Care and support at home

We were asked by the Welsh Government to bring people and organisations together to develop a five-year strategic plan to improve care and support at home in Wales. The strategic plan includes domiciliary care and support for adults and children, direct payments and the support provided by communities and unpaid carers.

We got people together, looked at what the research told us and asked people living and working around Wales what needed to be done to improve care and support at home.

We worked with partners to create a five-year strategic plan that describes what needs to happen so people can live in their own homes and access care and support when, where and how they need it.

We've worked with partners to develop some specific resources to support improvement in care and support at home:

Community resourcefulness

We worked with partners to develop a report about community resourcefulness and well-being in Wales. It includes draft principles to help understand how we can support the development of community resourcefulness.

Balancing risks, rights and responsibilities

Balancing risks, rights and responsibilities can be difficult as risk is often seen as something to be avoided and controlled by professionals. In reality, taking some risks is an important part of everyday life that supports people to do what matters to them – which includes living in their own home for as long and possible. We’ve produced a report exploring what the research says and how people are taking an outcomes-focused approach to balancing risk, rights and responsibilities.

Social care procurement

Social care procurement is complex because it needs to abide by both procurement law and principles such as voice, control and co-production in the Social Services and Well-being (Wales) Act. We worked with the National Commissioning Board to develop guidance to help commissioners with this area of work.

Outcomes focused commissioning

The National Commissioning Board has developed a toolkit to help commissioners work in a way that supports people’s personal well-being outcomes.

Outcomes based home care commissioning toolkit

Research

The Social Care Institute for Excellence (SCIE) has written a literature review, summarising research around care and support at home.

As well as the Care and support at home programme work, we’ve linked with other work supporting the well-being of individuals, carers and communities.

Dewis Cymru is a website with information about local groups, organisations and services throughout Wales that support individual and community well-being.

Working with carers

We have a range of resources aimed at helping practitioners work well with unpaid carers to support them in the hugely significant role they play in providing care and support at home.

Building care and support together

Co-production is at the heart of good care and support at home. We’ve produced a booklet, Building Care and Support Together to help people work in a more co-productive way more often in their roles.

The National Commissioning Board and National Provider Forum are key partners who support improvement in care and support at home, in particular around commissioning.

Understanding the value of social care to the economy is important for people making decisions about public spending to consider. The Economic Value of the Adult Social Care Sector – Wales report looks at the direct value of adult social care to the Welsh economy. It also looks at its wider impact, including on organisations supplying services to the sector and the spending power of people employed directly and indirectly in social care.

Domiciliary care worker registration

The domiciliary care workforce is the latest group to join our register of social care professionals.

The All Wales Induction Framework forHealth and Social Care (AWIF) has been developed for the social care workforce. It is an important part of registration and is closely aligned to the qualifications for the domiciliary care workforce.

Qualifications for the care and support at home workforce are currently being developed. These will play an important part in domiciliary care worker registration, but are also suitable for a other roles within care and support at home.

There's a specific area in the care and support at home plans around evidence from academic and practice-based research. This is being taken forward through a separate strategy and programme of work.

Building on the community response to Covid

The Covid-19 pandemic had a dramatic effect on how people could access care and support. In many areas of Wales, people came together to support each other. And this support, which was led by communities, found new energy because there was such a need for it.

What did we do?

We wanted to know how we could support partners to build on the way communities responded to Covid to support longer-term prevention and early intervention. So we commissioned Hugh Irwin Associates to find out.

The work involved desk-based research and engagement with representatives from the third sector, social care, health and housing organisations.

As the work progressed, our views changed. We moved from thinking about the resourcefulness of communities and the way they bounce back from challenges, to the strengths and resources communities have and how prepared they are to respond to different situations (we call this community resourcefulness).

Results of the work

We now have a new national forum, known as the Community Resourcefulness Partnership, and a framework, or structure, to help focus conversations about how communities can support well-being.

Community Resourcefulness Partnership

The Community Resourcefulness Partnership is a national forum that focuses on community well-being. The partnership meets monthly to bring together research and practice, and find ways to influence local, regional and national activity.

It has a mix of statutory and third sector members and is open to any organisations in Wales that support and develop community resourcefulness and well-being.

Framework

The framework provides a structure (which is based on evidence of what's happened, where the barriers are and what needs to happen next) to help focus local or regional conversations about community well-being.

The framework can be used to support the well-being assessments public service boards will need to renew from 2021 and the population needs assessments being completed by regional partnership boards.

The third sector in Wales plays a crucial role in supporting people in their communities. Some organisations provide regulated care and support services, but many more offer broad support for individual and community well-being. They often don’t see this as preventing, reducing or delaying people’s need for care and support or contributing to personal well-being outcomes.

What did we do?

We wanted to find out more about how much care and support is being provided by the third sector in Wales and the impact it’s having on preventing critical care and support needs.

We commissioned the Wales Co-operative Centre and Wavehill to do some research that helps understand the current picture in Wales, which included a survey and workshops with third sector organisations.

What did the research find?

The report explores the types and distribution of third sector care and support services and activities in Wales.

A survey of third sector organisations found that:

• south east Wales has the most care and support services and activities, with mid Wales having the lowest
• around a quarter of organisations don’t employ paid staff, a third have one to nine volunteers and a further third have between 10 and 24 volunteers
• the most common types of support service and activities offered were information, advice and guidance, preventative services, and care and support
• two-thirds of organisations plan to expand over the next three years.

The research also explored how third sector organisations measure the impact of their work. There was little shared understanding or agreement about how to do this and some reservations about impersonal and tokenistic ways of measuring impact. Different funders ask for different things, which is a particular challenge for smaller organisations.

The report also highlights opportunities for collaboration between commissioners and third sector organisations, especially around local needs and preventative services. There could also be greater collaboration between third sector providers. This could be supported by improved data to inform local authority commissioning.

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