The old saying about buses, “you wait ages and then two turn up together” certainly appears true of care legislation in Wales at present. New Wales specific care legislation (The Social Services and Well-being (Wales) Act, 2014 (SSWA) was enacted in Wales in April 2016. It brings about changes in the way care and support is allocated, funded, assessed, planned and delivered. Changes to inspection arrangements are also on their way.
The essence of the Well-being Act, is the centrality of eight core Well-being determinants and how these figure within the service user’s life:
(1) physical and mental health and emotional well-being
(2) protection from abuse and neglect
(3) education, training and recreation
(4) domestic, family and personal relationships
(5) contribution made to society
(6) securing rights and entitlements
(7) social and economic well-being
(8) suitability of living accommodation
In relation to an adult, “well-being” also includes—
(9) control over day to day life and
(10) participation in work
“Well-being cannot just exist in your own head. Well-being is a combination of feeling good as well as actually having meaning, good relationships and accomplishment” – Martin Seligman.
Critically the 2014 Act requires a super-high level of participation from the service user within their own care and support planning. Although this can be challenging when individuals are limited by mental or physical constraints, the principle is one of support being designed and approved by the service user where possible, so as to avoid ‘institutional’ approaches to care. Although we live in a largely post institutional age, remnants of the thinking can sometimes remain.
New Inspection Standards
The arrival of the 2014 Well-being Act required a new inspection regime for care services. This necessity arises because the new SSWA legislation with its new focus upon well-being determinants, person-centred care and support, direct payment, and outcome focussed interventions, has to be matched to new standards against which care services could be inspected and regulated.
This required a further piece of legislation, therefore The Regulation and Inspection of Social Care (Wales) Act received Royal Assent and became law on 18 January 2016. The Regulation and Inspection of Social Care (Wales) Act, 2016 therefore provides a new one-stop regulatory framework to ensure that care and support in Wales are concordant with the Well-being Act. Furthermore, given that Well-being determinants are central to care and support, it was important that new care standards reflected this approach and involved service users and care providers within the inspection methodology, in order to move away from a task focussed, tick box or minimum standards approach. The Act also sets out standards for staff groups whether registered professionals or support workers.
The new Act builds upon inspection approaches used by the CSSIW in previous years, and enables a clear focus on service improvement. It strengthens protection for Service Users and those who are vulnerable, establishes a regulatory system that is in-line with the Social Services and Well-being (Wales) Act 2014. It will also create a focus that is centred around people who need care and support, and the social care workforce.
The New Arrangements for Inspection
Although we are waiting for further detailed implementation guidance and to see how things work out in practice, there are some points that services can be assured on. The 2016 Act provides the statutory framework for the regulation and inspection of social care in Wales. In so doing it:
- Ensures compatibility with the Social Services and Well-being Act and places people who receive care and support at its centre;
- Governs regulation of the social care workforce;
- Creates a new agency – Social Care Wales, with new powers from April 2017;
- Reforms the inspection of local authority social services functions;
- Responds to the lessons learned from English and Welsh failures in the system. For example, Winterbourne View and Southern Cross Healthcare.
It makes perfect sense that if well-being is the focus of care and support legislation in Wales, inspection arrangements need to be able to evaluate services against this benchmark. This is exactly the focus that The Regulation and Inspection of Social Care (Wales) Act, 2016 enables. Meanwhile observers to the social care environment in Wales eagerly await definitive guidance as to what methodology and criteria inspectors will use to evaluate services, and find out how to get a good inspection rating.
Read more about inspection and regulation of social care in Wales here: Regulation and Inspection of Social Care (Wales) Act 2016
