Radical plans that will effectively result in the creation of a national care service for Wales have been unveiled by the Welsh Assembly Government.
Key social care functions formerly undertaken by councils will be taken over by a series of new national bodies by July next year, under the 10-year plan for social services launched on Thursday.
Funding for social work will be provided via a new Welsh Social Services and Social Care Improvement Fund, rather than through individual pots of money to councils.
“Our current arrangements of broad national direction, a general legal framework and high levels of local discretion will not build a sustainable future,” said Gwenda Thomas, deputy minister for social services.
“Doing everything 22 times is not an option. We expect to see positive examples of the planning of services on a regional or, where more appropriate, national basis,” she added.
Ministers say the current system wastes money because it is too complex with too much duplication.
The 10-year plan for social services sets out proposals to create:
• A national adoption agency
• Pan-Wales eligibility thresholds for adult social care
• Regional commissioning arrangements
• An independently chaired national safeguarding board for adults and children
• A reduced number of local safeguarding children boards
• A national contract for care homes and non-residential services, developed jointly with the NHS
• The commissioning of re-ablement services on a regional basis, with a stronger role for occupational therapists in delivering these services
• A Centre of Excellence for Social Care Research
• A national leadership college
• Mandatory registration of care services managers
• A more robust framework for adult protection.
The Welsh Assembly Government has asked local government to outline how it will implement these expectations by the end of the year.
ADSS Cymru president Bruce McLeron described the proposals as “radical”, adding that they offered “a constructive framework within which to address key issues facing social care in the modern century”.
But shadow minister for health Nick Ramsey, a Conservative, said: “The Welsh Assembly Government’s recent decision to cut £5m a year from children’s social services and £3m a year from the social services’ strategy flies in the face of this framework. How it expects to achieve all the goals it sets out – given its budgetary priorities – remains unclear.”
Ministers will lead a National Social Services Partnership Forum to drive forward the changes. This will include politicians, councils, social care providers, carers and services users. A priority for this forum will be how to fund and provide care for frail, older people.
Current social work targets and performance indicators will be replaced by a national outcomes framework. This will include a small number of measures that test the value of services, rather than the measuring processes.
Controversially, the English vision of personalisation in social care is rejected by the Welsh Assembly Government. “We believe that the label ‘personalisation’ has become too closely associated with a market-led model of consumer choice,” states the strategy document.
Instead, ministers propose “stronger citizen control”. This will be backed by legislation to create a stronger right for children to be heard. Social care providers will also be required to involve service users more.
Welsh ministers have differed from their Westminster counterparts by ruling out targets for increasing the number of people on personal budgets. Instead, service users who choose this route will be provided with more support.
The way in which social care services are provided will also be transformed.
“We expect a much greater range of services to be run by citizens themselves,” said Thomas. Social enterprises and social impact bonds are suggested as ways for this to happen.
Inspection of services will change. Instead of focusing on the point of service delivery, the focus will be on the organisations that provide the service. Service providers and employers of registered social workers and social care professionals will require a licence to operate.
The changes are likely to lead to reductions in the number of directors of social services in Wales, as the Welsh Assembly Government has said that one individual may carry out this role for a number of local authorities.
Under the proposals, the role of social workers will also change. The current social work approach to assessment and care management is described as “over-bureaucratic” and “outmoded”. Instead, ministers want a stronger focus on relationships, with social workers focusing on enabling people to make changes.
Ministers reject “a return to the prevention role for social services”, arguing that the whole community should be involved in providing services for older people like gardening, cleaning, shopping, luncheon clubs, dial-a-ride and befriending services. The document is clear that the NHS and social services should not be providing services such as these.
Central to the vision is stronger multi-agency working and closer ties with the NHS in Wales.
Other proposals include extending the entitlement of disabled children under the Children Act 1989 beyond the age of 18 and up to 21. Ministers are considering requiring local authorities to appoint a personal adviser to help young people make the transition to adulthood.
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