Health and Social Care Committee
HSC(4)-25-12 paper 1
General scrutiny – Deputy Minister for Children and Social Services
Evidence Paper to the Health and Social Care Committee
1. Introduction
1.1 Society is changing. Expectations of public services are being raised at the same time as the resources to deliver them are becoming tighter. Our population is ageing with a commensurate growing impact of frailty and dementia. Many of our citizens are enjoying successful and fulfilled lives beyond accidents and diseases that were fatal in previous generations. Children and young people have a new world of opportunities but they also face both traditional and new challenges, including mental health issues, changing family structures and disability. And as a society we are dedicated to tackling poverty across our generations, ensuring that all families have an equal chance going forward.
1.2 I see these as opportunities to transform our approach and to improve the wellbeing of citizens in Wales. I believe that early involvement with families, working in partnership, delivers real results. Giving citizens more control over their lives and the services they receive improves their wellbeing and gives public services the room to adjust to the new realities. Working together, across traditional divisions, can be done and does deliver.
1.3 Ultimately these are opportunities that we can only grasp by working together. Delivery will be achieved through a shared approach across the complex social services sector, with clear priorities to be achieved by different stakeholders. But the challenges we face, from child disability to poverty, from drugs and their effect on the family to the effects of our ageing society, cannot be solved by one part of the Welsh Government. These represent challenges that must be met by shared and co-ordinated action across our portfolios.
2. Our principles
2.1 In June 2009 I established the Independent Commission on Social Services in Wales under the chairmanship of Professor Geoffrey Pearson. That was the first step on a major transformation of social services towards a new approach, based on citizens’ voice and control, and a more collaborative and integrated approach to delivery.
2.2 The Commission’s report led to my publication of Sustainable Social Services: A Framework for Action in February 2011 which established a clear set of principles for the future:
· A strong voice and real control
· Supporting each other
· Safety
· Respect
· Recovery and restoration
· Adjusting to new circumstances
· Stability
· Simplicity
· Professionalism
2.3 These principles, and the actions to embed them, have been supported across the sector and in the National Assembly. In 2011 they were the foundation of our Programme for Government commitments in the field of social services and remain the bedrock of our policy going forward.
2.4 At its heart our policy seeks to focus our support on people in the context of their families and their communities.
3. A strong national direction
3.1 The Programme for Government set out the delivery tasks for this administration. First and foremost it recognised that the scale of the transformation required a new approach to delivery, one that was based upon a collective approach to change. In 2011 I set up new leadership arrangements for social services in Wales – a Partnership Forum that brings together the political leadership of the diverse stakeholders in social services (including representatives of all the main local government political groupings in Wales) and the Leadership Group which similarly sees the executive leadership come together to understand and overcome barriers to change. This year I have augmented these leadership arrangements by establishing citizen panels to advise on key strategic areas from the perspective of the user and carer.
3.2 Across the sector I have established a Programme approach to change with clear project areas and stakeholder engagement groups examining and advising on the main themes of our work ahead.
4. A new approach to improvement
4.1 These new arrangements have been key in developing one of the most transformative elements of our new approach – a National Outcomes Framework. These will change our understanding of success from one based on intervention to one based on the wellbeing of citizens. My officials are developing a formal consultation on a new framework to begin later this year.
5. Safeguarding citizens
5.1 A central part of our forward agenda is to simplify, strengthen and modernise safeguarding arrangements for adult and children in Wales. Safeguarding is a key priority of the Welsh Government. During the last year a consolidated programme of work has been put in place through legislation and guidance to strengthen arrangements which safeguard the most vulnerable citizens in Wales.
5.2 I will establish a more robust statutory framework for adult protection in Wales and provide the necessary programme to strengthen and protect the people in Wales through more effective inter-agency collaboration. I will establish a National Independent Safeguarding Board which will advise Ministers on legislation and policy required to strengthen practice for children and adults at risk.
5.3 The current 22 Local Safeguarding Children Boards will be reconfigured and replaced by Safeguarding Children Boards. New statutory Safeguarding Adults Boards will run in parallel. Many of these changes will follow the Social Services Bill although we are already working closely with others in the sector now to ensure the transformation is smooth and effective.
6. Voice and control for citizens
6.1 At the heart of our ambitions within the Programme for Government is to transform the citizen experience of social services. This can only occur when citizens feel they have genuine voice and control over the services they receive. Our work is to understand and improve the journey of the citizen through the system – from information to access to assessment to care planning. Our new legislative framework will deliver substantive changes to each of these elements and our work on complaints will ensure citizens have effective mechanisms for redress when things go wrong.
7. Prevention
7.1 It is absolutely clear that what most people want is to be able to access the kind of help and support that will enable them to maintain as much control over their lives as possible – the kind of services that can help prevent them needing more complex and long term care and support. It is through a new focus on the well being of people and the role of communities that we will shift services over time and this is a key focus in the Social Services Bill.
This approach includes a recognition that people themselves can and want to be engaged in the development and delivery of services. Over the summer I have been very pleased to have discussions with experts in the field of coproduction models of service development from Canada as well as discussions about the wider field of social enterprise. I am keen to ensure that we create an environment where such approaches thrive and we are currently considering our approach to this.
8. Early intervention
8.1 We know that wellbeing is closely associated with independence. Citizens want to feel in control of their own lives and to be close to their families and friends. We need to be able to support people quickly when their situation becomes unstable and intervene early to re-establish independence.
8.2 We have been working closely with local authorities and colleagues in health to embed reablement across Wales as a proven successful approach to providing frail individuals with support when they leave hospital. A survey tool will be launched in September 2012 - leading to a position statement on reablement and intermediate care to be prepared by the end of the calendar year.
8.3 Reablement will become a standard approach across Wales by 2016.
9. Services around the family
9.1 My portfolio was expanded in 2011 to incorporate Children and Families. This change was recognition of the linkages across the needs of people in Wales. It recognises that what we do for families early on will play a big part in whether more serious challenges develop later on.
9.2 Our delivery of Integrated Family Support Services (IFSS) continues to demonstrate real achievements. This flagship policy is providing intense support earlier to children and families with complex needs, focussing on children in need and parental substance misuse which accounts for one of the largest factors of parental capacity reasons for children being in need of protection and in receipt of social services.
9.3 The progressive phased implementation and roll-out of IFSS across Wales therefore is a key priority for the Welsh Government, and, in March I announced plans for pan-Wales implementation to be achieved by 2014. The current year (2012/13) will see the implementation of Phase 3 of the programme with the establishment of the Western Bay IFSS area (which is a consortium of Bridgend, Neath Port Talbot and Swansea local authorities, working in partnership with Abertawe Bro Morgannwg University Health Board); whilst Phase 4 of the programme (in 2013/14) will bring on stream further IFSS Teams in North Wales and Gwent, to effect pan-Wales coverage of IFSS.
9.4 This model of early intervention and support around the family is being taken forward across a series of other transformative changes such as Families First, Affordable Childcare and of course Flying Start which remains on track to double the number of children benefitting from its work over the life of this administration. These are substantial and additional investments we are making to support people in Wales, but with the confidence that they will provide a long-term payback for Wales and its citizens.
10. A National Adoption Service
10.1 Recognising the benefits of working together and of integrating services is at the heart of our transformation. One of the clearest examples of how this principle is being applied is in the area of adoption.
10.2 A National Adoption Service will achieve excellence for adoption through securing high quality, forever family placements for looked after children for whom adoption is in their best interests.
10.3 Individual adoption agencies will concentrate their area of expertise on placement arrangements for the child, preparation and maintenance of the adoption plan and to build the expertise required by the courts for child reports and assessments, when applying for a placement/adoption order.
10.4 The National Adoption Service however will focus on the adopter, providing a framework for adoption approvals, establishing a resource hub, providing a gateway for potential adopters, providing information on training programs, information on the assessment process and general advice line, linking adopters with children, commissioning services such as post adoption support and providing national leadership and overview of adoption services. These activities can be more efficiently and effectively carried out once rather than 22 times.
11. A new legislative framework for social care services
11.1 The transformation we have set ourselves is not possible without a major realignment of the legislative framework for social care services in Wales. That will mean two major bills during this government.
11.2 The first – Social Services (Wales) Bill – will reframe our legislative environment to move us towards a model of social care services built on wellbeing and a strong voice and real control for citizens.
11.3 In March this year I announced the launch of the 12 week consultation on the Social Services (Wales) Bill. This consultation exercise included events across Wales with stakeholders to introduce the proposals and to discuss their implications
11.4 The consultation closed on 1 June - 275 responses were received. Those responses have been analysed, and that analysis has informed the further refinement of the Bill.
11.5 At the time of consultation the Bill contained six areas:
· Maintaining and enhancing the well-being of people in need.
· A stronger voice and real control:
Assessments; Portability; Care planning; National eligibility framework; Information, advice and assistance; Rights of carers; Direct Payments; and Complaints (including Public Services Ombudsman).
· Strong national direction and local accountability for delivery:
National Outcomes Framework; Standards for social services; Code of Practice; Directors of Social Services; and Collaboration in integrated social services.
· Safeguarding and Protection:
A National Independent Safeguarding Board; Safeguarding and Protection Boards; and a new legal framework for adult protection.
· Regulation and Inspection.
· Services:
Adoption services; and Transitions for disabled children and young people.
11.6 Drafting of the Bill is now well-advanced, and work is on schedule for the Bill to be introduced to the National Assembly for Wales in early 2013.
11.7 When the Bill is published it will be accompanied by an explanatory memorandum and a regulatory impact assessment which will provide a clear description of the background to, and intended effect of the Bill, along with an analysis of the policy, legal and financial implications of the Bill.
11.8 The Welsh Government will also publish a Code of Practice and detailed implementation guidance in support of the Bill.
11.9 Following the analysis of the consultation responses, it was decided that the regulation and inspection aspect of the Bill would be separated out to provide the opportunity to be more ambitious in our proposals.
11.11 A second bill therefore, on Regulation and Inspection will allow us to put in place the regulatory framework for services and the workforce that will be needed given the changes we are putting in place, particularly through the Social Services (Wales) Bill. What that will look like cannot be clear at this stage. I will be issuing a white paper for consultation next summer (2013) with legislation receiving Royal Assent by the end of 2015.
12. The challenges ahead
12.1 The transformation of social services between 2011 and 2016 is a significant challenge. It incorporates major change in the legislative, policy, financial, management and cultural environment for the sector.
12.2 The delivery of Sustainable Social Services will be, primarily, by the diverse stakeholders within the sector. Our levers are limited in forcing the pace or scale of change and it is necessary to continually renew the shared vision to ensure progress.
12.3 The future costs of social care represent significant externalities whose impact is, as yet, unknown. The Department of Health’s response to Paying for Care may present significant challenges for the sector in Wales and thus the delivery of our programme of change. Similarly, Welfare Reform may present a significantly changed environment for social services to operate within.
12.4 Ultimately, however, the delivery of our transformation is the only way that we can ensure that social care services in the future are truly sustainable.