Helping people help themselves is the key to social care
Bruce McLernon considers the challenge of providing social services which are no longer based on institutions
THE combined impact of increasing demand for services and pressures on public finance is one of the major challenges faced by social services in Wales.
We are working hard to meet this challenge.
A report commissioned by the Social Services Improvement Agency (SSIA), called Better Support at Lower Cost, reviewed how councils were delivering efficient care and support services for older people.
It describes how a new model of services is taking shape.
The key features of this model are about social services working with partners in local government (for example housing), the NHS and other sectors to improve preventative services, helping older people retain their independence for longer.
Providing new intermediate care services across health and social services, with an emphasis on reablement and assistive technology, reducing the need for longer term care is also key.
As is improving the way in which they commission services from the independent and voluntary sectors, enabling the development of sustainable service models and getting best value for money.
It is increasingly recognised the twin goals of improving efficiency and delivering better outcomes for service users are not necessarily in conflict with each other.
One of the key findings of the report is that councils need to be aware they may inadvertently create a system which encourages older people to become dependent on care services at an early stage rather than helping them to remain as independent as possible.
A major challenge is how we change the existing approach within adult social care where the emphasis traditionally has been on providing services based on institutions, rather than on enabling people to remain a part of their communities.
A new development having a significant impact on this is the reablement service.
The approach is built on the simple premise that, when an older person becomes ill or has a medical intervention, they can get better.
Services are designed to help older people, after a critical event, to rebuild their strength (both physically and emotionally) so they can again live independently.
In essence, the reablement service approach is based on the objective that the older person should be encouraged and assisted to look after him or herself in contrast to traditional service models where the carer does everything for the older person.
Although the pace of development varies, all councils in Wales have developed such services.
Where they have become established, the results are impressive in terms of better outcomes for older people.
These services also contribute to a reduction in the demand for placements in residential care and for long-term domiciliary care services, against a background of an increasing elderly population.
Examples of ways in which councils are developing cost-effective services in addition to reablement services include more proactive purchasing of services from the independent and third sector; reducing the costs of care packages by using assistive technology to help people remain in their own home; developing creative care models through direct payments to the individual service user and establishing extra care housing as an alternative to residential care.
The SSIA report draws on similar work carried out in England.
When applying a simple formula on the proportion of spend on residential care by a council overall, Welsh councils out-perform their English counterparts.
In relation to programmes designed to achieve efficiencies and reduce costs, councils across Wales are offering real imagination and creative drive.
* Bruce McLernon is president of ADSS Cymru