Y PwHySllCg(6o)r-1Ie2c-2h3ydPTaN 14

Gofal Cymdeithasol

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Health and Social Care Committee

Senedd Cymru

Bae Caerdydd, Caerdydd, CF99 1SN

SeneddIechyd@senedd.cymru senedd.cymru/SeneddIechyd

0300 200 6565

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Welsh Parliament

Cardiff Bay, Cardiff, CF99 1SN

SeneddHealth@senedd.wales senedd.wales/SeneddHealth

0300 200 6565

Julie Morgan MS

Deputy Minister for Social Services Welsh Government

16 December 2022

Dear Julie

At its meeting on 30 November, the Health and Social Care Committee held an horizon-scanning

session with the Chief Inspector and Deputy Chief Inspector of Care Inspectorate Wales (CIW) to explore the key issues affecting social care and social services.

A transcript of the meeting is available on our website but there were some very clear and stark

messages around the fragility of the social care sector the Committee wanted to bring to your attention.

Increasing demand for services

The Chief Inspector told us there has been an unprecedented increase in demand for social care:

“…what we are faced with at the moment is a recruitment and, as seriously, a retention crisis for social workers and for social care workers, which is leading to significant fragility for services, and particularly in homecare and domiciliary support.”

When we took evidence earlier this year for our inquiry into hospital discharge and its impact on patient flow through hospitals, we were told that the situation in social care had been pressured for many years, and the pandemic had exacerbated what was already a very challenging situation. On 30 November, the Chief Inspector described a recruitment and retention crisis for social workers and social care workers, which is leading to significant fragility for care services, particularly in homecare

and domiciliary support. The Chief Inspector told us:

“…what we see is essentially a health and care system that is gridlocked. Many

social care leaders are describing it in terms of crisis, and we don't use that word lightly.”

Workforce

As the Chief Inspector pointed out, this will be the third winter that's been significantly pressured for the social care sector. The workforce is very tired and it is depleted, and existing staff are working longer shifts and more hours (due to shortages) which is not sustainable. There is therefore

considerable concern about the resilience of the workforce.

The need for parity between social care workers and their NHS counterparts, in relation to both pay and terms and conditions, is a longstanding issue and has been called for by successive Senedd Committees. It had been hoped that the spotlight shone on social care through the pandemic would help to raise the profile of social care, and the need to address some of the issues that have been endemic for many years would be dealt with. It was therefore disappointing to hear from the Chief

Inspector that the increased profile seems to have been short-lived for social care.

There is still a perception that social care work is a low pay and low skill workforce. If we are going to develop the workforce, parity of esteem and parity of terms and conditions is essential to dispel this myth and recruit and retain sufficient numbers of social care staff. CIW told us that if the staffing situation is not urgently addressed at a national level, local authorities and social care providers risk

not meeting their statutory and regulatory duties.

Pressure on unpaid carers

During our inquiry into hospital discharge, we heard concerns about the pressure being placed on

family and unpaid carers to fill the gaps in care provision.

The Chief Inspector told us that not only are too many people waiting for an assessment of their needs, too often there is not enough capacity in the system to meet those needs following an assessment. In addition, people’s care and support plans are not being reviewed in line with the Social Services and Well-being (Wales) Act 2014. This means when people’s needs change and they may require more care, this is not being provided. She also highlighted the untenable pressure being

placed on unpaid carers to fill in the gaps in care.

We also share CIW’s concerns that people are still being discharged from hospital to a care home when their choice is to return home but this is not possible because suitable care packages are not available. The Chief Inspector described this as “the least worst option”. CIW told us that where there is no alternative to being discharged from hospital into a care home, it is important people receive the right support to maximise their independence whilst living at the care home. This means ‘in reach’ reablement services should be provided or care staff in care homes be supported to develop

additional reablement skills.

None of these issues are new. Indeed, you acknowledged many of them in your response to our hospital discharge report recommendations. However, we are not yet assured that work is being progressed with the pace and urgency needed to address these issues, and bring about real change in the sector. We note the Social Care Fair Work Forum was due to publish a progress update by the end of 2022. We await this report with interest and are eager to see further action taken to improve the pay and working conditions for the social care workforce and address the shortages to “unlock”

our health and care systems.

Yours sincerely

Russell George MS

Chair, Health and Social Care Committee

Croesewir gohebiaeth yn Gymraeg neu Saesneg. We welcome correspondence in Welsh or English.