THE Older People’s Commissioner’s ‘A Place to Call Home?’ report should mark a watershed in our approach to residential care in Wales.

While concluding that minimum standards are on the whole being met, it also highlights examples of really good care homes: where care is person-centred, where health and wellbeing is paramount, and where residents have meaningful choice and control over their lives.

However, as the report makes clear ‘care delivered without abuse or neglect is not the same as good care’ and too often residents become institutionalised, their daily routine reduced to series of functional tasks, often framed in dehumanising language like ‘toileting’ and ‘feeding’.

Frequently, care homes are seen as places of irreversible decline, with barriers to the specialist support and services that can help people maintain their physical and mental health for longer.

Serious regulatory gaps were also highlighted; there is a clear lack of planning for care home provision at a national level in Wales; and the role and contribution of care home staff is undervalued, with a lack of support, limited opportunity for professional development and low pay and poor working conditions.

As I’ve said, there is good practice out there. Just last week, I attended the launch of the ‘Unified Menu Planning’ project - an exciting partnership between Torfaen Council and the local health board, highlighted in the report – that aims to support care home staff; boosting nutritional standards and choice.

However, more fundamental change is clearly required, and with recommendations broken down into specific action points with clear timescales - backed up by the Commissioner’s legal powers if necessary - this report offers a blueprint for delivering that kind of sea change.

In many cases the solutions seem straightforward: ensuring we have the right number and type of care homes through effective national planning, for example, or requiring all care home staff to undergo basic dementia training.

However, there is one very worrying aspect of our residential care sector that is only briefly touched upon. Because when St Dunstan’s Care Home in Griffithstown was closed after just three months’ notice, I saw first-hand the lives of the most vulnerable dictated by the brutal reality of a corporate profit and loss sheet.

If we are to build the kind of residential care sector in Wales I believe we all want to see for the future, tackling that chronic over-reliance on the private sector is a nettle we simply have to grasp.