Agenda item

Cabinet Member: Councillor Dilwyn Morgan

To consider the update on new developments in Gwynedd to support individuals with dementia

DECISION

To accept the report, noting the observations made during the meeting

The report was submitted by Cllr Dilwyn Morgan, Cabinet Member for Adults, Health and Well-being. He highlighted that the main purpose of the report was to outline the new developments in Gwynedd to support individuals who had dementia.

The Senior Manager of Adults Services added that the County's vision was to support individuals living with dementia in order to enable them to live at home as independently as possible for as long as possible with the need to ensure the correct, timely care provision and support, in the right place to meet a range of needs.  She explained that the role of Gwynedd Dementia Coordinator was recently created in order to lead in the field within the Council by working with individuals who had been affected by dementia, the Health Board and the Third Sector. The coordinator would be responsible for creating a vision and strategy for Dementia Gwynedd to respond to the care standards pathway. This was a temporary post funded from the Regional Integrated Fund (RIF).

Reference was made to the next steps, reporting that the Service was dependent on temporary funding to support a great number of the developments in care provision for individuals with dementia. The challenge would be to secure long-term funding to ensure the sustainability and continued development of these services. Work would be done to predict the impact of demand on budgets over the next few years and difficult decisions would need to be made in terms of reprioritising resources if no additional budget was available.

Gratitude was expressed for the report.

During the discussion, the following observations were submitted by members:

·       The development of Penyberth Care Home, Penrhos, was welcomed, a direction the Council wished to follow and which steered the direction of care in the future and the transformation of the service.

·       That the Gwynedd Dementia Actif Service was doing exceptional work that had been recognised across Wales - congratulations to the team.

·       That involving the family in care assessments was essential to dementia support.

·       That people must be kept in their communities.

In response to the observations and questions from members, it was noted:

·       In response to a comment that there was no specialist nursing provision available for individuals living in the Llŷn and Meirionnydd areas and the suggestion that adequate provision should be demanded through influence, it was noted that it had not been possible for Local Authorities to provide nursing care but that the Council was now intervening more in the market as gaps in services appeared in the areas.  It was noted that some elements of the provision could be resolved but that  neither the Health Board nor independent companies were compelled to provide a dementia specialist nursing care service in all parts of the County - however, business decisions could be encouraged and influenced.  Despite appreciating the work that was being done, the need must be responded to and therefore the Council was considering the efficiency of providing a service rather than buying in a service (in some situations). It was noted that there was a need to ensure equal provision across the County - possibilities would be considered for the Penyberth site in the future.

·       That Llys Cadfan Tywyn offered 33 beds with 15 being specialist dementia beds - nevertheless, some individuals were seen being moved from their locality (as far as Pwllheli or Bangor) to receive suitable care.  It was noted that staffing in the field of care was challenging and therefore staff were put to the best use to maintain a service in the most effective way. It was accepted that moving out of a locality created anxiety and that the aim was to remain in the community. It was explained that dementia residential care was being provided at Llys Cadfan. If the needs of individuals intensified and required specialist nursing care, then unfortunately there was no suitable provision available locally.

·       Following the Health Board's decision to temporarily close Dyfi Ward at Tywyn Hospital due to a shortage of staff, and to use beds at Dolgellau Hospital to safeguard patients, it was stated that the situation was not acceptable. Concern was expressed that Llys Cadfan would lose the support and expertise of the Hospital, but it was confirmed that the residents of Llys Cadfan were supported and cared for by community nurses, in accordance with the need. The service's effective response, within a very short time, to the decision to close Dyfi ward was appreciated.

·       That the service was aware of the shortage of doctors in the Tywyn area and that discussions had been held with the Health Board.  It was noted that a doctor from Dolgellau took care of Tywyn hospital patients but that no arrangement existed for doctors from Dolgellau to support residents in the homes. It was added that further discussions needed to be held with the Health Board regarding the development and provision of services in the area in the future.

·       That money for the dementia support workers scheme was delivered through specific funding programmes - some of which were regional allocations where bids would be submitted for a proportion of the money. It was explained that many elements of the service were now dependent on these financial sources and although dementia was a core service, there was no permanent fixed budget for it.  This was dependent on the national system.
In response to a comment that temporary funding leads to temporary appointments and that this was a reason for some choosing not to apply for jobs as they were not permanent, it was accepted that this was a problem but that there was enthusiasm among those who wanted to work in this specific field (although not true for all fields of work). It was added that there had to be strategic working, bearing in mind that the number of young people was decreasing while the number of people over the age of 85 was increasing significantly. We must therefore respond by considering preventive work, using effective technology and promoting direct payments in our Communities.

·       In terms of the recruitment and retention of staff in the care field and the need for the development at Penyberth to be successful, it was noted that workforce planning was an elementary part of the development.

                 RESOLVED

To accept the report, noting the observations made during the meeting.