Why are we still waiting? Delays in social care in Wales

This is Age Cymru’s third annual report on delays in access to social care in Wales for older people. Our dementia advocacy project, HOPE (Helping others participate and engage) advocacy project and Age Cymru Advice continue to hear about worrying delays for social care assessments and support to be in place. A year on, we wanted to know if changes we heard about in 2023 are improving access for older people across Wales.

This year we heard of work undertaken across many parts of Wales to address the underlying reasons from last year’s report recommendations, but change is not happening fast enough to meet increasing demand.

The surge in demand for social care following the pandemic has reduced, but nearly one in four older people are still waiting more than 30 days for a care assessment and one in six are still waiting more than 30 days for care to be in place. Delays are affecting older people and their loved ones across Wales.

One person we spoke to as part of this research told us about the huge challenges they faced in trying to get social care:

“As a carer for two parents with dementia the impact on mental health has been hard - a lack of support from local authority until crisis points. Having to fight for everything constantly giving up work to maintain my own mental health and ensure my parents were cared for. Putting my own future financial stability at risk.”

Social services departments are concerned they’re unable to adapt quickly enough to meet the increasing complexity of need and future population projections. Greater and quicker change is needed.

We found communication from councils with older people and their families on first point of contact and whilst waiting needs improvement.
We’re concerned that some of the efforts councils were making in 2023 to improve support for unpaid carers have stalled at the same time as we hear how much more strain older carers are under in 2024.

This year we’ve added a focus on social care charging. We hear from older people who are frustrated and confused about charging arrangements for social care, and how communication on charging isn’t clear. Calls on these issues to Age Cymru Advice often go hand in hand with requests for help to maximise financial entitlements as the cost-of-living crisis continues. How charges are communicated and explained needs to be improved.

Poor communication around hospital discharge means older people remain in hospital longer than they need to. We heard how poor communication between hospital staff and social care departments is making an already difficult time for families unduly stressful. Improving communications between hospital staff and social care is vital for safe and timely hospital discharge.

We recommend that:

1. Welsh Government, ADSS Cymru, Social Care Wales and local authorities need to work together to ensure that reporting mechanisms are able to show where positive outcomes rather than outputs are recorded and reported
2. Local authorities should assess whether their current processes for providing initial advice and information and ongoing access to advice and information are meeting the needs of older people. This needs to include a focus on how well information is communicated and understood on fairer charging
3. Local authorities should provide an additional focus on those individuals who are currently experiencing a wait longer than 30 days for a care needs assessment or implementation of a care package
4. Local authorities should provide proactive support for those waiting longer than 30 days
5. Regional partnership boards, local authorities and third sector services need to work together to improve the availability of earlier intervention and prevention support for older people
6. Welsh Government, regional partnership boards, health boards and local authorities should ensure that third sector funding is provided on a sustainable basis
7. There needs to be an emphasis on learning between local authorities and good practice sharing. This will reduce the volume of work that local authorities need to undertake and help them avoid pitfalls that other local authorities have faced
8. Welsh Government, regional partnership boards and local authorities should ensure the requirements of the Charter for Unpaid Carers are met.