The Social Services and Well-being (Wales) Act 2014 has been described as “ground-breaking”. Its purpose is to transform social services and provide a new legal framework for improving the wellbeing of children and adults who need care and support, and unpaid carers. The Act came into force in April 2016.
The Welsh Government commissioned an independent evaluation of the Act, which concluded at the end of 2022. A number of initial reports were published over the course of the evaluation. As we await the final report and overall conclusions, this two part series of articles looks at what we know so far about whether the legislation is having the desired impact.
In this article, we look at the Act and the social care workforce and services. Our second article (published tomorrow) will look at the views of service users and unpaid carers.
What does the Act do?
The legislation covers a wide range of areas, and its aims include to:
- give carers an equal right to an assessment and support as those they care for;
- improve assessments and focus on ‘what matters’ to the person;
- deliver a new national eligibility criteria for access to statutory services;
- strengthen safeguarding arrangements for children and adults; and
- provide better access to advocacy services to support individuals to have a voice in decisions that affect them.
The core principles of the Act are:
- Voice and control: putting the needs of the individual at the centre of their care, giving them voice and control over the outcomes that will help them achieve well-being.
- Prevention and early intervention: enabling access to advice and support at an earlier stage, increasing preventative services within the community to minimise the escalation of critical need.
- Wellbeing: supporting people to achieve wellbeing and their own personal outcomes and measuring the success of care and support.
- Co-production: involving people as equal partners in the process and encouraging individuals to become more involved in the design and delivery of services.
- Multi-agency: stronger partnership working to deliver improvements and more joined up services.
- Social Care Wales’ overview of the Act ;
- The Welsh Government’s guide to the essentials of the Act
- Professor Luke Clement’s briefing providing a legal independent analysis of the Act.
- The statutory Codes of Practice provide the detail of how each Part of the Act should be implemented.
How well is the Act working?
The independent evaluation project examines the implementation and impact of the Act through the five core principles outlined above. As the Welsh Institute for Health and Social Care (WIHSC) notes, there was near universal support for the principles and ambitions of the Act in 2016, and there is still almost universal support for them now.
While the final evaluation report is yet to be published, the WIHSC explains that evidence shows a divergence between the principles of the Act and the practice and experiences of people. It acknowledges the impact of factors including COVID-19 and the continuing pressures on the workforce.
The social care workforce
The process evaluation report (focused on the workforce) found positive aspects of the legislation. Areas the workforce felt were working well include the new safeguarding procedures, the ‘what matters’ conversations, and staff feeling enabled to be less risk averse in their approach.
However, overall the research found varying levels of success in meeting the Act’s duties and requirements, and in establishing new, transformative ways of working. According to the report, this variation is often linked to underlying structural, financial or capacity pressures. It concludes that leaders and workers within the social care sector in Wales are still “on a journey” towards the full implementation of the Act.
Access to services
The process evaluation identified a number of challenges to the delivery of preventative services and initiatives. This includes the access criteria for statutory services which may inhibit early intervention; lack of direct funds for prevention; and the development of preventative services which respond to complex structural issues faced by communities.
A legislative review by Audit Wales (2020) found that, with regard to preventative and early intervention services, different local authorities started in very different places. It said, for service users, there “remains a postcode lottery of provision”. In particular, Audit Wales found that there is still some way to go in key areas such as advocacy, befriending and help for carers.
Social care: a last resort?
The process evaluation sets out a view from the workforce that statutory care services are “reactive” and a ”last resort” and not early intervention oriented. There were comments that the threshold for support is too high, and clients have to wait until “needs are higher or in crisis before being able to access direct support. The need for an integrated health and social care system was repeated throughout interview responses.
Dr Alison Tarrant from the Wales Governance Centre notes that the language used in the Act and guidance typically frames independence as self-reliance and connected to a reduction in social care use. This is reflected in the Act’s eligibility criteria, which establish that a person is only eligible for care if (among other things) they cannot meet their personal needs alone, with the support of others, or through existing community services. She says, “In other words, in Wales social care is legally expressed as a ‘last resort’, to be used only where other options are not available”.
Dr Tarrant reasons that, while it’s the case that people typically wish to do what they can for themselves, a focus on self-reliance for its own sake is not necessarily a form of social value. She gives the example, if a disabled person can complete the tasks of a morning routine without support but is left with so little time and is so fatigued that their ability to carry out further activities is curtailed, independent living and social contribution are denied. She notes that it is also important to acknowledge that informal support and generic services do not necessarily enable, and may actually negate, independent living. Dr Tarrant highlights:
We must recognise that social care is a positive and welcome force for good, which enables people to live the life of one’s choice and contribute to their communities and to society.
Tomorrow’s article looks at the experiences of service users and carers, and whether the legislation has made a difference to them and improved wellbeing as intended.
Article by Amy Clifton, Senedd Research, Welsh Parliament
