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Health

Striking drop in home care hours in Carmarthenshire despite rising demand

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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

10-mile trek raises £1,000 for stroke unit

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A TEAM of 18 from CARA Wales took on a 10-mile trek and raised £1,000 for the Stroke Ward at Withybush Hospital.

The team from CARA Wales, an agricultural and rural consultancy and advice organisation, walked across the Preseli Mountains from Foel Drygan to Foel Eryr on 17th June 2023.

Mererid Sandbrook, who works for CARA Wales, said: “The walk started in Crymych and continued along the Golden Road up to Foel Eryr, the highest point of Preseli Mountain. It was a really enjoyable day.

“We were all really pleased to have raised such a great amount of money. We would like to thank everyone who donated money towards our challenge.”

They also raised £1,000 for Stroke Association.

Nicola Llewelyn, Head of Hywel Dda Health Charities, the official charity of Hywel Dda University Health Board, said: “We’d like to say a big thank you to CARA Wales for taking on the 10-mile trek in aid of the Stroke Ward.

“The support of our local communities enables us to provide services over and above what the NHS can provide in the three counties of Hywel Dda and we are extremely grateful for every donation we receive.”

Your donations are making a positive difference to the health, wellbeing and experience of NHS patients, service users and staff. For more details about the charity and how you can help support local NHS patients and staff, go to www.hywelddahealthcharities.org.uk

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Health

Hywel Dda to engage on Tregaron Community Hospital beds

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HYWEL DDA University Health Board is inviting members of the public to share their views about the potential of decommissioning the nine beds currently at Tregaron Community Hospital.

The proposal for a new model of care, which is part of the broader Cylch Caron project, will see the move of care from the hospital to people’s own homes enabled through a different model of support. This can only be achieved by staff working in different ways, focused on keeping people well at home, and with more available to help people in the community.

Peter Skitt, County Director Ceredigion at Hywel Dda University Health Board explains: “Members of our local community will be familiar with our vision, which includes the development of the Cylch Caron model of care that includes an integrated resource centre.”

Dr Sion James, Deputy Medical Director Primary Care and local GP for Tregaron, adds: “Tregaron Hospital has been a part of our local community for a number of years, and we need to provide our community with a range of services that meets their current and future needs.

“The Centre is an exciting and unique project that aims to offer many opportunities and benefits for people in the area. This will bring together a range of services in a central hub for the Tregaron and surrounding rural areas. The project will create an innovative rural model of community-based care to meet care, health and housing need in the area, which is fit for today and sustainable for tomorrow.”

The Cylch Caron scheme is being developed in partnership between Ceredigion County Council, Hywel Dda University Health Board and the Welsh Government. It will consist of a GP surgery, community pharmacy, outpatient clinics and community nursing and social care facilities, as well as extra care flats and integrated health and social care units.

Ceredigion County Council recently announced that they are inviting companies to tender for the design and build of the new fully-integrated health, social care and housing centre.

Peter adds: “While we develop our Cylch Caron scheme, we also need to consider our current model of care for patients at Tregaron Hospital. Despite efforts to recruit to positions, our current level of staffing is insufficient, and our staffing rotas are fragile. Our staff have voiced how challenging it is to support our patients through our current model of care at Tregaron Hospital. Our proposal is to move our staff from being hospital based and looking after the nine beds, to being community based. This will enable us to support more patients in their homes.

The Cylch Caron model of care is focused on providing more community nursing and enhanced care in people’s own homes. This would be achieved through outreach nursing and increased provision of same day urgent care. Outpatient appointments will continue to be provided from Tregaron Hospital and the building will serve as a hub for our staff until the new Cylch Caron Integrated Resource Centre is built.

Peter continues: “We know that being close to home, or in their home, is important for our patients. We want to increase the opportunity for people in Ceredigion to be able to stay well for longer, with the support of enhanced staffing in their own homes.

“At the moment, the patients in our care at Tregaron hospital live more than ten miles away from the hospital, and most are medically fit. And this has been common for a long time. Our proposal to move our staff to focus on advanced care in people’s homes provides a different way of supporting our patients. It will enable us to deliver our community care model quicker and support more people in our communities.

“Patients have consistently shared that they would prefer to be at home, or closer to home, and this tends to enable their recovery. We will work with our patients and their families, and our broader community, to understand their views during the planned period of engagement.”

The proposal to decommission the nine beds and the engagement period will be discussed at the Board meeting held on 25 July. The four-week period of engagement will launch on 1 August and run until 29 August 2024. Individuals will be able to attend online and in-person events and be able to share their views through the Health Board’s Have Your Say portal. Feedback from the engagement will be presented to the September meeting of the Health Board.

Further information on the events and how individuals can share their views will be shared at the end of July.

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Health

Equipment and games for Glangwili children’s ward thanks to donations

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THANKS to donations, Hywel Dda Health Charities, the official charity of Hywel Dda University Health Board, has been able to provide equipment and games worth over £300 to Cilgerran Ward at Glangwili Hospital.

The NHS charity funded TV brackets, universal remotes, Nintendo Switch cases and Nintendo games including FIFA, Chocobo and Minecraft Dungeons.

Karen Thomas, Head of Therapeutic Play, said: “We are so grateful that charitable funds have allowed us to purchase more items for Cilgerran Ward.

“The new items will help the therapeutic play team work more effectively and focus their time on the children and young people in our care.

“Being able to play while in hospital means the children and young people can continue an aspect of their normal life. Arts and crafts help as they go through treatments and procedures in hospital, minimising the effects of isolation, stress and anxiety.

“The items will help make the ward and all the areas the children attend more friendly and promote wellbeing for all.”

Nicola Llewelyn, Head of Hywel Dda Health Charities, the official charity of Hywel Dda University Health Board, said: “The support of our local communities enables us to provide services over and above what the NHS can provide in the three counties of Hywel Dda and we are extremely grateful for every donation we receive.”

For more details about the charity and how you can help support local NHS patients and staff, go to www.hywelddahealthcharities.org.uk

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