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.
http://www.communitycare.co.uk/Articles/2011/02/18/116314/wales-creates-...
PDF version Legislation to give councils responsibility for emergency poverty payments contravenes social work values, and would harm practitioners' relationships with service users and deepen poverty.
That was the warning from welfare rights experts after the government included plans to localise the payment of discretionary community care grants and crisis loans under the Social Fund in the Welfare Reform Bill, published last week.
The move is likely to see social workers administering income payments to vulnerable users, though some councils may choose not to provide the service and use the budget transferred by the Department for Work and Pensions for other purposes, as it would not be a duty.
The Independent Review Service for the Social Fund, which reviews Jobcentre Plus decisions on Social Fund awards, would be scrapped.
The plans were originally revealed by Community Care last November and sparked concerns that social workers' relationships with clients would be harmed.
Giving social workers' the power to award payments or not "would make their relationships with clients a far more unequal one," said welfare rights specialist and registered social worker Neil Bateman this week. "It fundamentally alters the role of the social worker as advocate and some service users will be more difficult to engage as a result of that."
His views were echoed by Gary Vaux, head of money advice at Hertfordshire Council, who said: "It potentially places local authority stuff in an invidious and difficult position of having to make decisions about financial matters that run counter to social work values and practice, possibly to the detriment of that practice."
He warned that making councils the sole port of call for families needing help in financial crises would also "create new and substantial demand, from many families who are not social work clients".
However, Bateman said there was a big risk of councils not setting up the service and using the money for "filling potholes in roads", deepening poverty. "There is currently a legal framework and national consistency and accountability, which will be completely lacking if this goes ahead."
He accused the DWP of trying to "offload the worst aspects of the social security system" and said the plans would "recreate many of the features of the Poor Law".
Under the plans, the discretionary Social Fund would be scrapped, ending the national payment of community care grants to families in stress who need essential household items, and of crisis loans to vulnerable people who need general living expenses covered in an emergency.
Local Government Association policy consultant Philip Mind said concerns about the impact on social workers were valid, but councils would not necessarily give social workers responsibility for gate-keeping payments. “That doesn’t strike me as a sensible way of discharging this responsibility," he said.
However, he admitted that the LGA had concerns about the plans. “Our stance is that there are big risks around the [impact on] customers’ experience and big risks around finance [for councils], including because of the [wider] turbulence in the welfare system, but we are prepared to engage with government to see a way through,” he said.
In a consultation on how the plans would work, the Department for Work and Pensions said decisions on eligibility for grants and loans had been criticised in the past and were currently taken too remotely, which did not support "the high levels of discretion that are needed".
It claimed its proposals would create a "more responsive, better targeted and relevant service".
The other parts of the discretionary Social Fund - budgeting loans and alignment loans to cover delayed welfare payments - would be replaced by a new national scheme to cover welfare claimants who need advanced payments.
The consultation closes on 15 April 2011.
http://www.communitycare.co.uk/Articles/2011/02/21/116315/welfare-rights...
Beverlea Frowen, director for social services and health improvement for the Welsh Local Government Association, said Wales had decided that quality of care would come through involving the public sector and voluntary services in a "co-production" approach to ensure "sustainable social services".
She said: "Our relationship with the private sector is that we see them fitting into a public sector. That's very different from England."
The private sector would instead have to fit into a public sector framework. She said quality of care should improve through commitment to learning from the best councils and continuous improvement, rather than from outsourcing to the private sector.
Frowen insisted that moves to create a version of a national care service were not about funding cuts or increasing control from Cardiff but about improving efficiencies in commissioning and procurement.
She said that the urgency of reforms in Wales had been brought on by financial pressures, though these are seen as an evolution rather than a large-scale reorganisation.
Frowen echoed the comments of Gwenda Thomas, the minister responsible for social services in Wales, when she said: "Without some serious injection of money we are going to be significantly under pressure."
She said there were concerns about a lack of understanding of the impacts of the Westminster reforms on Wales, particularly with welfare reform measures and personal budgets for all by 2013 in England.
http://www.communitycare.co.uk/Articles/2011/02/21/116317/welsh-social-c...
The minister responsible for social services in Wales has hit out at David Cameron's Big Society vision, arguing that it is short-sighted not to invest more in social care.
Speaking to Community Care following the launch of Wales' 10-year plan for social services last week, Gwenda Thomas said: "It's not about the Big Society in Wales, it's about our society, the way we work. It's not about the government pulling out – the Welsh Assembly Government is working in partnership with the social services family.
"The Big Society is not a concept we are adopting in Wales - it's about us all working together in the firm belief that respecting the role of all partners is the best way forward."
Thomas insisted that moves to create a de facto national social care service in Wales were not designed to facilitate cuts. "This is not a cost-cutting exercise. We have protected social services, where funding will rise by 3% year on year until 2013-14 - an extra £35m," she said.
Shadow minister for health Nick Ramsey, a Conservative, has accused the Welsh Assembly Government of cutting £5m a year from children's social services.
"I haven't seen that," said Thomas. "He may be talking about cuts to grant funding to outside bodies, but I stand by what I've said about funding for social services."
When pushed on the cost of not investing in social care, Thomas said: "We can't afford not to. The sky could be the limit if we don't look at working in different ways."
Thomas said the 10-year strategy for social services was about creating consistency in assessment and provision.
"We're looking to have a uniform assessment process so everyone in Wales is treated the same. From 11 April we will see consistent charging. There will be an upper limit of £50 a week for social care packages provided by or commissioned by our local authorities."
In addition, transport charges for day centres will be abolished, at a cost of around £1.7m a year.
"We will recompense local authorities for the income lost through these changes and have budgeted for £10.1m a year on an ongoing basis," said Thomas.
Thomas said doing more on a regional and national basis would not lead to fewer social workers. "We've had the workforce review in Wales and that clearly states that we need to be defending recruitment and retention in social work and social care," said Thomas.
However, she admitted the changes could lead to fewer directors of social services as councils make joint appointments.
The detailed costs of the changes and implications on staff won't be known until councils submit their plans by end of the year though.
Thomas said the timescale for reform, July next year, was realistic. "We have got to move quickly and have received widespread support for our proposals," she said.
http://www.communitycare.co.uk/Articles/2011/02/21/116316/big-society-wo...