National Assembly Committee calls for reduction in reliance on residential care for older people

13 December 2012

Wales needs to re-examine its approach to caring for older people, according to a new report from a National Assembly Committee.

The Health and Social Care Committee is calling for a further reduction in the use of residential care as a default choice, building on the actions already taken by the Welsh Government to shift services towards more community-based options.

The Committee either saw for itself or heard evidence about a wide range of services and facilities which enhanced the lives of older people, maintained or gave them back their independence and, in many cases, accelerated their physical and mental rehabilitation.

It also concluded that everything possible must be done to reduce the stress faced by people when making difficult decisions regarding either their own care or the care of loved ones.

Measures could include making information about care options much clearer and inspection reports for care homes widely available and easy to understand.

“Considering care options for our later years can be an incredibly difficult process, as it is a recognition either of our own diminishing independence or that of those we love,” said Mark Drakeford AM, Chair of the Health and Social Care Committee.

“Sensitivity and clarity is of paramount importance at this time. The Committee believes that more must be done to reduce the pressures associated with making these hard decisions.

“Part of this process is to make information on all the available options as clear and simple as possible so that everyone involved in the process, including older people and their families, can make informed choices.

“We also believe that more could and should be done to reduce our reliance on residential care. The Committee has seen many imaginative ways and high-quality services which allow older people to keep their independence. The positive effects of such an approach are evident.”

The Committee was assisted in its inquiry by an external reference group made up of members of the Welsh public. The group considered the same evidence and contributed its own findings.

“The reference group’s contribution was vital to the inquiry as they were able to weigh up the evidence against their own experiences,” added Mr Drakeford.

“Many of the group either have relatives in care or are at the point where they are making tough choices, so to be to able see the issues from their perspective was invaluable.”

The Committee makes 13 recommendations in its report, including:

• Residential care should not be viewed simply as an option where irreversible decline is the only outcome. We believe that the Welsh Government should work with the sector to ensure that residents are enabled to experience a more stimulating and purposeful life that encompasses their spiritual needs.

• More should be done to provide advice and information to support older people, their families and carers in making decisions about their long-term care.

• The Welsh Government should work with partners to develop new initiatives that give residents, their families and carers greater voice and control. The aim of this should be to influence the shape and direction of services and exert continual pressure on service quality

• The Welsh Government should ensure that older people are always offered a period of reablement or intermediate care following a period of illness, particularly when this has involved hospital treatment. Care decisions should take full account of a person’s potential for maintaining and increasing their independence. Entry to permanent residential care straight from hospital should not occur.

• The Welsh Government should take action to ensure that arrangements for the financial scrutiny of independent providers are strengthened. This should be achieved by re-visiting and re-assessing current ‘fit and proper person’ arrangements in cases of care home acquisition to ensure that they include consideration of financial sustainability and are applicable to corporations as well as individual managers / owners.

Link to more information on the Health and Social Care Committee

Link to more information on the Residential Care for Older People inquiry