Thank you, Deputy Presiding Officer. I do actually want to thank the committee for the work that they have undertaken in producing this report on antipsychotic medication in care homes. I recognise the tone of the debate and the disappointment that some Members expressed, but I do actually think that there is a large amount of agreement on the priority of action that is required to be undertaken on this. Actually, the 'accept in principle' is not a malign attempt to try and avoid recommendations or to explain why nothing will happen. It's actually because of some of the detail and how we want to work that through. We don't exactly agree on all the wording, but we do actually accept and understand the direction of travel the committee want to take in the recommendations. I have something more to say at the conclusion on how I want to actually be able to take that work forward and provide more information to the committee about what we are doing, but I don't think that's going to be possible in the time available in today's debate.

But the committee's findings did provide additional confirmation that our focus does need to be on the provision of person-centred care, and how we use non-pharmacological responses before considering a pharmacological one. And that has to be appropriate—appropriate prescribing in all instances. There is a clear focus on that in the dementia action plan that I launched back in February—again, a plan that was designed and delivered, working with people who are living with dementia themselves, their carers, as well as providers. So, it really has had buy-in from people across the dementia community about what matters to them.

The Government has agreed, or agreed in principle, 10 of the 11 recommendations, and it is about how we take those forward. Of course, I do recognise that the committee understand that there are steps that we are already taking to improve the availability of data, which is a key point that has come up in a number of contributions, in relation to prescribing antipsychotic medication amongst older people. We do acknowledge honestly in our response that there are limitations at present in our data collection, particularly in how you can attribute prescriptions to residents in care homes. The potential over-prescribing of antipsychotic medication is a concern, regardless of whether it is an individual who is resident in a care home, because, indeed, reducing rates of prescribing among older people in general would have a positive impact on the use of these medicines among care home residents too. I just want to reiterate the point about the fact that we will take seriously what we are proposing to do. So, just in relation to recommendation 1, the expert group that I said that I will be setting up, I expect that to report to me with advice before the end of the calendar year—so, not kicked off into two or three years' time to try and avoid dealing with the issue, but within this calendar year, to have advice and to update Members on action that we expect to be taken as a result of it.

A number of the recommendations made by the committee are about the availability and reporting of prescribing data. There is, of course, more to be done, and so we've accepted a range of those recommendations. I have, of course, considered again recommendation 11, and I have moved the response to 'accept' rather than 'accept in principle'. So, I have asked officials to convene a group of those relevant experts to examine the usefulness of various data sources. There is something there about—. The point of that is to help us reduce inappropriate prescribing of antipsychotic medication.

The committee also refers to the importance of ensuring that comprehensive, person-centred assessments are undertaken to enable the provision of generally person-centred care and support. That, of course, is a key focus of the dementia action plan—not just a plan, but a plan that is backed by £10 million of additional investment from this year to support delivery. Many of the dementia action plan points are consistent with the committee's recommendations, which should be no surprise—for instance, the reference to the need to enable people who work with those living with dementia to have the skills to feel confidence and competent in caring for, and supporting, those living with dementia.

So, within our response, we reaffirm our commitment to the roll-out of the 'Good work: A Dementia Learning and Development Framework for Wales' within care home settings. That framework does provide guidance on the training and principles for challenging behaviour, and I do recognise the description that Lynne Neagle has provided. It is about understanding what is behind that behaviour rather than simply saying that you just need to deal with it in the way that we recognise it is, on a far too common basis, dealt with, with inappropriate prescribing of medication. So, there's no disagreement about that. It's about understanding that behavioural distress and having alternative strategies for staff, whether they are health and care professionals with a professional qualification or, indeed, other staff working within the care home. The point about training is well understood as well.

I am pleased, though, to see a focus in the report on the use of allied health professionals, including speech and language therapists. So, allied health professionals, we recognise, make a critical contribution to enabling people to live well with their dementia. Those professions identify and address possible causes of behaviour that is described as 'challenging', including the unmet physical, cognitive, emotional and communication needs and how we provide interventions to reduce the level of stress and anxiety and indeed the frustration that we recognise often accompanies this. That's why, in terms of having the right number of allied healthcare professionals, the next stage of our 'Train. Work. Live.' campaign is going to be extended to include allied health professionals.

With the dementia action plan, we're working with partners to develop multidisciplinary teams around the individual to help provide person-centred and co-ordinated care, support and treatment. We recognise the need to ensure that there are good links between care homes and community services with the teams around the individual. The all-Wales dementia allied health practitioner consultant post, when recruited, will have a remit to work with care homes, health boards and local authorities to evidence and promote best practice from allied health professionals across our whole health and social care system.

I do want to try and address the recommendation that was rejected, on developing

'a method for assessing the appropriate skills mix...for care home staff' and to provide guidance to ensure safe and appropriate staffing levels. The aim of the recommendation isn't something that I oppose, but it is about that I think we've got the right frameworks in place through the Regulation and Inspection of Social Care (Wales) Act 2016 and the Nurse Staffing Levels (Wales) Act 2016. Now, I've written to the committee with more detail on the work that we have done and are doing, and that includes the work led by Bangor University, and their work concluded that there is no single evidence-based tool that will identify the numbers and types of staff to be employed in the care home sector, but the Chief Nursing Officer for Wales is commissioning further work to set guidance and support commissioners for placements within the sector. That will learn from the work to date already on implementation of the nurse staffing Act and the NHS national collaborative commissioning unit.

Now, there's something here about understanding the work we're already doing and understanding what we will do to actually make fit for purpose the legislative framework we already have and deliver a real and practical difference. But I accept that, of course, the committee and Members will want to come back and see if that is happening in practice. So, we'll monitor our progress on the recommendations alongside the dementia action plan. We've set up a dementia oversight of the implementation and impact group, and that will involve people who have been affected by dementia in their membership; they're actively involved in monitoring our success or otherwise, and they've already met for the first time in June. So, it won't simply be about the Government assessing its own action.

I do recognise and agree with the committee that inappropriate prescribing—and that includes not regularly reviewing prescribing—is a real cause of harm. There's no lack of concern or an approach from this Government that dismisses those concerns or is complacent about the need for improvement. And I will consider again the points made by Members in this debate in a number of areas that we have accepted in principle, and I will write again to outline the action we are taking to try and deliver on the purpose of the recommendation the committee has made, because we are looking in good faith at how we meet shared objectives, even though we don't agree on all of the detail. And I will of course update Members on the progress made in dealing with the recommendations and the timescales for action and future action in implementing the dementia action plan.