Improving domiciliary care for older people in Wales

Budget cuts and under-funding are leaving thousands of older people across Wales struggling to live at home independently.  

And many are being hospitalised with preventable conditions because the system that should help them with basic tasks such as eating and washing, is close to breaking point.

That’s according to our new report called ‘Improving domiciliary care in Wales’.

‘Improving domiciliary care in Wales’ identifies four key areas where action is needed to create an age friendly Wales where quality domiciliary care is provided in Wales:

1. Commissioning practices: Commissioning practices are fundamental to ensuring a good quality service can be provided. In recent years, a number of problems have highlighted how commissioning has impacted negatively upon the delivery of good quality domiciliary care. Best known is the impact upon the length of care visits, resulting in the widely-reported and much-denigrated phenomenon of the 15-minute care call. This cannot be considered a sufficient time period for personal care to be delivered with dignity.

2. Workforce – regulation and registration: We have high expectations of our social care workers, which are not reflected in the way in which the role is viewed in broader terms. Registration of individual workers can help to tackle the issue of standards and inappropriate behaviour, as well as helping to enhance the status of the role in the eyes of the public.

3. Training and dementia care: It is essential that care workers receive appropriate training. Training alone cannot ensure quality care, but it can help to increase the confidence of staff in carrying out their jobs and the ability of those staff to do their job to a good standard. Whilst many already do this, it is often a result of their innate personal qualities as much as a consequence of the training that they have received.

4. Joint working – health and social care: A number of obstacles and challenges to providing quality person-centred care derive from the separation of the health and social care systems. Joint working between health and social care is regularly proposed as transfers of care between sectors often cause difficulties that can lead to disruption in the provision of appropriate care. The most obvious example of this is delayed transfers of care, where older people who are medically fit to be discharged are delayed in hospital because they lack appropriate social care support that would allow them to return home.