Western Mail Column: ‘Working together will improve social care sector’

Working together is the key to improvement, says Gwenda Thomas

TOO often the public only hear about the shortcomings in social care services.

While these failings need to be improved, they only represent a small proportion of the services that are provided to the most vulnerable people in society.

There are a huge range of social care services throughout Wales that work with people and families, who are experiencing problems and need support.

The demands on these services are ever growing and there are higher expectations as we as citizens want to have a greater say about the services.

The Welsh Assembly Government has already taken positive steps towards taking social care forward. We are currently seeking additional powers in the area of charging for non-residential social care.

As things stand, charging for home care and other non-residential social services is at the discretion of individual local authorities.

This has resulted in significant variations in policies for services across Wales.

We have a One Wales commitment to achieve a fairer and more consistent approach to charging for all adult recipients of non-residential social services.

By legislating against such disparities we will fulfil this and we are currently in the process of obtaining the necessary new powers.

Earlier this year I announced a new £4.5m-a-year, three-year scheme to help older and disabled people live more independent lives.

The new funding is being put towards preventing unnecessary hospital admissions and supporting people to live in the community.

By ensuring that every stage of the care pathway is as effective and integrated as possible we can increase capacity for services to support people to live more independent lives.

The Assembly Government’s 10-year strategy – Fulfilled Lives, Supportive Communities – sets out our vision for social services as a core service within local government covering adults and children.

We are also seeking to use the new opportunities for Legislative Competence Orders to extend the powers of the Assembly Government in relation to children’s services and carers’ rights, enabling us to bring forward distinct service initiatives of our own here in Wales.

This will be seen in the strategy we are developing for vulnerable children being accommodated. It will be supported by two legislative planks – the Children and Young Person’s Bill and our own Measure, which will focus on children at risk because of parental problems.

There are some 4,800 children in care – parental drug or alcohol misuse and mental health problems are the main causes of entry of into care.

But a wider group of children who are known to social services and other agencies either do not enter care, or do so after a time, and yet fail to thrive and reach their full potential.

We will shortly consult on new arrangements to improve the delivery of health and social care to families where substance misuse coexists with concerns about the welfare or vulnerability of a child and to pilot a new integrated family support services.

We have an opportunity to set a new direction for services for our most vulnerable children.
We must strive to achieve good quality care for children, adults and older people – whether in family, residential or community settings and have to use all our resources to best effect to do so.
Social services must work closely with health services and with voluntary and private providers to develop service models for the future which can respond flexibly and effectively to people’s needs.

Everyone in the sector is aware that there are occasional instances where individuals and their families are sometimes let down by the care system. But there is also plenty to shout about when it comes to social care in Wales.

I am confident that by ensuring all stakeholders work together we will further improve the sector for the benefit of those that need it most.

Gwenda Thomas AM is Deputy Minister – Health and Social Services

Western Mail Column: ‘We all have a role to play protecting the vulnerable’

Deputy Minister for Social Services Gwenda Thomas explores how we can all make a difference and overcome the challenge of elderly abuse.

As with anything, the first step towards tackling a problem is to recognise that the problem exists. Like child abuse, or domestic abuse, it is only when we face up to the realities that we can do something about it.

In recent years there has been a growing awareness and better understanding of the abuse of older and vulnerable people, although it should be acknowledged that systematic and structured approaches across Wales to address this are still at a relatively early stage of development when compared to the arrangements that exist for child abuse.

I know that all too often older people and their families may not be fully aware of arrangements that exist to protect vulnerable adults and of the help and support that can be available.
The Welsh Assembly Government is taking steps to address this. Most recently I gave funding to a consortium led by Learning Disability Wales to produce a DVD on the protection of vulnerable adults, which is aimed at adults, including older people, with learning disability themselves.

This will help ensure they have the information they need about their rights, to protect themselves from harm and abuse and to know what to do if abuse happens. The DVD will be published this autumn.

We also need to consider how to make it easier for members of the public to raise specific concerns. These are clearly issues that we need to work with the statutory agencies to address.
Tackling adult abuse is not just a matter for the Welsh Assembly Government, service providers, statutory authorities, regulatory bodies or the police to deal with. All citizens and organisations have a role to play in protecting vulnerable adults from abuse whenever and wherever it occurs.

I know too that the Commissioner for Older People has a particular interest in protecting older people from abuse as she recently addressed an Elder Abuse Seminar organised by Age Concern Cymru. The Welsh Assembly Government’s own focus has to be those areas falling within our devolved powers and responsibilities.

Firstly, we need to ensure that we have the necessary and appropriate national framework in place to strengthen local arrangements, clarify principles of good practice and help the development of approaches to prevent abuse of vulnerable adults, and to identify and deal with abuse when it happens and seek to prevent its re-occurrence.

Secondly, WAG’s Care and Social Services Inspectorate also has an important role in adult protection, including:

• Providing professional advice to support policy developments and encouraging good practice across Wales;
• working with local authorities when the local authority carries out its lead role in this area in relation to individual service users. The inspectorate checks that regulated services overall protect the safety and well-being of service users;
• the inspectorate produces an annual monitoring report on adult protection and will be undertaking an inspection of local authority adult protection arrangements in 2008-09.
  Our main guidance on adult protection is “In Safe Hands”. That statutory guidance identifies councils as having the lead responsibility for developing local adult protection arrangements.

Local authorities need to work closely with a number of other agencies, including commissioners and providers of health and social services; providers of sheltered and supported housing; regulators of services; the police and voluntary and private sector agencies. Every part of Wales has already had local adult protection arrangements in place for a number of years.

We have also actively supported the UK Government in developing and implementing non-devolved measures such as the establishment of the list of people who are unsuitable to work with vulnerable adults and accordingly banned from such work.

However, we will not be complacent in fulfilling our adult protection responsibilities. Earlier this year, I established an Adult Protection Project Board to consider and report on the effectiveness of our adult protection policies to ensure that they are appropriate and robust.

I shall report on the outcome of the work of this group when its tasks have been completed.

Western Mail Colimn: Bridging generation gap is important

Gwenda Thomas explains how the strategy for older people will work

THE second phase of the strategy for older people in Wales is set to build on the achievements of the first phase, which has seen the introduction of popular schemes such as free bus travel and free swimming for older people, and the appointment ofment a Commissioner for Older People – unique to Wales.

The strategy was originally launched in 2003 and the first phase aimed to raise the profile of older people’s needs and ensure that their views were sought in the development and delivery of local services.

I am proud to be able to say that the strategy has been successful and has been recognised internationally as best practice for the way to engage in which older people have been engaged in the decision making process.

The new phase of the strategy, – from April 2008-2013 – will be supported by an additional £7m from the Welsh Assembly Government to ensure that it is effectively implemented. It will concentrate on four key strategic and cross-cutting themes – engagement with older people; economic status of older people; health, wellbeing and independence; and implementation. Overall, this will help older people to stay independent and active for longer.

Indeed, as the number of older people grows, the challenge that this places on society grows too. One key to addressing this challenge is to unlock the potential for older people to play an even greater role in their communities.

Too often older people are treated as passive recipients, rather than active consumers with their own views. We must challenge this misconception and support independence rather than enforcing dependence, and our policies and services should reflect individual need rather than being predetermined by chronological age.

When creating services for older people we must recognise that they are as diverse as any other group in our society in terms of age range, gender, orientation, race, culture, religion and health; and, correspondingly, they have a wide range of goals, needs, knowledge and abilities.
As part of One Wales we are committed to developing a Wales that is inclusive and offers equity in opportunity and treatment to all people who live in Wales. For older people this is particularly significant.

Addressing the implications of an ageing Wales is not a quick fix – and one of the real challenges for the strategy over its next phase will be to evolve our approach so that issues about ageing and older people are mainstreamed.

As phase two of the strategy begins, I look forward to working with the new commissioner for older people Ruth Marks, who takes up her post next month.

This post will be at the heart of our wider vision for the future governance of Wales and will act as a very practical tool to help older people speak out about problems or issues of concern, and to seek redress when things go wrong.

Over the next five years I expect to see the good work already started to continue and develop further.

One key area of work is breaking down stereotypes. Research tells us that many older people in Wales are unable to live the lives that they want or deserve because they feel marginalised and discriminated against, with too many barriers preventing them from making a contribution.
These barriers prevent older people from using their knowledge and skills for the benefit of our economy and everyone in our society.

It is therefore essential that we take action to combat the prevalence of age discrimination and to build upon the role older people play in our society so that they are fully engaged in decision making.

To do this the Assembly Government is working with young and older people to help shape its future policy on intergenerational practice – people from across the generation gap working together to share experiences and expertise. Re-establishing links between generations is a very effective way to dispel myths and fears and encourage mutual respect between young and old.
I am also encouraged by the work being carried out across Wales to ensure that older people receive respect and dignity when in a care setting.

There are many challenges ahead, for example in addressing poverty among pensioners, making life-long learning a reality for more and increasing economic activity, to mention but a few
One of the real challenges for the strategy over its next phase will be to evolve our approach so that issues about ageing and older people are mainstreamed – that is they are integrated on an equitable basis in all aspects of public policy. We are on the right road and making steady progress.

Gwenda Thomas AM is deputy Minister for Social Services

Western Mail Column: Taking care of these youngsters

Deputy Social Services Minister Gwenda Thomas meets some remarkable and determined youngsters

I MET a remarkable group of young people who came to see me at the Senedd building in Cardiff last week.

Hannah S, Craig, Grace, Hannah J and Beverly are all young carers, who take responsibility for someone who is ill, disabled, elderly, experiencing mental distress or affected by substance use, or substantial responsibility for caring for a brother or sister.

They had each been chosen by young carers in projects across Wales to represent them and to present the views of young carers to the Welsh Assembly Government.

There are particular reasons for listening to young carers. They may be the person providing all of the care in the family or may also be helping someone else to provide the care.

And caring is not just about the things you can see – it is also about how the young carer feels or thinks because of their role.

The young carers I met came well prepared and they immediately presented me with a practical challenge. They asked me to write down on a piece of paper what I had done that day. But there was a catch.

As soon as I started, I was asked, “Please, could you get me a glass of water”. Then, “Please, could you pick that up for me”, “Could you open the window for me please?” I didn’t get very far with my assignment.

Of course, what they were demonstrating was how they have to fit their schoolwork in with the constant demands of their caring responsibilities.

It is no wonder that they may find it difficult to realise their full potential, and I was disappointed when they told me how, with some notable exceptions, many schools are still unaware of these issues or even that they have young carers on their registers. I intend to discuss this with colleagues.

We went on to discuss their report that highlighted the needs of young carers in Wales.
They had been thinking about how the National Assembly’s new legislative powers – for example the Vulnerable Children Legislative Competence Order or the legislation on carers’ rights proposed under the One Wales agreement – could benefit young carers in Wales.

They developed a 10-point action list for the Assembly Government to consider, and we agreed that I give them an initial response in June, during Carers’ Week.

Their suggestions included:

• Legal requirement for each local authority to provide dedicated young carer services;
  Information packs for professionals, including an all-Wales information pack collated and produced by the Assembly Government with young carers’ input;
• Compulsory core training on young carers to be included in social work degrees, teacher training and in nursing and other medical training;
• Free bus passes for young carers;
• Support for young carers to be included in school contracts;
• Funding to support workers to deliver awareness-raising training in schools and colleges;
• A nationally-recognised carer ID scheme;
• Support for young carers to continue to 25;
• Flexible respite care to be accessible for young carers;
• Health workers need to recognise the role of young carers and, where appropriate, involve and inform the young carer in the treatment of family members;
• The Assembly Government and other agencies need to listen and respond to young carers.
  Young carers play a vital role in our community facing serious responsibilities.

In addition to the daily tasks they complete for their parents, they live with the added pressure of school and, often, a lack of understanding from their schoolmates.

It is imperative that we listen to their opinions and concerns. As such I will be considering, with colleagues, all the points raised when I met the young carers and I will publish my response during Carers’ Week, as they asked.

Western Mail Article: Moving into care ... how to get it right

Deputy Minister for Social Services Gwenda Thomas explains what support is available for people moving into a care home.

MAKING the decision to leave your own home and move into a care home is a big event for all concerned.

The first port of call with any decision along these lines would be to social services.
If social services thinks you may need its help, it will arrange for an assessment of your needs to be carried out.

This assessment will look at your health and social care needs and is known as a “unified assessment”.

If it is agreed that you require care, the next step is to consider what help you need to meet your care needs and to agree this with you – the care plan.

It could be decided that you, or your family member, can stay at home with slight alterations made to the house, or that you need help with your personal care needs.

As well as services delivered to the home, you may want to think about other housing options. For example, you could consider moving to a smaller house that would be easier to look after, or moving nearer to relatives, or to a bungalow or house with different facilities.

It is a good idea to investigate these options at the earliest opportunity. Social Services will be able to tell you about the services in your area and help you to explore which are the right choices for your situation.

For those that have recently received hospital treatment the doctor will decide if you are ready to leave.

If you are likely to have difficulties coping at home, your doctor will usually suggest a unified assessment of your needs.

It may be that – after a time for recuperation and with the right support – you will be able to go back to live in your own home. Depending on local arrangements, social services may be able to arrange for you to have six weeks’ free home care to enable this.

Or the NHS and social services can arrange for you to go into a care home or somewhere similar for a while to help regain your independence.

This type of help is known as intermediate care and in Wales it should be provided free of charge for up to six weeks.

Even if you don’t qualify for intermediate care and are not sure whether you wish to move permanently into a care home, you can ask for a trial run and live there temporarily for a while.
If your assessment concludes that your needs are primarily for health care, you may qualify for continuing NHS health care. The NHS can arrange for this care to be provided in hospital, in a care home with nursing which has the facilities you need, or sometimes in your own home.
If the NHS is arranging your care, it will meet all the care costs.

If you decide, having discussed the matter with your doctor, social services and family members, that a move into a care home is the best option, you need to start looking for the home that will suit your requirements best.

Sadly, nobody can tell you which would be the best home for you. But social services can help you decide which will suit your care needs best. You can even ask them to arrange everything for you, if you prefer.

You are free to choose a care home of your choice provided the arrangements can be agreed.
What is certain is that making the decision of moving into a care home can – if taken on your own – be a rather complex and stressful decision.

However, by making the decision in partnership with family members, your doctor and social services you can get as much information made available as possible to help you make the best decision for you and your family.

Given the importance of making the right choice the Welsh Assembly Government will be issuing an information guide to help you through this process.

Thinking About A Care Home – A Guide to What You Need to Know is currently being produced and will be available at the end of February.

Western Mail Article: A merry Christmas for everyone in Wales

Look out for each other, says Deputy Minister for Social Services, Gwenda Thomas

For most of us the festive season is a happy time for families to gather around the Christmas tree. But for some of the more vulnerable people in our community – the children and older people who need care and support – Christmas can unfortunately be the hardest and loneliest time of year.

That is why it’s important that as a caring society we help support and keep an eye on these vulnerable groups not only during Christmas but throughout the year.

It’s also important that as an Assembly Government we help support vulnerable groups which is why we have made several One Wales commitments that echo this thinking.

Improving the lives of older people is one of the key aims of the Welsh Assembly Government. To reflect this commitment we will be shortly announcing in the new year the appointment of the first ever champion for older people.

The Commissioner for Older People will not only benefit older people but also sets a standard for other parts of the UK, Europe and the world to follow.

The Commissioner will ensure that the interests of older people in Wales, who are aged 60 or more, are safeguarded and promoted.

As an ambassador and authority on older people’s issues, the Commissioner will speak up on behalf of older people and help them to resolve problems when things go wrong.

We will make an announcement about the appointment of the Commissioner early in the new year.

I am delighted Wales is setting an example and that this adds to the work already started through the Welsh Assembly Government’s 10-year action plan to deal with things that matter most in the lives of older people in Wales.

Demographics are changing and by 2026 about 29% of people in Wales will be over 60 years old. This appointment will mean that older people are put at the centre of all policy making.

To complement the work of the Older People’s Commissioner we will shortly be announcing the appointment of the new Children’s Commissioner to make sure that the children and young people of Wales have a stronger voice.

To further strengthen the voice of children we sought extra powers over the summer to improve the welfare of children and young people in Wales.

Vulnerable children and tackling child poverty are central to the Assembly Government’s programme for children and young people.

Although we have made good progress in recent years, with poverty rates for children in Wales now below the UK average for the first time, we are not complacent. There are still some 28% of children in Wales living in poverty.

Assembly Government budgets have provided increased investment in children, especially in the early years and a lot has been done through our anti-poverty programmes like Cymorth and Communities First. This year will see the continued roll-out of Flying Start, which is targeted at the 0-3 age group in the most deprived communities in Wales . About £46m is being made available between 2006 and 2008 to support disadvantaged children in their early years, £15m in 2006-7 and £31m in 2007-8.

There are 4,800 children in local authority care in Wales and some 1,600 young people who have left care. The Assembly Government and local authorities, as corporate parents, have a unique responsibility to ensure that the experience of children in care is positive and they get the right opportunities and support so that when they leave care they have the right skills and confidence to allow them to live independent lives as responsible adults.

I am pleased that the Vulnerable Children and Child Poverty Legislative Competence Order (LCO) that we introduced over the summer aims to allow the Assembly to make a real improvement in their lives.

The LCO aims to empower the Assembly to implement changes in the law relating to the welfare of children and young people that could see free child care for two-year-olds in greatest need and top up payments to Child Trust Fund accounts of children in Wales, with more for those living in poverty.

We issued another LCO at the end of last month that sought further powers for the Assembly to secure a fairer deal for vulnerable people who need care in their homes across Wales.

The charging for home care and other non-residential social services is currently at the discretion of individual local authorities. This has resulted in significant variations in charging policies for similar services across Wales.

Under the current system weekly charges for a similar service can range from a maximum of £16.20 to £185.

This new LCO – Charging for Non-Residential Social Care (Domiciliary Care) – aims to enable the Assembly Government to legislate against such disparity and help produce a fairer and more consistent system to close the gap.

As the Deputy Minister for Social Services and Carers I’m proud to say how the Assembly Government places such an emphasis on the needs of vulnerable people in our community.

Having taken a brief look back at the year I’m confident that, although our work is far from done, we are certainly moving in the right direction.

But there is still more that we can do as a Government and that we can all do as individuals.
We could offer practical support, like writing Christmas cards or getting some shopping in, putting up decorations or even something as simple as dropping by with a neighbour regularly for a chat.

And if we have some time on our hands, we could always invite an elderly neighbour or relative around for a Christmas lunch in the week leading up to Christmas.

This will help make sure they have a good meal and company and you may find you make a friend.

Championing the cause of carers

This is an article I wrote for the Western Mail in my role as Deputy Minister for Health and Social Services, which was published today.

Deputy Social Services Minister Gwenda Thomas explains plans to improve the lives of people looking after loved ones

"AS SOMEONE who has been a carer myself for more than nine years, I know how demanding and rewarding it can be.

Like many carers, it was something I wanted to do. As a result I have a greater understanding of the invaluable role that carers play in looking after loved ones. It has highlighted how different people cope with different situations.

I was extremely lucky I had the help and support of my family and friends but not all carers are in that position.

A great deal has been done to raise awareness of the role that carers provide and more needs to be done to build on the achievements so far.

Carers make a huge difference to the lives of so many people in Wales, providing much needed support to family or friends.

It is essential that the social services, the NHS and other service providers recognise carers’ key role and engage with carers as partners.

To mark the importance placed on carers, in January 2000 we published a carers’ strategy to improve the health and well-being of carers and the people they care for.

Much work has already been done to improve the situation for carers, but a re-focused strategy was published in March this year backed with an extra £1m a year for carers’ services.

Between 2000 and 2006, the Assembly Government provided more than £28m in specific grants to local authorities to develop services for carers. This money has now been mainstreamed into local authorities’ revenue support grant.

Projects approved under the carers’ grant included respite services, help around the house, young carers’ projects and information services. This was boosted in 2006-07 by the mental health carers’ grant and by the announcement of an extra £9m capital funding over two years to support around 10,000 people with telecare technology, which will help vulnerable people to be safe at home and £3m a year to provide extra support for carers of people who have mental health problems.

Before joining the Assembly, I chaired the social services committee at the former West Glamorgan County Council and later at Neath Port Talbot Council. Before that I worked for the Courts Service and Benefits Agency. This made clear to me that there was often a cycle of poverty, debt and dependence on benefits and that this was an intergeneration issue for many vulnerable people. We are working to address this.

In June last year, the then deputy Health and Social Services Minister John Griffiths was appointed as carers’ champion. I was pleased to assume this role in May this year.

In his short time as champion, John achieved a lot with the publication of the action plan for carers. He highlighted the importance of wider carers’ issues within the Assembly Government and focussed attention beyond health and social services.

I intend to build on John’s achievements. Next year, as a result of the One Wales document, we will be reviewing the UK Government’s carers’ strategy and looking to bring forward legislation to cover carers’ rights.

Each local health board in Wales also has a carer member. The involvement of carers on LHBs is intended to ensure that carers’ issues are better understood and are taken into account in local service planning and commissioning.

December 7 will mark carers rights day and this is an excellent opportunity to make carers aware of their rights.

Later this year, we hope to appoint a new Children’s Commissioner following the death of Peter Clarke earlier this year and also to appoint the first Older Person’s Commissioner. Both will have a role to play for championing the rights of carers.

By working closely with colleagues in government, the health service, local authorities and the voluntary sector I am determined to improve the quality of life for carers and those they care for.