Part of the debate – in the Senedd at 5:41 pm on 10 October 2017.
I thank you very much for those questions and begin by also recognising your comments particularly on the enthusiasm and commitment of the people who are working on the front line in health and social care—I’ve seen that for myself when I’ve visited many of the ICF projects that are taking place across Wales. I’d certainly, as always, encourage Members to go and visit the projects to be inspired by the kind of innovative working and sheer enthusiasm that people have working on the ground through the ICF.
Also, you said about the importance of prioritising the individual, and that’s exactly what the Social Services and Well-being (Wales) Act 2014 sets out to do, in the sense that it puts the individual at the heart of the decisions that are made about them. It’s about personal outcomes, having that ‘what matters’ conversation with them to understand what it is that the individual would like to achieve, and understanding that they are equal experts alongside the professionals—they’re the experts in their lives, so they should be treated as equal experts in those conversations.
You also made the point that the cohesion of health and social services is absolutely crucial, and I couldn’t agree with you more. You gave a very distressing case as an example of just why it’s so important that we do have cohesion between health and social services. Again, this is something that the integrated care fund seeks to deliver. For example, in Cwm Taf, they’ve spent £1 million to develop a Stay Well @home service. That’s operated seven days a week, 365 days a year, and it consists of a multidisciplinary team based at the hospital, in the Royal Glamorgan and Prince Charles hospitals. They undertake initial assessments of individuals and commission or provide health, social care and third sector community support to facilitate the safe and timely return home of people and prevent unnecessary admission in the first place, so making sure that people do have that wide package of support around them, taking in health, social care and the third sector to ensure that there is a package to allow people to stay home.
You also talked about the importance of people not having to give their story many times, because that can be distressing and there’s absolutely no need for it in a time when we have such access to technology and so on. That, actually, is one of the things that they’re using in the Stay Well @home service in Cwm Taf. We’ve also invested £2 million of the ICF this year specifically in the Welsh community care information system, and that’s gone live between health and social services in Powys, in the first instance, so they have access to the same kind of information. I was happy to launch that particular initiative fairly recently, and had the opportunity to talk to staff, who said what a difference it makes to be able to access the information about the individual on the same level between health and social services. It’s gone live also in local authorities in Bridgend, Anglesey, Gwynedd, the Vale of Glamorgan, Ceredigion and Torfaen. Powys is the only area where it’s fully integrated at the moment, but we are moving towards that, and have provided £6.7 million of capital funding, actually, for the initial set-up and costs for an all-Wales licence—just demonstrating the priority that we are putting on that particular initiative.
I’m not sure I recognise the figures that you quoted on detox in terms of them being up-to-date figures, because they have certainly decreased again since the figures that you quoted to us. The total now is 7 per cent down on the same period last year, and in common with all the totals, actually, in the current year, it’s lower than any of the totals reported in the previous two years for the same months. So we are certainly making good progress, and this is at a time when individuals’ needs are escalating, as we have an ageing population, and so on. So this is certainly an area where we’re making very good progress.
One of the things that interested me when I first came into post in terms of delayed transfers of care was the fact that, actually, a large number of the delays are down to an individual’s choice. So, not being able to access their first-choice care home, for example. Lots and lots of the delays are down to that, which is why the Regulation and Inspection of Social Care (Wales) Act 2016 is so important in terms of driving up standards right across the sector so that people don’t have such a difficult choice to make when they’re weighing up the choices between two different care homes. Actually, we want to have a care home sector where all of the care homes are attractive to the individual, so there won’t be such reticence in terms of making those difficult choices as well.