12. Short Debate: Caring for care homes: How we could do more to care for care homes in Wales

Part of the debate – in the Senedd at 7:05 pm on 2 October 2019.

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Photo of Julie Morgan Julie Morgan Labour 7:05, 2 October 2019

In terms of supporting the improvement of services' quality, we're funding the care home improvement Cymru programme over a three-year period. It's aimed at building supportive care home environments that move away from the top-down compliance approach and start with what matters to people living in, visiting, working in or managing a care home service. I was very struck by what Janet Finch-Saunders said about the lively nature of the care home, and how much actually goes on in a care home. This programme engages with all parts of the organisation, including front-line staff, residents and families, to understand each other's contribution to achieving outcomes for people.

I also think that that very important point was made by Janet Finch-Saunders about the link between the hospital and the home, because I think it is those transition periods when things happen, like false teeth get lost, and all these really important things that are so important to people's lives. That transition is vital, so I'm very pleased you made those points so strongly. Certainly, that is something that I think we have to emphasise in the support that we are giving to care homes.

So, as I say, this care home improvement Cymru programme does engage at all levels. We also intend to support care home providers by developing an online facility as part of the Dewis website, which will allow them to display real-time vacancies. We see the real benefits here in terms of time saved and engaging with commissioners and in opportunities to market their services. But this is in its early stages, and we'll be working with providers and others in its development.

I'm acutely aware that adding the prospect of the EU exit into the mix does create further uncertainty for providers. I was actually at a forum today where we were discussing the impacts of the EU exit on care home providers, and maintaining the quality and sustainability of care homes and other social care provision is a top priority throughout this unsettling process. So we are taking a range of measures in co-ordination with wider contingency planning arrangements, to support providers and to mitigate the impact of a 'no deal' EU exit. Two examples that are particularly relevant to care homes are food and medical supplies.

In terms of food, we've established arrangements to allow providers to report any local food supply disruption to local authorities quickly and easily. They in turn can escalate the matter to local resilience fora if necessary. Welsh Government is also fully engaged in UK Government planning for the import and distribution of critical goods, including medical supplies and clinical consumables. We've procured additional storage capacity, including providing a 12 to 15-week supply of these products, which will help increase resilience in both the Welsh NHS and the social care services, because these are issues that are being brought to us by the social care providers, and we think it's very important to try to address those as much as we can.

Turning now to our partners and their contribution, our regulators, Care Inspectorate Wales and Social Care Wales, have both undertaken significant work to implement the regulatory framework established by the Regulation and Inspection of Social Care (Wales) Act 2016. As part of the transition to the new system of regulation, the inspectorate has reregistered 1,550 services since last April, and this is a considerable achievement and is in addition to its day-to-day responsibilities and inspection activity. I'm extremely pleased with the very positive feedback that the inspectorate has received about this process, and the level of support it provided from providers themselves.

This legislation represents an exciting opportunity for us all. It recognises the role of service providers and responsible individuals as professionals with responsibility and accountability for the care and support services they provide. It deliberately doesn't seek to manage services at arm's length, but enables providers to focus on what matters to individuals, their well-being and personal outcomes. Both Care Inspectorate Wales and Social Care Wales will support improvement through their regulatory roles.

I mentioned the importance of workforce earlier, and that has been mentioned by Janet Finch-Saunders and by Angela—the importance of workforce. I think there is a consensus that we need a better understanding of the social care workforce, including in care home services. Social Care Wales and Health Education and Improvement Wales are developing a joint health and social care workforce strategy to identify current and future capacity and capability requirements and how these can be met. This will help ensure we have the right number of people in place able to deliver flexible and agile health and social care that meets the needs of the people of Wales. I know that Angela raised the importance of having a professional way of moving up in the service, and that's one of the things that we are looking at, because there is a differentiation between jobs that are done in the social care service and that are done in the health service, and other places as well. So, I think this is one of the areas that we are going to look at. 

The health service, of course, has been mentioned. Local authorities and health boards also have a key role here, both in terms of their statutory responsibilities and as commissioners of care home services. I know that Janet raised that issue at the end of her contribution, and I'd be grateful if you could write to me about what happened with that individual person and how that differentiation arose. Local authorities and health boards must work with providers to ensure that there is the right care and support available to meet people's needs within the care home they have contracted to provide effective care. I also expect them to play their part in supporting care home sustainability by paying fees due to the providers quickly and efficiently in order to help avoid unnecessary cash-flow pressures, which do happen. 

Last year, we issued the 'Let's agree to agree' toolkit to assist commissioners of and providers of residential care for older people in agreeing appropriate fees for placements. This was developed in collaboration with providers and commissioners. Initial feedback from local authorities is that the toolkit is being considered as part of their fee models for care homes, with some adopting it in full or in part. A more detailed review of the toolkit will be undertaken by the national commissioning board next year, and I want to encourage all local authorities to make use of this resource. Then finally, the sector itself, including those who own services and the people who work in those services, is integral to both the quality and future sustainability of care home services. I really want to recognise here at the end of my contribution the significant contribution they've made to adapt to the new regulatory framework and to making their own contribution towards meeting cost pressures and through investment in the workforce. 

I hope I've been able to show that the Welsh Government is working on a number of fronts in terms of recognising the importance of the homecare services and that we have got plans about trying to further and support the workforce in what is now a very difficult and unsettled time. But I do think that we do want to end on the optimistic note that Janet started with about the great service that is provided in so many homes and the really good practice that there is. I was particularly appreciative of the comments as well made by Jayne Bryant and her reference to the work with people with dementia, and particularly her mention of the Forget-me-not choir, because I've had personal experience of the Forget-me-not choir in my constituency of Cardiff North. I do believe, as Jayne had said, it is one of the most moving experiences you'll have to listen to the Forget-me-not choir. I know that they do operate in a number of homes. 

I also take into account the proposal that clinics should be able to take place in local authority homes, because I think there does need to be a degree of flexibility. And as it was said, there's absolutely no reason why that shouldn't happen. In fact, it does happen in some voluntary settings in Cardiff now. I know that the health authority does provide clinics in voluntary sector settings. I think the more that that can be done—because the nearer it provides them to homes, and to people's own homes, it makes them more likely to take advantage. So, I will finish now. We must continue to work together to ensure that this very important sector thrives and goes from strength to strength in providing the best possible care and support for people in Wales. Thank you very much.