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
Bathing water samplers set for a busy season of water quality checks
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WHILE families across Wales start making plans for the summer, samplers from Natural Resources Wales (NRW) are embarking on their annual programme of bathing water quality tests.
This year, there are 110 designated bathing waters which will be sampled multiple times between 15th May-30th September, in line with the UK Bathing Water Regulations. 109 of these are coastal waters, and one inland lake (Llyn Padarn).
Last month the Welsh Government announced that Nefyn Beach in Gwynedd had been added to the list of designations, following a successful application.
Bathing water samples are sent to NRW’s laboratory in Swansea, where they are tested for levels of Escherichia coli (E. coli) and intestinal enterococci (IE).
Results from a four-year rolling period then determine the classification for the next bathing water season; excellent, good, satisfactory or poor.
Last year, 98% of Wales’s designated bathing waters met stringent environmental standards, with 80 out of 109 meeting the ‘excellent’ criteria.
Clare Pillman, Chief Executive of NRW said:
“More and more people are enjoying the benefits of open water swimming, and where better to take a dip than at one of the many fantastic bathing waters Wales has to offer.
“Our blue waters offer a wealth of recreation opportunities, providing a vital boost to Wales’ tourism sector and the health and well-being of our communities.
“Our teams continue to work hard to tackle the many sources of pollution which threaten our water quality, including from agriculture and storm overflows. Much progress is being made, and we are pressing for record levels of water company investment for the environment in the coming years to safeguard the future health of our waters.”
Prior to the start of the traditional bathing water season, NRW officers undertake a number of pre-season checks and samples. This includes checking to ensure permit conditions for nearby discharges are being complied with.
Issues or deteriorations flagged in last year’s results are investigated by local teams to identify any sources of pollution which may be contributing to high bacteria levels found in samples.
Information about where to find designated bathing waters, and the standard of bathing water is available on NRW’s website.
Visit the Adventure Smart website for information about swimming safely in open waters.
Community
Further pleas to save Anchorage Day Centre
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A PLEA by a concerned parent to keep Pembroke Dock’s Anchorage Day Centre open was heard at a full meeting of Pembrokeshire County Council.
The Anchorage Day Care Centre in Pembroke Dock has been a “safe and happy place” for adults with learning difficulties and additional needs for decades.
In more recent years it has expanded to support elderly dementia sufferers.
But now the centre is expected to close, with services instead being offered elsewhere in the county, including Haverfordwest and Milford Haven.
A series of engagement events have taken place at The Anchorage recently, outlining the reasons and the options in continued service.
One parent, who wished to remain anonymous, said: “One young woman who attends ran out of the first meeting sobbing when she was told it was going to close. Another, at the second meeting, tried to address the meeting but was so choked up at the thought of not seeing her friends anymore she could hardly speak.”
In a submitted question heard at the May 9 meeting of Pembrokeshire County Council, concerned parent Peter Welsh asked: “Is the council aware of the huge impact the impending closure of the Anchorage Adult Day-care Centre in Pembroke Dock is already having to the health and mental wellbeing of my daughter and 20 other vulnerable adults with special needs and learning difficulties, who are unable to cope with changes to routine, or to process and understand what is happening to them?
“And would the council, therefore, please review its closure decision and retain the centre and the vital and invaluable service it provides not only to the individuals concerned but also to the parents?
“If not, what specific measures does the cabinet member have in place to support my daughter and these other individuals who need extra assistance to enable them to maintain their independence, value and allow their carers to have valuable respite from their caring responsibilities and what are the estimated costs for these substitute measures?”
Responding, Cabinet Member for Social Care & Safeguarding Cllr Tessa Hodgson said an engagement with service users, carers and families was made immediately after staff were informed about the potential closure following the council’s March budget setting.
Members were told two sessions were held with all concerned, with a list of alternative day opportunities in the county outlined, with opportunities to attend short sessions at the other centres being available so they “can fully explore which opportunity is best suited to their needs and wants”.
“All service users of the Anchorage will be offered alternative day centre arrangements in order to preserve their independence and also to support the caring needs of their families, these assessments are still taking place and are likely to continue to do so at least until the end of May.”
Cllr Hodgson said she was unable to provide estimated costs of the new arrangements until all the assessments were in place, hoping to update members at a future date.
An online e-petition, on the council’s own website has been launched calling for the Anchorage to stay open.
Health
Calls for Welsh Govt to improve both maternity and neonatal safety
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LEADING pregnancy charities have urged the Welsh Government to take stronger measures to enhance maternity and neonatal services, in order to realise the substantial changes necessary to reduce infant mortality. The Sands and Tommy’s Joint Policy Unit released a revealing report today, stating that initiatives in Wales are inadequate to instigate the vital transformation required to prevent baby deaths.
The report, titled “Saving Babies’ Lives 2024: Progress Report,” notes that strides toward diminishing stillbirths and neonatal deaths have halted in Wales, mirroring a stagnant situation across the UK. The findings suggest that with improved care, as many as 800 infant lives could have been saved throughout the UK last year. The document emphasises the urgent need for meaningful action to tackle the severe and enduring disparities in baby loss and pregnancy complications across different demographic groups.
Particularly alarming is the continuing disparity in outcomes for infants from varied ethnic backgrounds and socio-economic statuses. The report underscores that the stillbirth rate in Wales has exceeded that of any other UK nation since 2014, with minimal improvement in neonatal mortality rates over the past decade. Unlike England, which aims to halve the rates of stillbirth, neonatal death, preterm birth, maternal death, and brain injury by 2025 relative to 2010, Wales has set no similar goals.
Moreover, the report criticises the Welsh Government for the insufficient number of reviews conducted following infant deaths, which are crucial for understanding potential lessons and providing grieving parents with needed explanations.
Robert Wilson, head of the Sands and Tommy’s Joint Policy Unit, commented, “Our report unequivocally shows that the Welsh Government must establish clear targets for reducing pregnancy loss and baby deaths, and for eliminating inequalities. These targets should catalyse a thorough suite of policy measures, adequately supported by necessary funding and resources.”
The report provides specific recommendations to enhance maternity safety in Wales, including the consistent involvement of staff and patients, especially bereaved parents, in assessing the quality of maternity and neonatal services. It also calls for transparent and independently overseen reviews of individual services, and improvements in the completion rate of reviews following a baby’s death.
The Joint Policy Unit is advocating for a unified commitment across all four UK nations to eradicate inequalities in pregnancy and baby loss. Disturbingly, the 2021 data revealed that the rate of stillbirths and neonatal deaths among Black babies was almost double that of White babies, and significantly higher than the overall UK rate. This disparity was similarly stark between the most and least deprived areas in the UK.
The report also highlights that only about 2% of public and charity health research funding has been allocated to reproductive health and childbirth over the last two decades, signalling a need for increased investment in these crucial areas.
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