1. Will the Minister make a statement on the importance of home adaptations as a way of helping older people to live more healthily and independently? OQ56408

Diolch, Llywydd. Forgive me, I missed the question there. I wonder if Rhun would mind repeating it. My internet cut out.

It is the question on the order paper, but Rhun—

Okay. Apologies, my internet completely cut out as you called my name, so I didn't quite catch it. 

Okay. Are you able to take it from the order paper, or do you want Rhun to—?

Absolutely, as long as I didn't miss anything else I'm more than happy to do that. 

No, he didn't stray away from the order paper. I wouldn't have allowed him to do that. 

Diolch, Llywydd. Yes, indeed, then, the pandemic has served to highlight the vital role that home adaptations, large and small, play in helping people to maintain their dignity and independence and live safely in their own home. Despite the challenges, these services have continued throughout the pandemic.

Thank you very much for that response. I will make the point that it's not only older people who can benefit from home adaptations. I applaud the Motor Neurone Disease Association for the campaign that they're running at the moment pushing for more home adaptations for people living with that condition. But looking at older people particularly, we know that older people falling is very expensive to the NHS—it costs over £2 billion to the NHS across the UK. We know that home adaptations can reduce injuries by as much as 26 per cent. Now, given that people have been spending more time at home during the pandemic, can the Minister tell us what the situation is in terms of a backlog in terms of home adaptations as a result of the pandemic, and what does the Government intend to do to tackle this, because of the help that adaptations can provide in terms of living independently and healthily?

Yes, thank you very much, Rhun. You're absolutely right, adaptations absolutely do facilitate stopping hospital admissions in the first place and they also facilitate hospital discharge and support the discharge to recover and access pathways, freeing up hospital beds and avoiding the need for step-down placements in residential care. They obviously just help people have a happier and healthier life in their own home, so we're very keen to continue the good work that's been going on. The rapid response adaptations take around nine days, on average, to deliver. 

You're right, though, that in the beginning part of the pandemic, we did have a fall-off in the rate of adaptations. Even though we were clear that adaptations could continue throughout the pandemic as one of the essential works that have always been allowed, people were understandably more reluctant to let people into their homes and so on, particularly in the first stages of the pandemic. But I'm really delighted to be able to say that work has picked up significantly in the second half of the year, and current levels of activity are similar to previous years, so there isn't much of a backlog and the average response times are pretty much back to normal now. And as I say, for the rapid response ones, they are an average of nine days to deliver; medium adaptations like stairlifts and so on are an average of four months; and the largest adaptations like extensions and so on are an average of nine months.

Minister, thank you for that response. In my colleague Nick Ramsay's short debate on motor neurone disease last week, you were talking about the 40 weeks for large-scale home adaptations, and of course, it's not just for people with MND. With COVID, having listened to Long Covid Wales's evidence this morning in the health and social care committee, it's pretty obvious that there are going to be some cases there; people who've had road traffic accidents, survived sepsis, been in intensive care; very often there are serious things that require their homes to be adapted. Forty weeks is an incredibly long time. I had one particular farmer who broke his back on the farm and because he lived in a listed house, they just simply weren't even allowed to put a steel rod in to be able to have a hoist that would have allowed him to live at home. And you talked earlier just now about just allowing people to live healthier, happier lives at home; well, actually, for some people, that's where they want to be and we're all about giving choice.

So, will you look at seeing how we might be able to liaise with the planning department in these very rare instances where people need those adaptations to be able to have a way through the entire planning system? Because the alternative if you cannot get those plans through, if you cannot build that extension, if you cannot put that hoist in and the structure that's needed for it, is that those people will have to leave their home and either go into state care or the whole family have to sell up and try and find somewhere else to live. That's a shocking disruption, and I would have thought in our society we could have said, 'Actually, occasionally people are allowed an exception to the normal rules and regulations.' I just think we should be able to put a plan in place and I'd like your thoughts on that.

Yes, thank you, Angela Burns. I wasn't aware of that particular instance, but I'm more than happy to have a look at the procedures, particular for houses that are listed; there's obviously an added complexity there. In terms of the bigger adaptations and planning in general, we do have a pathway for that, and care and repair agencies are very familiar with working with planning departments. But I'm very happy to look at any individual instances you've got where that isn't working. It may be that there's a particular planning department, or there are particular instances. I'm happy to look at that if you want to let me know specifics.

But in general, we do work with planning departments to make sure that the average times are around nine months. And 40 weeks is a very long time, you're absolutely right, but obviously, sometimes they're building a whole extension and so on, so they're very, very big adaptations. The smaller adaptations—as I say, stairlifts and so on—are around four months and the rapid response ones are around nine days. I'm happy to say at this point that, just today, I've issued a written statement because we've been able to agree the removal of the means test, which I did mention during my response to Nick Ramsay on motor neurone disease. So, I'm happy to say that we've done that as well, and that will speed up some of the adaptation response times as well.

Minister, I wonder if you'd join me in paying tribute to the work that's been done through the pandemic with some brilliant local organisations like Bridgend County Care and Repair. Despite the constraints and restrictions of the pandemic, they carried on trying to do those adaptations throughout my area. But, also, would she agree with me that this is more than that, as well? It's about things like the Cwm Taf Stay Well at Home service that we funded several years ago through the integrated care fund, bringing together Rhondda Cynon Taf, Merthyr and Cwm Taf University Health Board with a service that brings together social workers, therapists, physiotherapists, therapy technicians, in order that people, rather than going into hospital and staying in hospital, can be rapidly discharged and then live at home and recuperate at home, where they want to be. So, I just ask, Minister, will you recognise the amazing work that's gone on through this pandemic, even with the additional constraints that they've faced, and just join me in thanking them for what they've been doing?

Absolutely, Huw Irranca-Davies, I would very much like to join with you in thanking everyone who, despite all the challenges you've outlined, have worked to ensure that those who need them continue to get the adaptations they need to live safely, avoid hospital admission and make a timely return home. You know as well as I do that the Princess of Wales, Royal Glamorgan and Prince Charles hospitals all participate in the Hospital to a Healthier Home scheme, in partnership with Bridgend and Cwm Taf care and repair agencies. I'd just like to tell you that, in the 10 months to the end of January, 739 patients received an adaptation that assisted their safe discharge, saving over 4,500 bed days. Eighty-six of those patients were helped to access additional benefits as well, with an annual value of around £420,000, so you're absolutely right, the working together of the various agencies has resulted not only in safer, quicker discharges, but additional income and support for people who need that support to be able to live a happy, healthy life at home.