The Framework of Services for Older People will promote the development of the appropriate range of local services working together to respond to the needs and the preferences of older people and their carers. These services should help them to continue or return to live at home or in a homely environment as independently as possible. Independence means either caring for oneself as much as possible or when practical assistance is required, it is based on the older person’s own choices and aspirations.  This applies equally to those people who fund their own care as well as those whose care is funded by the local authority or NHS.

The range of services will include social care, housing and transport and other local government services together with services provided by the local private and Third/voluntary sector. They will also include services provided by and in partnership with health services. These services should provide a coherent integrated response and will support both the older person needing assistance to maintain their independence thereby supporting those who care for them.

The reason for focusing on older people is that the need for help and support to maximise their independence increases with age. In celebrating the fact that people in Wales are now living longer lives, we need to ensure that services promote adding quality of life to years and not just adding years to life. Promoting independence responds both to the preferences of older people and the need to make better use of resources.

What is the Framework?

The idea behind the Framework is to encourage Local Authorities and their partners to develop a comprehensive range of effective local services designed to support older people at home or in a homely environment.

Older people want local services which are sufficiently robust to help them and their families cope with crises and emergencies with the minimum of disruption avoiding inappropriate admissions to hospital or residential care and facilitating a smooth transition between services.

The development of the Framework will also stimulate discussion about how services relate to one another. The problem for service users, carers and even professionals is that the picture of services is often fragmented and confusing.  We also know that services are inextricably linked in terms of their impact both on the individual and on the agencies providing them. A good range of effective local and integrated community services, including re-ablement services, will help to prevent inappropriate hospital admissions as well as facilitate discharge. They will also help to avoid premature admissions to residential care. Service gaps or ineffective services will have the opposite negative impact.

The Framework will consist of examples of services valued by older people provided by all sectors. The Framework will speed up learning by sharing good practice.

Principles underpinning the Framework

To achieve maximum impact, services need to be based on a set of core principles that will achieve positive outcomes for older people.

The Principles

• Services should be person centred in that they are flexible and responsive to need.
• Older people continue to make a contribution to society and should be viewed as assets to society.
• Older people want to live independently in their own homes or in a homely environment in their chosen community.
• Older people want services that help them to help themselves.
• Older people want local services to help them maintain their independence and safety in the community and promote good health.
• Services need to provided in a timely fashion as soon as possible once the need has been identified.
• Services will support informal care networks in terms of family, friends, and community.
• Older people should be protected from harm, abuse, neglect and isolation.
• When they require treatment in an acute hospital setting they want:
o the best quality treatment as close to home as possible
o a smooth transition of care between community services and hospital and between hospital and community services.
o to return home as soon as possible with appropriate support when required
o access to rehabilitation services to maximise their level of independence
• Older people want access to good quality information to enable them to make informed decisions about services they may need.
• Older people want to retain control of decisions concerning their life and lifestyle.
• Admission to residential care will be made on the basis of positive and informed choice.

These principles are consistent with the 18 United Nations Principles for Older Persons which focus on Independence, Participation, Care, Self-fulfilment and Dignity. In addition the Welsh Assembly Government requires sustainable models of service delivery to promote independence and manage rising demand. Services need to be delivered in such a way that people experience them as integrated and seamless. Services should be based upon partnership working enabling smooth transitions of care and more effective use of resources.

Good quality services that meet people’s needs are dependent upon an appropriately skilled, flexible and confident workforce and a strong service infrastructure.

Developments in new technology will also be utilised to support the independence of older people and their carers.

How will the Framework make a difference?

In Wales there are many examples of good services but there is inconsistency in the range available. Wales is a small country and this needs to be turned to our advantage by identifying good services which are valued by older people, their carers and the professionals who work with them. The idea is to share good practice and speed up learning so that when Local Authorities, the NHS and their partners are planning and developing services, they will have a rich source of practical examples to draw on.

The Framework document supported by a website with more detailed descriptions of services and how they are integrated will hopefully prove a useful resource for you to draw upon.

We will build up a series of practical examples of service delivery ranging from services designed at preventing deterioration in personal circumstances to services providing high levels of care when required. These services will cover all sectors and will encompass social care, housing-related support and health care.

How can you help us?

Please tell us about services that have made a positive difference to the lives of older people in your area.

If you are an Older Person or Carer or if you work in the Local Government, Health or Housing Sectors or if you work in the private and Third/Voluntary sectors

If there are services out there that have helped change and improve the lives of older people or the lives of families of older people then we want to know about them. If there are gaps in existing services where people need help but cannot get it then we want to know about them.

Please contact Sarah Austin via Sarah.Austin@wales.gsi.gov.uk or at the Office of the Director of Social Services Wales, West Core, Pillar H02, Health and Social Services Directorate General, Welsh Assembly Government, Cathays Park, Cardiff, CF10 3NQ.

What happens next?

A steering group is in place and an outline Framework has been developed.
A series of meetings will be arranged across Wales to encourage discussions and contributions to the development of the final Framework. Written contributions will also be invited. The Framework will be published in 2010. Your council, your Local Health Board and partners in the Third/Voluntary sector will be working together to make it a reality.

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