there’s a Wales-wide issue with some local authorities over how the introduction of integrated generic access teams is being used as an excuse to withdraw that personalised condition where condition-specific support is needed. How, urgently—not waiting for the review, but how, urgently, will you intervene with local authorities now, or perhaps after the election, to ensure that officers and the new elected executive members understand that this is your requirement, the requirement of your Government, and the requirement of this whole Assembly?

Photo of Rebecca Evans Rebecca Evans Labour 4:49, 4 April 2017

I thank you for those questions. I’ll begin on the point that you made about access teams. Access teams are really important in terms of the gateway to all that the Act can offer individuals, especially through the assessment for all care and support needs, and so on. I’m aware that various different organisations have expressed concern that perhaps the access groups aren’t fully aware of an individual condition. For example, I met with organisations representing deaf people recently, and they felt that the access teams weren’t fully aware of the various adaptations that could be available for those individuals. So, I made an undertaking then to make sure that our access teams were made aware. If there are other conditions where people feel that access teams need more training and so on, then I’ll certainly explore doing that.

People can apply for direct payments, and local authorities should know that. We discussed it recently at the national partnership boards—the variation in terms of the way in which direct payments are being promoted across Wales—and that new direct payments group that I referred to has been tasked with ensuring that we do have a more consistent offer being made across Wales and that people are being made aware of their right to have direct payments. When people do have direct payments, local authorities must ensure that the value of that payment is equivalent to the estimate of the reasonable cost for the care and support that the person needed, and they must ensure that the value is sufficient to enable the recipient or their representative to secure that care and support as well. So, there’s no limit on the maximum or minimum amount of direct payment, and it must be sufficient to meet the outcomes. So, if we are hearing that people are being either denied the opportunity to access direct payments, or that direct payments are being offered at a level that isn’t realistic in terms of meeting the identified care and support needs, then, again, we’re the early stages in the Act—please let me know, and we’ll take action in order to address that.