Health and Social Care Committee

HSC(4)-04-12 paper 2

Inquiry into residential care for older people: external engagement

To:                        Health and Social Care Committee

From:                    Committee Service

Meeting date:      2 February 2012

Background

1. The National Assembly for Wales’s Health and Social Care Committee will undertake an inquiry into residential care for older people in Wales between February and July 2012. The inquiry’s terms of reference are attached at Annex A.

2. To ensure that the Committee hears the views of current and prospective service users on the provision of residential care for older people, the Committee has indicated a desire to engage as widely as possible.

Purpose

3. Although traditional means of gathering written and oral evidence are very helpful when undertaking Committee inquiries, Committees often struggle to reach those who are not necessarily engaged in discussions about the development of services but have first-hand experience of them.

4. The purpose of the external engagement activity proposed in this paper is to ensure that the views and experiences of current or possible future users of residential care - including family members and those caring professionally or voluntarily for older people - form part of the Committee’s consideration of this subject.

5. An organisation with the capacity and expertise to help facilitate further engagement with key sectors within the residential care field is being sought to deliver the role specified in this paper.

Methods of engagement

6. In order to hear a wide range of views of current and prospective services users, it is proposed that an appointed facilitator assists the Committee in the following actions:

(i) the establishment and facilitation of an external reference group; and

(ii) the facilitation of other engagement work.

(i) The establishment and facilitation of an external reference group

Role and make-up of the group

7. The role of the external reference group will be to provide a view to the Committee on the formal evidence being provided as part of the inquiry, reflecting the diverse experience and perspectives of the reference group’s members.

8. It is envisaged that this work will include shadowing the Committee’s inquiry by:

- receiving, considering and discussing the oral evidence received by the Committee at regular intervals (working about a month behind the Committee);

- feeding the group’s views on the key issues raised during the course of the inquiry to the Committee, including the extent to which members of the group feel that:

i.  the information being provided reflects their own personal experiences;

ii. policy is developing in a direction with which they would agree;

- meeting with the Committee periodically to discuss the inquiry’s emerging themes;

- providing the Committee with any lines of questioning the group believe should be pursued with witnesses during the course of the inquiry;

- acting as a sounding board to test the Committee’s findings and recommendations.

9. The Committee is seeking a group comprising 5 – 10 members of the public. Members of the reference group will represent, as far as is reasonably practicable, the residential care journey, including:

- individuals – or family of those individuals – yet to enter residential care, but who are at, or near, considering the possibility of doing so;

- family of those in residential care or facing the prospect of residential care;

- those caring in a voluntary or professional capacity.

10. Due to issues of accessibility, it is acknowledged that the reference group may not include residents themselves but will predominately comprise: carers; family members; and those starting the journey into residential care. It is envisaged that the other engagement tools listed later in this paper could be used to ensure that the Committee reaches those residents who may wish to share their experiences with Members.

11. Members of the group should also, as far as is reasonably practicable, represent the diversity of need amongst older people who use – or face the prospect of entering – residential care, including their cultural, linguistic, geographical, physical and mental health needs.

Role of the facilitator

12. The facilitator will be expected to establish a reference group in accordance with the requirements listed in paragraphs 7 – 11 of this paper. The group will be expected to meet regularly, for the duration of the inquiry.

13. The facilitator would be expected to support to the reference group by:

- ensuring that all prospective group members are clear about the group’s role within the Committee’s inquiry and the time commitment involved;

- ensuring that the group receives accessible, clear and regular information about the evidence received by the Committee;

- arranging opportunities for the group to discuss their views (by whichever means deemed most suitable for participants) on the information received during the inquiry;

- facilitating the group’s discussions (without getting involved in any discussion that ensues) by working with the Committee’s secretariat to identify key questions and themes for the group to consider;

- taking responsibility for communicating the group’s views and conclusions, and any lines of questioning they would like the Committee to pursue, back to the Committee via regular written feedback;

- arranging periodical meetings with the Committee at relevant points (by the most practicable means for the group) to discuss the inquiry’s emerging themes;

- facilitating a discussion with the group to discuss and assess the Committee’s findings and recommendations;

- ensuring that the group are informed of the outcomes of the inquiry and how their input has been used; and

- evaluating the work undertaken by the Committee in relation to the reference group, particularly  from the group’s perspective.

(ii) Other engagement work

14. In order to ensure a broad spectrum of engagement, it is proposed that the Committee undertakes the following additional activity:

- a number of one-to-one visits with individuals in residential care;

- visits by committee members to local groups of people;

- informal visits to nursing homes across the spectrum of provision.

15. The appointed facilitator would be expected to support the Committee’s delivery of the activities listed above, in cooperation with Assembly staff, by:

- Arranging a number of one-to-one visits with residents in care homes across Wales. In arranging these visits, it is envisaged the facilitators would do some preparatory work with the residents in order to make sure they are aware of the information required by Members;

- Working with Assembly staff to identify a number of local groups to meet informally with the Committee. 

Timing

16. The inquiry into residential care for older people in Wales is scheduled to take place between February and July 2012.

17. It is hoped that the external engagement activity can be on-going throughout the inquiry with scheduled Committee time being allocated to hold visits and meetings.

18. The reference group would be established during February/March 2012 for the duration of the inquiry with their first meeting taking place approximately a month after the Committee starts taking evidence.

19. As the reference group will be expected to parallel the Committee’s inquiry, it is envisaged that the group will meet periodically (three or four times during the inquiry) to discuss their views. The group may also be asked to meet on one or two occasions with the Committee.

20. Group members may be expected, where reasonably practicable, to travel.

Proposals for facilitators

21. The Chair and Committee Secretariat have conducted initial discussions with potential organisations regarding the facilitating role.  Through these discussions it has been proposed that a collaborative approach between Age Cymru and Crossroads Care is adopted, which would enable all / the majority of the specification to be delivered.

22. The appointment of a facilitator would be made in accordance with Standing Order 17.55 which provides for the appointment of expert advisers to Committees, subject to the Committee’s agreement.

Action

23. The Committee is invited to consider and agree:

i. the proposed engagement activity outlined in this paper (paragraphs 7 – 15); and

ii. the appointment of Age Cymru and Crossroads Care to work collaboratively to facilitate this work (paragraphs 21-22).

ANNEX A - Terms of reference

The inquiry will examine the provision of residential care in Wales and the ways in which it can meet the current and future needs of older people, including:

- the process by which older people enter residential care and the availability and accessibility of alternative community-based services, including reablement services and domiciliary care.

- the capacity of the residential care sector to meet the demand for services from older people in terms of staffing resources, including the skills mix of staff and their access to training, and the number of places and facilities, and resource levels.

- the quality of residential care services and the experiences of service users and their families; the effectiveness of services at meeting the diversity of need amongst older people; and the management of care home closures. 

- the effectiveness of the regulation and inspection arrangements for residential care, including the scope for increased scrutiny of service providers’ financial viability.

- new and emerging models of care provision.

- the balance of public and independent sector provision, and alternative funding, management, and ownership models, such as those offered by the cooperative, mutual sector and third sector, and Registered Social Landlords.