I'm not a member of this committee, but can I really, really thank them for this report? One of the things I like about it is it absolutely conveys a sense of urgency, at least in terms of political decision making, for a quick and relatively straightforward response to a problem that we shouldn't have. I have to say I think it uncovers a whole range of other omissions that, frankly, I find pretty shocking.

Fist of all, can I say from my family experience that the correct use of antipsychotic drugs can be very useful? When, as a result of rapidly advancing dementia, my grandmother's delusion prompted her to threaten my equally aged grandfather with a kitchen knife, you could all see why a rapid response might be necessary as an emergency measure. Even so, and I admit I'm not sure how some of these meds work, why the report is not even stronger on the periods for reviewing use—. Because three months, to me, seems an awfully long time for someone to be on this type of drug at all if they'd been prescribed to deal with an episode of acute psychosis rather than a chronic and worsening pattern. When it comes to an individual who is exhibiting a sustained pattern of behaviour, that individual already has the right to a full assessment of his or her need under the Social Services and Well-being (Wales) Act 2014, as indeed does their carer, if we're talking about at-home care.

I want to know, when it comes to recommendation 3, why we're giving anybody six months to compile a checklist. This legislation is four years old—four years during which a list could have been compiled pretty universally, allowing for differences for individuals with particular presentations, and do you know, Minister—sorry, Cabinet Secretary—I'm really bored when I come to reading responses that say, 'We will work with stakeholders.' You've had four years since the social services Act came in. Why isn't this thing in place already?

In a similar vein, regarding recommendation 5, am I really reading that Care Inspectorate Wales—or Care and Social Services Inspectorate Wales, as it was, to be fair—hasn't been challenging the monitoring of individuals' medication harder as part of looking at care homes' compliance with care plans? I don't expect them to make medical decisions, but I would expect them to inquire as to long periods of no change in medication, or sudden increases or decreases in medication, particularly if the increases involve antipsychotic or other worrying drugs, and especially when you know that these drugs are being prescribed pretty much off label. I mean, was it clear in the evidence you received—I genuinely don't know—why NICE has not signed off these drugs for the use to which they're being put frequently now? I saw what you told about the benefits being outweighed by long-term consequences in some case, but the report talks repeatedly of inappropriate use without any clarity on what constitutes 'inappropriate'. It doesn't seem to me, from the report, that off-label prescribing is inappropriate per se, so what is?

I appreciate that what you need to answer this is reliable data, and so I'm pleased to see recommendation 1. But can I suggest, however, that, alongside a collection of quantitative data from health boards, there is a complementary qualitative data collection from care homes, who see the daily effect of the continued use of these drugs on residents over a period of time? That qualitative evidence might include not just whether the challenging behaviour seems to have improved or not, but what other elements of the individual's character, interests and capacity have changed as a result of that use.

Now, another shocker for me is recommendation 10. Is it really the case, considering dementia is hardly a new phenomenon, that NICE guidelines for training care home staff in dealing with challenging residents aren't already mainstreamed into induction training for new care home workers? Now, I realise, of course, there are problems with recruitment and retention in entry-level care work. Perhaps their sense of vulnerability due to inadequate training is part of the reason why they leave. And, yes, it's fine that Social Care Wales is looking at professional development and career paths, but how have CSSIW in the past been able to give the thumbs up to homes if their staff are not trained in this essential element of dementia care?

I raised the overall inadequacy of CSSIW criteria and reporting processes with Gwenda Thomas way back in the last Assembly. Lynne Neagle today has mentioned a legacy report of the last Assembly. How many dementia strategies will we need? Why is this still an issue? Because, even with my minimum wobbly bookcases dementia training, I can understand that possible confusion, and certainly communication difficulties, can be infuriatingly frustrating for anyone. If you can't explain the excruciating discomfort—even the hallucinations—of a feverish urinary tract infection or your distress at the loss of dignity that is inevitable when another person has to help you with intimate care, yes, you're going to get challenging. So, accepting these recommendations and implementing them is an easy one for the Welsh Government, Cabinet Secretary. You were eviscerated last week, as was the rest of the Welsh Government, on the 'Mind over matter' report, and I think you're making the same mistake with this, with your responses. I say to care home managers: don't wait for the Welsh Government, get training your staff now. And, GPs, don't wait for data: ask more questions when you're being pressurised by care home owners to prescribe. Safety first, of course, but don't let kindness and understanding get poor second in this atrocious situation.