Now, when visiting these homes, I have seen the passion that staff have for looking after their patients and residents, and have been pleased to listen how they—the people working in the sector—think we could do more to care for care homes. This brings me to the first way through which we could champion care homes: communication. Dementia is a condition that affects linguistic ability, so not providing care through the medium of Welsh can lead to frustration and the loss of dignity and respect. 

I have met Welsh language staff in care homes, but the Welsh Language Commissioner and Alzheimer’s Society Cymru have highlighted that care is not often available in Welsh unless someone requests it. This cannot be right, so I would like to see you, as the Deputy Minister, putting more plans into implementation to support homes to develop a capacity to make an active offer of care in Welsh—through the medium of Welsh.  

Additionally, there is a serious need to look at improving care home communication with health boards and local authorities. For example, we should look at the digitalisation of patient records. It is true that you have the Welsh community care information system, and I accept that implementing the new ICT system across local authorities and health boards could help accessibility to information, but what about care homes? 

It was explained to me by one manager that they would benefit greatly from being able to access information on the health board’s system about their clients—the very same clients that they are caring for on a daily basis—wanting to meet all their needs, including their health needs. The Welsh Government does not have oversight of the content of health boards’ internet platforms, but it does have the ability to set a clearer level of expectation. This could actually result in care homes more easily accessing information, which could improve their care.

Another way through which connectivity between health and social care could be strengthened is by acting on calls by Age Cymru for a duty to co-operate in this. I agree with the organisation, and believe that a duty could go a long way in boosting quality of care for people being transferred from care home to hospital setting and vice versa. I was actually quite shocked to realise that patients can leave their care home needing to go to hospital, but actually return needing significantly more care.

The need for a stronger dialogue is apparent when considering incidents such as care home staff not being told what rehabilitation their residents have had in hospital, patients being discharged to care homes with no information at all, and care home staff not being asked for important information, such as how an individual signals their need for the toilet and whether they like drinking from a particular cup, contributing to the situation in which some patients return to homes from hospital unrecognisable from when they went in. I've heard—you know, a simple thing like false teeth going missing in hospital. So, patients return to a care home without their false teeth—something so simple and such a basic requirement, but so important, has been highlighted by Angela Burns here earlier on dental healthcare.

Care home staff have a wealth of information that could transform the care of some patients in hospital. However, as Age Cymru have stated, existing professional boundaries militate against the engagement of care home staff, and even against informing them at a very basic level of how their resident is whilst the resident is in hospital. There's a cut-off—once the resident goes to hospital, there is very little dialogue continued then with the care home. The onus is on the care home to contact the hospital. That can't be right. This has to change and steps taken to ensure that the Welsh NHS recognises the value of the contribution care home staff can make, and how much they care about their own residents.

Such a wall has been a point of concern with regard to staff training too, which brings me to another way through which we could do more to support care homes. Wales needs around 20,000 more people to work in care by 2030. Now, I recognise that you've recognised this, and it is only fair that I acknowledge the work that is being undertaken to attract, retain and recruit staff in Wales as part of the We Care Wales campaign. However, more could be achieved by looking at the training that is provided to nursing staff. Organisations have spoken to me of the need to ensure that nurse training includes experiences in both the NHS and social care sector. Too long there's been this division between the two; it needs bringing together.

For example, we should encourage nursing placements in care homes, as this could help address the lack of cross-pollination between nursing and care skills. People assume that a nurse can only train in a hospital. It's not correct. They could learn a lot of skills actually training in care homes. Also, you cannot deny that there is much that can be learnt at care homes, as many are a hive of activity. In fact, they have the potential to be even more important community hubs.

I have already had it confirmed to me in writing that health boards are allowed to organise walk-in clinics in a non-NHS setting, and know that some homes are keen to open these up to the local community where they can, such as holding intravenous therapy clinics, blood testing clinics. This idea is certainly worthy of consideration. Such co-operation could represent value for money, especially for the service user where they would otherwise have to travel considerably further than a home to see a nurse. Care homes' professionals are well trained, and, where there is a will, it should be the Welsh Government’s mission to ensure that there is a way for homes to host these clinics and undertake tasks its staff are more than capable of doing.

For example, it is ridiculous that some care home staff have had to wait hours for a GP to attend to take blood pressure and temperature readings, and it is disheartening that some homes face a long wait when someone falls. We should all be supporting staff to take readings, looking at upscaling proven models such as the Welsh ambulance service's I-Stumble toolkit for care homes. Common sense dictates that an increase in clinical interventions available in homes would reduce the need to send patients to hospital in the first place, or the need to call an ambulance or GP, so the Welsh Government should get on with it.  

This brings me to my final suggestion as to how we could do more for care homes. I know of a home with a resident funded by a local authority, who, as a result of a deterioration in health, will now have responsibility for fees transferred to Betsi Cadwaladr University Health Board. Shockingly, despite providing more intensive care, the home will be paid less. In fact, the health board pays less than local authorities pay in north Wales, setting one care home on course to be £155,000 worse off this year in their budget, because of the difference between local authority and continuing healthcare fees.

Clearly, you must look at ensuring that care homes are paid the actual cost of the care, and certainly at least look to match the CHC fee to that paid by local authorities. Undoubtedly, this should be regarded as a short-term solution, as I believe that a full review of how care homes are funded is required, and it is required now. Nonetheless, such a move towards sustainable and fair funding would be a boost to private sector homes that feel as if they are being repeatedly punished. It is time, Deputy Minister, that we start to show our care for our care homes and that we take some actions, just as some of those that I have outlined today, to show our seriousness, the Welsh Government's intent, about helping to secure a positive future for the homes of over 15,000 people in Wales. Thank you.