Agenda item

To consider the report.

1.    To accept the report, noting the observations made during the discussion.

2.    Express concern that the provision is not consistent across the Council, and emphasise the importance of providing respite to unpaid carers.

3.    Request a further report on the review of Transport Policy and the review of Day Care to enable Members to provide timely input.

 

A report was presented by the Cabinet Member for Adults, Health and Well-being, Head of Adults, Health and Well-being Department, Assistant Head – Supporting Communities, Health and Well-being and Assistant Head – Adults Services.

During the discussion, the following observations were noted:

 

It was reported that all employees within this field complied with the statutory requirements of the Social Services and Well-being Act.

 

A reminder was given that there was an expectation for employees to identify individuals' outcomes as well as the best method of providing them with care and support. It was noted that individuals' personal resources, family support, level of independence, local support networks and financial considerations were taken into account.

 

The most common day care provision was explained, clarifying that there were three provisions within Gwynedd. These were located at Llys Cadfan (Tywyn), Plas Hedd (Bangor) and Plas-y-don (Pwllheli). It was elaborated that Plas Hedd provided day care for the highest number of individuals living with dementia and with day needs, with five individuals attending for a specialist service for two days a week. It was confirmed that 10 individuals were receiving a service at Plas Hedd with two members of staff looking after them. It was reported that four individuals were receiving a day care service at Plas-y-don and three individuals at Llys Cadfan. It was acknowledged that fewer individuals were using the service in these areas, but it was felt that this was not due to transport reasons. It was pointed out that services were being provided in other residential homes that belonged to the Council but it was stated that these were carried out on an occasional basis.

 

It was confirmed that it was the families who transported these individuals to the day care provision because conditions were too profound to allow independent use of taxis, but it was noted that there were some cases where taxis were used.

 

It was emphasised that staff had not received complaints about a lack of transport and there were no noticeable changes in attendance numbers due to transport issues.

 

It was noted that the Department collaborated with the Health services on a very regular basis. It was elaborated that the Health service ran specialist day care services mainly on the Llŷn Peninsula and in south Meirionnydd on some occasions. It was elaborated that 10-15 individuals attended day care provision (up to 33 individuals per week for a service that took place on two days a week) and each individual was encouraged to make their own transport arrangements. It was explained that they were doing this because the most suitable site for provision within the areas was Bryn Beryl and hospital transport was considered to be unreliable. It was emphasised that the Health service encouraged families to provide transport or rely on social transport such as O Ddrws i Ddrws or Cymrod. It was reported that Hafod Hedd (Bryn Beryl) staff were seeing an increase in the numbers of individuals attending and were not aware of anyone not attending due to transport problems.

 

A report was provided on other services available to individuals living with dementia, which also offered respite to unpaid carers. The Dementia Actif service was preventative support that supported a number of individuals and their families. It was explained that the service was run for individuals with a wide range of needs, and it held entertaining and sociable exercise classes. It was explained that the service collaborated with several community hubs and was constantly accepting new attendees. It was noted that the service offered transport to the activities at a reasonable cost.

 

Pride was expressed in receiving the ICF budget grant from the Welsh Government which had resulted in the appointment of five Dementia Support Workers. It was explained that these workers mostly provided one-to-one specialist care in the homes of individuals with profound dementia when day care provision in a centre or residential home was not suitable for them. It was reported that they supported between five and 10 individuals each with a 9-5 service Monday to Friday. It was also added that they transported individuals to day activities in the community when suitable if no other support was available. Attention was also drawn to Eryri Co-operative, which was a similar service commissioned by the Council for individuals where it was not suitable for individuals to attend day activities.

 

Some of the barriers when considering transport to services were highlighted such as the need for the vehicles to be suitable and safe for users. It was confirmed that officers had been aware of a lack of transport for years as a minibus or taxi was not a suitable option in many cases, as well as in the case of individuals with challenging behaviour at times resulting from their condition. It was emphasised that teams noted that it was difficult to find a company willing to carry out this transportation work on behalf of the Council and the services provided by private companies, if they agreed, could be very expensive. They added that transportation vehicles needed to be modified in some cases to ensure the safe transit of individuals and therefore the family was deemed to be the most suitable method of providing transport in many cases.

 

Financial matters were considered, noting that there was a fee of £4 for day care provision, which was used to contribute to catering costs. It was explained that there was no request for a contribution to fund the care. It was elaborated that financial welfare support was provided to anyone who expressed concern through the Income and Well-being service.

 

Members were encouraged to contact the Department if they were aware of anyone wishing to attend day care services but facing transport challenges so as to ensure a solution and access to services.

 

During the discussion, the following observations were noted: 

 

The numbers of individuals living with dementia and attending a day care service were considered to be low. In response to the observation, the Assistant Head of Adults Services added that travelling to a centre for a service was no longer attractive to individuals and that many more individuals wished to receive care tailored to them in their own home.

 

In response to a query about waiting lists for the day care services, the Assistant Head of Adults Services confirmed that everyone requesting the service was currently receiving it and no one was waiting for care.

 

It was noted that unpaid carers did not receive much respite because they transported their relatives to the activities rather than receiving transport. The Cabinet Member added that the relatives of the service users were also welcome to attend the activities, sharing examples of instances where this had been very successful.

 

It was reiterated that relatives would be willing to pay more than £4 for a good standard of care for individuals with dementia and that increasing those fees should be looked into. Further, it was commented that it was necessary to ensure that individuals received the correct and appropriate benefits to ensure that they had the funds to pay for their care when a fee was due.

 

In response to the development of a Transport Policy, the Head of the Adults, Health and Well-being Department confirmed that this policy was soon to be in the pipeline. It was elaborated that the intention was to try to develop it so that the policy was in effect from April 2025 and work was ongoing to achieve that target.

 

There was reference to the challenges to provide services throughout the County, noting that distance from the services could motivate individuals and their relatives not to attend services.

 

In response to a query, the Assistant Head of Adults Services confirmed that a consultation on the day services would be prioritised but noted that there was no specific timetable to carry out this consultation at this time.

 

RESOLVED

 

1.    To accept the report, noting the observations made during the discussion.

2.    To express concern that the provision was not consistent across the County and emphasise the importance of providing respite to unpaid carers.

3.    A further report was requested on the review of Transport Policy and the review of Day Care for Members to provide timely input.