Health
Striking drop in home care hours in Carmarthenshire despite rising demand

Richard Youle – Local Democracy Reporter
THE NUMBER of hours of home care commissioned by Carmarthenshire Council has halved over the last decade, despite rising demand from an ageing population.
Jake Morgan, director of social services, said in a report that this “striking” trend was the result of measures such as helping people who might need support at an earlier stage, more help for people who have left hospital but who need care before they can go home, and more instances of one home carer – where appropriate – visiting a client when previously two had.
At the end of April this year, the council commissioned 8,601 hours of home care for people who need help with things like washing and dressing. A decade ago it was around double that.
Mr Morgan’s annual report said the council was managing home care demand, although there are more than 100 people waiting for the service. It added: “However, had we not made these radical reforms over the last 10 years then we would have a waiting list of 500 people and spend of an additional £20 million annually.”
His report, covering key trends in adult services and children’s services, was discussed by the council’s health and social services committee on October 4.
Speaking at the meeting, Mr Morgan said Carmarthenshire was the only area in Wales where home carer pay was on a par with NHS peers, and that this had helped with recruitment and retention. “But it has not solved fundamental shortages in the workforce,” he said.
In Carmarthenshire, as across Wales and the UK, many elderly people in hospital are medically fit for discharge but remain in a ward due a lack of onward support. Mr Morgan said a fortnightly meeting took place reviewing all long hospital waits, and that this had had a positive impact.
He said: “Seventy five per cent of our beds in hospital, sometimes upward of 80%, have frail and elderly people within those beds – hospitals that are designed for mending broken legs and dealing with cancer and all those kinds of functions are now largely overwhelmed by people who have multiple chronic complex illnesses.”
He said the average length of stay in Glangwili and Prince Philip hospitals, in Carmarthen and Llanelli, was more than double the equivalent of comparable hospitals. The more time frail and elderly people remained in a hospital bed with minimal movement, he said, the more they deteriorated and the harder it became to discharge them.
Mr Morgan said the health board had a very good relationship with Hywel Dda University Health Board, but he was concerned that significant health board budget deficits in Wales could mean funding being cut for initiatives to reduce hospital stays.
Moving on to social workers, Mr Morgan said the council was focusing on sponsoring and training its own, while still recruiting externally where possible.
“I think we had 22 (social workers) join last year who we had some role in sponsoring or supporting in doing their professional qualification,” he said.
His report, though, pointed out that the council had been unable to fill social worker posts that were created via a “significant” investment” in mental health services by the authority last year.
Meanwhile, referrals to the child and family services department have increased by around 70% from a decade ago. Mr Morgan said outcomes for children helped by the council were the best in Wales compared to other authorities. “We still have low numbers of looked-after children, and we are good at keeping families together,” he said.
Caerphilly Council, he said, spent £20-25 million more per year on children’s services than Carmarthenshire did. However, Mr Morgan said numbers of young people on the child protection register had risen in Carmarthenshire.
He added that the authority had plans to ramp up its provision of residential care for looked-after children to avoid them having to go outside of the county. “The looked-after children market, particularly in terms of residential care, is not serving children well,” he said.
Councillors asked questions about the fortnightly hospital stay meetings, a rise in suicide in the region, and home care agency funding, among other things, and accepted the report.
Health
Mind, Body and Spirit Awareness Day at North Pembrokeshire venue

This Saturday, April 12, thoughts will be turning to the mind, body and spirit, thanks to the ever-popular Awareness Day that takes place at Canolfan Hermon in North Pembrokeshire.
This is the fourth event of its kind at the village hall and each year the event continues to grow from strength to strength.
This year, there will be a total of eight therapists in attendance as well as two mediums, a card reader and ten stall holders selling spiritual, mind and body items including crystals, jewellery, honey and cosmetics. There will also be a stall from the Jig-So Children’s Centre in Cardigan while hot food and refreshments will also be served throughout the day by Fusion Kitchen.
As with previous events, the Mind, Body and Spirit Awareness Day will be raising funds for Breast Cancer and Thrombosis UK. As a result, there will be a £1 entry fee as well as optional raffle tickets and a Memory Tree for additional donations. A light language healing demonstration will take place at 1 pm.
People near and far are invited to experience the different therapies, while event organiser Lynda Barnes says there is guaranteed to be something here for everyone. The event starts at 11 am and will continue until 3 pm.
For further information, contact Lynda Barnes on 07920249194.
Health
‘Nobody taking responsibility’ for paying care workers the real living wage

CARE HOME providers urged the Welsh Government to follow through on a key commitment to ensure care workers are paid the real living wage.
Giving evidence in the Senedd, Care Forum Wales, which represents more than 450 care homes, warned funding did not reach all parts of the sector in 2024/25.
The non-profit organisation said funding for the real living wage (RLW) was not ringfenced, so some councils chose to spend the money on libraries and teachers’ salaries instead.
Care Forum Wales raised concerns about “nobody taking responsibility”, with the Welsh Government claiming to have provided the money and councils saying it was insufficient.
Labour’s manifesto for the 2021 election contained a pledge to “ensure care workers are paid the real living wage during the next Senedd term”.
But Sanjiv Joshi, Care Forum Wales’ treasurer, warned the Welsh Government’s push for care workers to receive the real living wage has become an aspiration rather than a reality.
He told the local government committee: “The first year when it was announced … providers had to give an undertaking to commissioners that we were paying the real living wage.
“Since then, that’s now become aspirational as commissioners have not had the funds – or so we are told – to follow through and maintain those real living wages.”
Giving evidence on April 3, Melanie Minty, policy adviser at Care Forum Wales, said: “The real living wage, as Sanjiv said, isn’t reaching the sector necessarily.”
But, describing the RLW as a drop in the ocean, she warned care homes cannot compete with councils and the NHS which pay a higher rate than used in costing commissioned care.
Under the Welsh Government’s 2025/26 budget, funding for the real living wage is allocated to councils within the revenue support grant, meaning it can be spent on other areas.
Ms Minty also voiced concerns about an increasing number of councils receiving grants to build care homes that “will never recover their costs”.
She pointed to the example of Carmarthenshire Council building a £19.5m residential home despite free capacity in the county’s independent sector.
Cautioning that commissioning too often focuses on cost over outcomes, she said: “I’ve heard of commissioners going into homes and saying ‘you’re spending too much on food’.
“Things like holidays have been drastically cut back for younger people.”
Mr Joshi, who runs the Caron group of care homes in mid and south Wales – which includes Valley View Care Home in Hengoed – warned of a £9,000-a-year difference in nursing fees between neighbouring councils.
He said: “We’re talking about Cardiff and RCT … imagine the pressure that puts on and it’s not driven by the needs, the needs would not be that different.”
Pressed about the minimum level of profits required to make services feasible, Mr Joshi replied that he targets an 11% return which is unachievable in parts of Wales.
Warning of an “irrational” policy direction, he said: “We have the private sector delivering incredible value for money [yet] being eroded by underfunding. Then we have the public sector spending four or five times that amount, it doesn’t make sense.”
Mr Joshi told the committee families are increasingly having to make up a difference in costs that should be provided by councils and health boards.
Warning charity providers are exiting the market, Ms Minty said: “Most of our third-sector members have sold their care homes because they are not viable.”
Ms Minty called for a fee methodology that can be applied consistently across Wales, with some councils far more transparent and understanding of the costs than others.
“Cardiff, while giving a really good increase this year, has been very honest in admitting they know it’s not going to meet all the changes,” she said. “Whereas other local authorities … have been known to make an offer and say this will cover all sorts of things.”
She said the sector has stabilised since the pandemic and Brexit but increasing employer national insurance contributions have added to the pressure.
She told the committee: “I think we’ll see an unintended consequence will be that employers are forced to suppress pay increases … and some will be forced to make redundancies.”
Health
New patient deal aims to cut NHS waiting times across Wales

A NEW deal between the NHS and the public is at the centre of a plan to drive down the longest waiting times for healthcare in Wales.
Health Secretary Jeremy Miles is expected to unveil a strategy this week aimed at reducing the overall waiting list by 200,000 patients by March 2026. The plan also sets targets to eliminate two-year waits for planned treatments and restore a maximum eight-week wait for diagnostic tests.
A key part of the announcement is the introduction of a new “patient deal”, which aims to improve transparency, reduce missed appointments and ensure better preparation for surgery. This deal will be incorporated into updated referral-to-treatment guidelines due later this month.
What the new deal includes:
- Faster access to planned care with patients told how long they can expect to wait once added to the list.
- Waiting time tracking through the NHS Wales App, with updates available from June.
- Only fit and well patients will be added to surgical waiting lists, in line with evidence showing they recover more quickly and have better outcomes.
- Support to get surgery-ready, with help to improve health before treatment.
- Appointment changes, where patients will be offered two dates. If they miss both without good reason, they will be removed from the waiting list.
- Alternatives and risks explained, so patients are fully informed before deciding on surgery.
Each year, around 700,000 outpatient appointments in Wales are either missed by patients or cancelled. Health boards will now be under stricter obligations to reduce these disruptions, and to minimise the number of cancellations made by the NHS itself.
Mr Miles said: “The NHS will do all it can to prioritise faster access to treatment. In return, we are asking the public to prioritise and keep their appointments so that, together, we make the best possible use of scarce NHS resources.
“We cannot continue losing one in seven appointments due to no-shows or other avoidable reasons. These missed slots delay care for everyone and waste vital resources.
“Evidence shows people in better health recover more quickly and require shorter hospital stays. By preparing patients properly and ensuring they understand all treatment options, we can deliver better outcomes and greater efficiency.”
The Welsh Government hopes the new plan will bring waiting lists closer to pre-pandemic levels. As well as reducing overall waiting list size by 200,000 by March 2026, the government has pledged to ensure no one waits more than two years for planned treatment and to restore the eight-week target for diagnostic testing.
Health boards will be expected to continue transforming how they deliver planned care over the next 12 months. This includes adopting more regional working models and implementing recommendations from the Ministerial Advisory Group on NHS Performance and Productivity, due to report later this month.
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