Domiciliary care providers and markets are facing a range of challenges as a result of changing population demographics and funding pressures, which produce market fragility and workforce shortages. Alternative models of domiciliary care are being explored in Wales and elsewhere as possible responses to these challenges. The Coronavirus pandemic has placed additional pressure on social care, amplifying these existing challenges and leading to new ones including the additional costs of personal protective equipment (PPE) and other measures to prevent transmission of the virus. On the plus side, it has opened up the possibility of accelerating the introduction of new ways of working, presenting an opportunity for disruptive change.
The first section of this report brings together findings from a series of interviews that we conducted with policymakers, managers, and researchers with expert knowledge of domiciliary care in Wales, as well as some key themes identified from UK and international models of domiciliary care. It outlines what is known about the current state of domiciliary care provision in Wales and the key issues that need to be addressed. The second section examines approaches elsewhere that may offer valuable insights for Wales, bringing together existing evidence and new evidence that we have gathered through conversations with experts in England, Scotland, the Netherlands, Sweden and Quebec.