Health and Social Care Committee

HSC(4)-09-11 paper 15

Additional information from the Older People’s Commissioner for Wales

 

This paper provides additional information requested by Health and Social Care Committee Members, following the attendance of the Older People’s Commissioner for Wales on 6 October 2011.

 

Work linked to consultation on service reconfiguration

 

The Commission noted an increase in enquiries relating to care home closures, particularly about the associated consultation processes and the need for these to be clearly communicated and more inclusive.

 

Older people and the relatives of those residing in care homes told the Commission that the procedures for closing a home should be fairer and the decision-making process must have the best interests of residents at its core.

 

As a result of these concerns and ongoing issues relating to the consultation on care home closures in Carmarthenshire, the Commissioner issued the following statement in December 2010:

 

Statement on Care Home Closure

 

Introduction

 

One of the functions of the Older People’s Commissioner is to “promote awareness of the interests of older people in Wales and of the need to safeguard those interests”. The Commissioner has a particular interest in the needs of older people who are in situations where they are vulnerable.

 

Through her contact with older people and with voluntary and statutory bodies across Wales the Commissioner has been made aware of people’s anxiety and distress surrounding the issue of care home closure. This statement sets out the views formed by the Commissioner so far.

Rights Framework

 

The United Nations Principles for Older People aim to ensure that priority attention is given to the situation of older people. The Commissioner must have regard to these Principles when considering what constitutes the interests of older people in Wales. The Commissioner considers the following Principles to be particularly relevant to the issue of care home closure:

 

Principle 5:

“Older persons should be able to live in environments that are safe and adaptable to personal preferences and changing capacities.”

 

Principle 14:

“Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care or treatment facility, including full respect for their dignity, needs and privacy and for the right to make decisions about their care and the quality of their lives.”

 

The Commissioner’s View

 

 

 

 

 

 

 

The Commission has called on the Welsh Local Government Association and Association of Directors of Social Services for assurances regarding consultation about the changes to services used by older people, specifically the closure or change of home setting and changes to domiciliary care providers.

 

The Commissioner also highlighted these concerns to the Deputy Minister for Social Services, as well as concerns linked to ‘Escalating Concerns guidance and social care commissioning guidance twice during 2011.

 

Most recently, the Commission was made aware of issues relating to the consultation process that was used as the basis for decisions to reconfigure services at Rondel House and Gardenhurst day centres in the Vale of Glamorgan. Following correspondence with the local authority, which re-iterated the principles in the statement above, the consultation was re-opened meaning that those using the service could contribute to the process in a meaningful way.

 

The guidance has also been used as a source of advice for those involved in reconfiguration of residential care services in other parts of Wales e.g. Gwynedd.

 

Care Home Closures Research led by Swansea University

 

The Commission is working with researchers at Swansea University to look into the effects of care home closures in Wales following a funding award by the National Institute for Social Care and Health Research (NISCHR).

 

Care home closure is often the subject of media coverage and can be an extremely emotional topic for those that are affected. The closure of care homes is highly relevant because of the impact of relocation on the health and well being of older people.

 

The 18-month project replicates a study conducted in England, using a variety of methods to investigate care home closure in the last year, including:

 

·         analysis of data collected by the Care and Social Services Inspectorate Wales (CSSIW);

·         telephone interviews with CCSIW inspectors and (ex)managers/owners; and

·         analysis of local authorities protocols.

 

The project extends the research conducted in England to look at outcomes for those involved in the closure of care homes and will undertake in-depth interviews (before and after relocation) with providers, older residents, relatives and carers during the closure of four different care homes in Wales.

 

The project will:

 

·         Identify issues associated with closures of care homes in Wales

·         Identify areas where the process of closure departs from Welsh Government guidance

·         Provide examples of good practice which could be used in further guidance

·         Identify the impact of particular processes of closure on the well-being of older people, their relatives and carers

 

The research report will be completed in November 2011 and subject to peer-review by NISCHR before it is officially published and distributed as appropriate.