Preventative Social Care and Community Development in Wales: “New” Legislation, “Old” Tensions?

Abstract

Prevention is becoming ever more central in UK care policy for older people, though precisely what this entails, and how it works most effectively in social care and support, remains ambiguous. Set against the “newness” of recent social care legislation in Wales, this article explores the perspectives of professionals on prevention and community development, particularly for older people. This draws on qualitative data collected from 11 Welsh local authorities, four NHS Wales health boards, and eight regional third-sector organisations, incorporating 64 interviews with directors, executives, and senior managers. Recent research has highlighted concerns over the slipperiness of prevention as a concept, resulting in multiple interpretations and activities operating under its banner. Consistent with this, our data suggested a kaleidoscopic picture of variously named community-based initiatives working to support the intricate web of connections that sustain older people, as well as provide practical or material help. Similarly, professionals highlighted varied agendas of community resilience, individual independence, and reducing the need for state-funded health and social care, as well as a range of viewpoints on the roles of the state, private sector, and the third sector. Analysis revealed fragments of familiar themes in community development; positive hopes for community initiatives, tensions between the mixed agendas of state-instigated activities, and the practical challenges arising from systems imbued with neo-liberal ideas. Realising the promise of prevention will require deft steering through these challenges.

Reflections on Community Development, Preventative Care, and Ageing

“…Several articles throw light on what is happening regarding care in parts of the world, namely Australia (Buchanan et al, 2024), China (Xia et al, 2024), Italy (Lodi Rizzini et al, 2024Riccò et al, 2024), Wales, UK (Barker & Roach, 2024;Read et al, 2024), Finland (Rantala et al, 2024), and Rwanda (Irambeshya, 2024).…”

“…Articles describe some of the measures taken to assess, investigate, and understand the nature and extent of social care problems across these different nations, as well as the success, or otherwise, of efforts to mitigate them. Subjects covered include providing home-based care in isolated mountain regions (Lodi Rizzini et al, 2024), the application of social hubs (Rantala et al, 2024), a senior community care model (Riccò et al, 2024), older LGBTI people's views and experiences of homecare provision in the context of "predominantly heteronormative" health and social systems (Duffy et al, 2024), and community-focussed prevention initiatives (Read et al, 2024).…”

“…and processes for this approach, whilst Read et al (2024) suggest the need for a "deftness" in working within governmental systems that can privilege other values and interests.…”