The Older People’s Commissioner for Wales has criticised the Welsh Government for failing to take action on previous findings, saying ‘too many’ care home residents in Wales have an ‘unacceptable quality of life’.
In 2014, Sarah Rochira issued her Care Home Review report ‘A Place to Call Home?’ listing 15 areas of concern, including falls prevention, the use of anti-psychotic medication, dementia training, inspection processes and workforce planning.
In the commissioner’s latest report, a follow up study called ‘A Place to Call Home: Impact & Analysis’ found too many older people living in care homes are no longer able to do the things that matter to them, they lose choice and control over their lives and they have their emotional needs neglected and do not have their basic rights upheld.
In addition, many care homes in Wales often fail to meet the needs of an individual and instead adopt a one-size-fits-all approach.
Ms Rochira had harsh words to say about the overall lack of leadership and commitment displayed by the Welsh Government since the original report.
A ‘disappointing lack of progress’
The commissioner said of the lack of progress since 2014: “I am very disappointed, that the Welsh Government has failed to show sufficient leadership and take sufficient action in a number of key areas, such as continence care, falls prevention and workforce planning, where a national approach is needed to drive meaningful cultural change, ensure greater accountability and promote the more effective use of evidence-based good practice.”
Ms Rochira was less damning in her comments about health boards and local authorities and said that some improvements had been made since the last report. She added: “Health boards and local authorities have made some positive progress and as a result of my review are now delivering a wide range of activity focused on improving the quality of life of older people living in care homes, but more needs to be done and the pace of change must increase significantly to deliver the best possible outcomes for care home residents.”
‘Renewed focus’ needed from Government, health boards and local authorities
The report offers advice on how national and local Government should deliver ‘best-practice’ care services.
Areas requiring drastic change are:
• Continence care
• Re-ablement and rehabilitation
• Falls prevention
• Dementia training
• Anti-psychotic medication
• Medication reviews
• Engagement and quality of life
• Integrated Inspection, governance and transparency
• Public Information
Ms Rochira called for ‘renewed focus’ from all parties to address these areas for concern. She said: “There must be a renewed focus from the Welsh Government, health boards and local authorities on taking meaningful action to deliver upon the commitments they made in response to my Care Home Review.
“A failure to do so will mean that our care home system is unable to meet the changing care and support needs of older people and, more importantly, will mean that too many older people living in care homes continue to have an unacceptable quality of life.”
A lack of care homes
The report also highlighted how the closure of smaller homes, particularly those in rural areas, are of particular concern, with larger providers less likely to be attracted to sparsely populated areas with lower workforce availability. This could leave significant gaps in market sufficiency in an area for future years.
The report’s issue of a lack of available homes was singled out by Mario Kreft, chair of Care Forum Wales, who said:
“The message is loud, clear and very straightforward. We need to be building more care homes. Unfortunately, the opposite is happening and we are seeing care homes closing right across Wales because it is not financially viable to keep them open.
“Given the inescapable demographics of an ageing population, we are sitting on a social care timebomb.
“I think Sarah Rochira’s report is a real wake up call. It shows that we really do need to look at the leadership here in Wales of how we can actually develop a climate and culture where people want to invest and take the risk and actually build these much needed facilities.
“It is very, very clear that after two decades of people in local government particularly saying we don’t want new care homes, we’ve now had the Parliamentary Review and the Commissioner for Older People saying they’re desperately needed as we’re losing them faster than we’re building them.”
Praise for ‘front line’ staff
Ms Rochira, however, recognised the continued commitment and strong leadership of care home managers, owners, and other front-line leaders in the report. She said: “Following the publication of my Care Home Review, there has been a significant change in the attention given to the care home sector in Wales and the quality of life of the older people who live in care homes.
“In visiting a number of care homes across Wales and listening to the voices of older people and their families, I have seen some positive developments. In many cases, the good practice I have seen is linked to strong leadership by individuals such as care home managers, owners, and other front-line leaders, who work hard to inspire their teams of staff and ensure that standards are upheld.”