Welsh Policy Context

The action research that this thesis is based on was conducted in Conwy, Wales. It included a survey of fifteen Welsh local authorities, and two in England to provide a comparison. Therefore, this section of the introduction covers relevant Social Care and Housing policy in Wales, in order to provide context to the case study, mainly focusing on policies specifically targeted at older people. However, the UK as a whole is the target for this work so that issues highlighted and solutions found are not intended to be specific to Wales.

34 The Welsh Government has devolved power over areas such as Housing, Health, and Health Services. Therefore, many policies are different to those in England, for example, medical prescriptions are free for all in Wales. The Welsh Housing Quality Standard in Wales is the equivalent of England's Decent Homes Standard. However, the Welsh version is more wide ranging, including stipulations for outside the home as well as inside (Twinch, 2011).

In 2001, the Welsh Assembly Government developed their first formal national housing strategy ‘Better Homes for People in Wales’. As well as laying out the terms for the Welsh Housing Quality Standards, this strategy identified a need for a long term strategy for older people in Wales. Consequently the ‘Strategy for Older People in Wales’ was developed in 2003. One of its five aims is, "to promote the provision of high quality services and support which enable older people to live as independently as possible in a suitable and safe environment and ensure services are organised around, and responsive to, their needs" (Strategy for Older People in Wales, 2003:9). This aim places an emphasis on personalisation, as it is clearly supporting a person-centred approach to service delivery. Within this aim, the strategic objectives highlighted the need for the development of more housing specifically for older people. The Welsh Assembly Government allocated a budget for the development of extra care housing in order to encourage local authorities to develop this type of dedicated accommodation. Conwy currently has four extra care housing schemes. The ‘Strategy for Older People in Wales’ places an emphasis on more unified, person-centred support to enable older people to live independently. It highlights the importance of Housing, Health and Social Care services being delivered in a joint up manner in order to help older people to maintain their independence, mirroring the policy of the central UK government. The Institute of Public Policy Research conducted a study comparing the policy and practice of governments in the UK regarding older people. Whilst England was complemented on their pilots across the country to develop integrated, preventative services, the study identified that "the Welsh approach seems to be the most coherent long term commitment to improving the position of older people of any administration in the UK in the last decade" (McCormick et al, 2009:26). This is because the Strategies for Older People in Wales demonstrate a commitment to ensuring that the consideration of older people

35 is included across numerous policy areas. The most recent version of the Strategy for Older People in Wales (2013-2023) focuses on older peoples' participation in society, age friendly communities and encouraging future generations of older people to plan ahead for some of the challenges they are likely to face in the future (Welsh Government, 2013). This document highlights that the main success of the previous strategies has been to give older people a voice in the development of policy, both at a local and national level. Whilst England is ahead in terms of actually delivering more joined-up services, Wales has laid the foundations in policy to ensure that the needs of older people are considered across the board (McCormick et al, 2009).

The ‘National Service Framework (NSF) for Older People in Wales’ was launched by the Welsh Assembly Government in 2006 in order to set national standards for addressing the Health and Social Care needs of older people. These standards aim to ensure that, as people grow older, they are enabled to maintain their health, wellbeing and independence for as long as possible, and receive prompt, seamless, quality treatment and support when required. However, these objectives are limited to Health and Social Care.

‘A Strategy for Social Services in Wales over the next decade' (2008-2018)’ sets out the strategic direction for Social Services over this ten year period (Welsh Assembly Government, 2007). It emphasises the importance of working closely with partners and developing shared outcome measures, with the vision to support people "to have control over the life they wish to live". People have a right to expect services that enable them to make use of their full potential; protect them from harm and offer a choice about how they are supported. For older people, this means an emphasis on independence, participation, care, self-fulfilment and dignity. 'The Social Services and Wellbeing Act Wales 2014' promotes partnership working, cooperation and integration; placing a statutory emphasis on joint-working and providing a legal framework for improving wellbeing of people who need care and support (Welsh Government, 2014).

The second national housing strategy was produced in April 2010 and is entitled ‘Improving Lives and Communities: Homes in Wales’ (2011-2016) (Welsh Assembly Government, 2010). This document focuses on a ‘whole approach’ to improve

36 people’s lives and one of the key elements of this is to "improve housing-related services and support". It emphasises the importance of responding to the needs of our ageing society and encouraging services to become user-led wherever possible. This is a person-centred approach, with the client involved in the decision making regarding service development. In cohesion with the first national housing strategy, the document continues to place an emphasis on the importance of enabling older people to maintain their independence in their own homes through the use of quality care and support. This ensures that this strategy supports the National Service Framework for Older People in Wales. By ensuring that all strategies place the same emphasis on partnership working and independence, the Welsh government is pushing for a more integrated approach between Health, Social Care and Housing. These policies highlight that Housing is at the focal point of service integration in Wales, whereas, in English policy, the importance of integrating Housing into the whole system of care is identified in Housing policy, but is not commonly identified as a key entity in Health and Social Care policies.

In 2011, the Social Services Improvement Agency for Wales (SSIA) produced a report: Better Support at a Lower Cost: Improving Efficiency and Effectiveness in Services for Older People in Wales. This report emphasises that a shift in culture is needed throughout Social Services departments, to ensure that all staff are working towards enabling the client to do tasks for themselves, instead of doing it for them. This is the ethos of reablement, spread across general care services. This creates the independence that is a theme throughout all recent policies relating to older people, in both Wales and England.