As the number of older people in the city increases, it is more important than ever that we have a clear and effective approach to supporting our older citizens.
Our aim is to support older people to live well in their homes and communities.
We recognise how much older people contribute to our city and we will provide the right help at the right time, to allow older people to continue to live full and active lives.
Research has shown that "ageing in place" has many benefits. It is easier to stay active and to maintain existing social connections when living in your own home. This in turn can increase resilience, prevent the risk of falls and improve health outcomes. The comfort and familiarity of home can help prevent confusion and mitigate the impact of memory issues.
Therefore, a key element of our approach is to support independence, through a range of measures including equipment, home adaptations and technology. As needs increase, so will the care and support provided, both to individuals and their unpaid carers.
Our core values and policy principles for the delivery of care and support are:
- Fairness and Sustainability: We aim to ensure both fairness and sustainability in the delivery of care and support, helping individuals and meeting their needs while ensuring provision is cost effective and sustainable into the future.
- Choice: We will provide choice in care provision wherever possible, while balancing this with consideration of the sustainability and cost of care.
- Providing the right help at the right time: We will build on an individual's strengths, encouraging independence not dependence by ensuring that care and support are provided at the right time and at the right level.
- Individual Voice and Control: We are committed to giving individuals a strong voice in, and control over their care and support, helping them to achieve their own personal goals and working with them to remove barriers to their well-being.
- Quality of Care: Where care and support is needed, we will ensure this is of a good quality, effectively meeting the individual needs of older people, ensuring that they can age with dignity.
- Fairness in Charging for Care: We aim to ensure that our charging policies are clear, transparent and fair and that the care provided remains affordable.
These values will inform all aspects of how we provide care and support for older people.
Our policy principles
The following policy principles clarify how we will provide sustainable support for older people in Cardiff. These principles have been grouped into 5 sections:
- Promoting Independence
- Domiciliary Care
- Care Home Placements
- Charging for Care and Support
- Debt Recovery
Promoting independence
- We aim to offer support at the right time and in the right way, so that as many individuals as possible can remain independent in their own homes.
- We will provide high quality information, advice and assistance to support individuals to retain their independence and to remain active and connected to their community.
- We will take a strength based and preventative approach, understanding what is important to the individual and working with them to identify a range of community-based solutions to support their wellbeing.
- We will seek to recognise and promote what is working well for each individual, while offering appropriate support where there are identified difficulties or concerns.
- We will take an "at home" approach, supporting the individual to stay in their own home by identifying the right equipment, adaptations and technology that can support their independence.
Domiciliary care
- When an individual's needs increase, we will work with them to carry out a full wellbeing assessment. Where it is determined that the individual has an eligible assessed need, which cannot be met by other means, we will arrange for domiciliary care to be provided.
- Where an individual wishes to commission their own care, we will provide them with both funding and support to help them to make their own care arrangements. This is known as a direct payment. Direct Payments will only be made to meet an individual's eligible assessed needs.
- The maximum hourly rate we will pay for domiciliary care and for direct payments will be set out each year and published on our website.
- In most cases domiciliary care will only be provided for personal care. We will not usually provide domiciliary care for other support such as domestic cleaning and laundry services. Instead, we will work with an individual so that they can achieve the help they need, including maximising their income to allow them to fund this support directly or by seeking alternative community solutions.
- While our principle will be to support an individual to remain at home, this will be balanced against a number of factors including:
- the sustainability of any domiciliary care package and the ability to deliver care safely within the home;
- the complexity of their needs;
- the impact that this will have on unpaid carers and;
- the financial support required to maintain a safe level of care.
- It may not always be possible to support an individual to stay at home.
- Where the cost of supporting an individual to remain at home exceeds our published care home rate, consideration will be given to whether this is sustainable, and we may work with the individual to identify an alternative solution.
- Where an individual cannot be supported at home, we will aim to offer a choice of accommodation that will meet their eligible assessed needs. This may be through a supported housing or extra care scheme commissioned by us or in a placement in a care home that is on our Approved Care Home Provider List.
- We will only consider a placement in a care home where there is a need for this level of care as assessed by the social work team.
Care home placements
- Our approved Care Home Providers have undergone quality assurance checks and are registered with Care Inspectorate Wales (CIW), ensuring they can deliver services and that they meet required standards.
- We will publish care home rates each year, setting out the rate we will pay for different levels of care provision, including residential, nursing and dementia care. These rates will be the maximum we expect to pay for this level of care, unless the individual has exceptional care and support needs, as assessed by the social work team. Our care home rates will be available on our website.
- Details of homes on our Approved Provider List that have vacancies and offer services within our published rates will be made available. We will work with an individual and their family to help them choose their preferred home.
- If there is no vacancy on our Approved Provider List within our published rate, we will aim to offer a choice of care homes with rates that are as close as possible to our published rate.
- Where an individual has an eligible assessed need for a care home placement and we have offered them a choice of care homes from our Approved Provider List, but they wish to move to a different home, the maximum financial support provided will be the level of our published rates. Any additional cost will need to be met by the individual or a third party, such as their family.
- If the individual wishes to move into a care home in another area of the UK, but outside Cardiff, we will pay up to the care home rate set by that Local Authority. Any additional costs will need to be paid by the individual or third party.
Charging for care and support
Many people who receive care, either at home or in a care home placement, will need to contribute to the cost of their care. A financial assessment will be carried out to ensure that no one is asked to pay more than they can afford, in accordance with the regulations set by the Welsh Government. The full cost of the care provided will be recovered where it has been assessed that this is affordable for the individual.
- We will ensure that our charging arrangements are consistent, equitable and fair.
- Domiciliary care is subject to a maximum weekly charge set by the Welsh Government. We will that ensure our charges are in line with this maximum charge.
- Where the cost of the chosen care provision is above our published rates and an individual or a third party is paying towards the additional cost, we will seek evidence that the arrangement will be financially sustainable for at least three years.
- Where an individual has chosen to self-fund a place in a care home and their funds are no longer sufficient to support them to remain in the home, we will first carry out a full assessment of their needs, then:
- If they do not have an eligible assessed need for a care home placement, we will support them to move to alternative provision; or
- If they do need to be in a care home but the cost of the placement exceeds our published rate, we will consider whether there are special circumstances that make it appropriate to fund the placement or whether the individual should be supported to move to alternative accommodation which meet their needs.
- Any decision to change the care home placement will only be made following a full assessment by the social work team and taking into account all factors including the risk of any move.
- We will seek to ensure that good advice is available to help individuals to make decisions about their care and to prevent the need to change a care home placement.
Debt recovery
- To ensure that the provision of care remains sustainable, it is important that care charges are paid. We will take a fair and consistent approach to debt recovery.
- We will work with individuals to explore the reasons for any non-payment, ensuring that a suitable payment arrangement is in place.
- We will pursue all reasonable alternative options before using formal debt recovery powers such as court action.
