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Adult social care reform in Wales

Tarrant, Alison 2021. Adult social care reform in Wales. Cardiff: Wales Governance Centre, Cardiff University. Available at:

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Social care in Wales is in crisis. In recent years increasing numbers of people have been unable to access adequate or appropriate support, providers have relinquished unsustainable contracts with local authorities, careworker vacancies have increased, and informal carers have been pushed to their limits. These difficulties have been exacerbated by the Covid-19 pandemic, which has also revealed that the rights of older and disabled people receiving social care support are not always being upheld. It is essential that social care is stabilised in Wales as a matter of urgency. The need for social care reform is now broadly accepted. However, discussion remains focused on financing social care, and adjustments to the existing structures and forms of support. These are not currently achieving what is needed. Reform must be about something other than perpetuating what we have. This report focuses on two aspects of social care in Wales where reform is needed: exploring and reconceptualising the purpose of social care, and policy and provision of direct payments. Consideration of the purpose of social care is particularly necessary in the light of the potential incorporation of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) into Welsh domestic law. The UNCRPD articulates the right of disabled people to live their lives on an equal basis with others, in terms of all life opportunities. Social care is fundamental to thousands of disabled and older people if they are to exercise this right, and must be understood as such. Discussion of social care in Wales is still dominated by narratives of individual dependency and reliance. The current legislative framework constructs social care as a ‘last resort’. Rather than maintaining this view of social care as an unwelcome necessity for some, reform should be centred on the principle that it is a valuable and desirable resource which liberates those using it and is fundamental to the realisation of social justice, equality and people’s basic human rights. Direct payments offer people who use social care more control over their support and their lives. They are stated to be a central element of social care provision in Wales. There remain, however, a number of ongoing problems around their use in the Welsh context. These include low take up and a lack of awareness of entitlement to direct payments among social care users, limited access to peer support, a lack of entitlement where support is funded by health, and policy reticence around the use of personal assistance. If direct payments are to be effectively used in Wales, these barriers must be better understood so that they can be removed. The ways to remove them need to be developed by policy-makers working together with disabled and older people and their representative organisations.

Item Type: Monograph (UNSPECIFIED)
Date Type: Publication
Status: Published
Schools: Law
Publisher: Wales Governance Centre, Cardiff University
Funders: Economic and Social Research Council
Date of First Compliant Deposit: 29 September 2021
Date of Acceptance: 28 September 2021
Last Modified: 07 Oct 2021 07:30

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