Social care – Welsh Government assessment

There have been some welcome reforms to the policy and legal framework for social care in Wales in recent years, but there is a lack of available data about levels of unmet need for adult social care services. Levels of satisfaction with the quality of care remain consistent, but evidence of improved outcomes for those receiving care is limited. The coronavirus (COVID-19) pandemic has restricted the provision of care and raised serious concerns about the ability to keep people in care homes safe. The human rights of disabled people and older people have been disproportionately affected.

• Before the COVID-19 pandemic, social care services in Wales were under substantial pressure due to demand for local authority-funded care, funding pressures, and staff shortages.
• In 2018, concerns were raised about the levels of unmet need and in 2019 it was estimated that 96% of all care in Wales was provided by unpaid carers, who are disproportionately women.
• Satisfaction levels with the quality of care remained consistent; in 2018–19, 71% of people who received care or support rated it as excellent or good.
• In 2018, the Older People’s Commissioner for Wales raised ongoing concerns about the experience and rights protections of older people living in residential care homes, including the use of antipsychotic medication, the lack of dementia training for staff, and issues with workforce planning and inspection processes.
• A 2020 national review of Welsh care homes for people with dementia raised concerns about breaches of human rights caused by significant delays in Deprivation of Liberty Safeguards applications.
• Research has highlighted the need for social care reform in Wales to address funding for increasing demand, improve conditions for the workforce, and tackle a fragmented social care service.
• The number of ‘looked after’ children in Wales has increased by 28% between 2015 and 2020, and the gap is widening with other UK countries.
• A national review of care homes for children in Wales in 2018–19 found that many children received good quality support but raised concerns about the growing number of children going missing from care homes.
• The Coronavirus Act allowed for the modification of certain duties by local authorities in relation to adult social care, but these were not used. However, in July 2020, the Welsh Government stated that 460 care packages out of 23,000 had been withdrawn during the COVID-19 pandemic.
• A 2021 report, ‘Locked out: liberating disabled people’s lives and rights in Wales beyond COVID-19’, written by disabled people and disabled people’s organisations, found evidence of a correlation between the reduction and withdrawal of care during the COVID-19 pandemic and a negative impact on disabled people’s wellbeing.
• Care home residents were disproportionately affected by the COVID-19 pandemic. The total number of care home resident deaths from any cause in 2020 was 36% higher than the previous year, in part due to the number of care home resident deaths from suspected or confirmed COVID-19.
• There were a number of criticisms about the provision of personal protective equipment, testing and shielding policies in adult social care and residential care settings during the early stages of the COVID-19 pandemic. These criticisms have significant human rights implications.
• School closures during the COVID-19 pandemic withdrew vital safeguarding provision, which created additional risks for children in vulnerable situations.
• The Welsh Government did not agree to provisions allowing easements relating to social care for children in Wales.