English: Thank you for calling me to speak on this very important report. I'm a member of the Health, Social Care and Sport Committee and I think this is one of the most important reports that we have produced. I'm sure like many others in this Chamber, on Saturday I celebrated the NHS's seventieth birthday in my constituency with a stall and a birthday card for the NHS in Whitchurch in Cardiff North. It was a fantastic experience, because people were queuing up to sign, they were so enthusiastic about the NHS, people were telling me that their lives had been saved on three occasions, and other people talked about working in the NHS for 40 years, and it was a really stimulating morning. There were so many stories of care that it was wonderful, but the whole of that time in the morning, we didn't hear any of the stories about elderly people in care homes, or elderly people cared for by the NHS, and I think that is one of the key points - that those people can't tell us their stories, which is why this report is so important. We need to speak out for them, because they can't speak out for themselves. We do need to hear patients' voices and we do need to work out what are the care needs of people who are in our care. I think that Lynne, when she was speaking, mentioned 'challenging behaviour' as a means of describing how people behave, and, again, I feel a reluctance to use that sort of way of speaking. But the important thing is to find out what are the real needs of people, the person-centred approach, and not to prescribe medicine that just effectively sedates them. We did hear some disturbing inquiries and the one that sticks in my head is the man in the care home who was constantly banging his head against a glass door. Instead of seeking a prescription for antipsychotic drugs, a carer worked out that why he was banging his head on the door was because he could see the door of a greenhouse that he wanted to go out to, because he'd been a gardener, and gardening had been his hobby all his life. He felt that this place would be a safe haven. That's an example that sticks with me in terms of how we've got to look at the person and not just take what may be an easy solution. I wanted to talk now a bit about the recommendations from the committee and the Government's response. I was going to start with recommendation 3, which is really to reinforce what the Chair said when he made his introduction, because we did recommend that there should be developed a standardised checklist tool to be used by health and social care staff to identify the cause of challenging behaviour. Quite a bit has already been said about the 'accept in principle' expression and how that is something that I hope we might move away from, but I know that, in the response, the Government says, 'developing one standardised checklist tool is not considered to be appropriate.' I cannot really understand that reason for not developing a standardised tool, because recommendation 6 is accepted, where it says that 'medicines monitoring should be a key part of care homes inspection, and that Care Inspectorate Wales mandates documented evidence'. So, I can't see why you can't have a standard tool that would be used for every care home, every setting where a person has been. It would give the staff the tools to check out every eventuality and make sure they weren't prescribing something when there was another reason for it, such as toothache, or problems with vision - you know, lots of things that are causing distress. The Chair referred to the evidence we had from Professor Sue Jordan of Swansea University college of human and health sciences, who has developed the adverse drug reaction profile tool that has actually been tested and has been shown to reduce considerably the amount of antipsychotic medicines that have actually been used. It's been peer reviewed and has been very successful. I think that there's no point in reinventing the wheel; we know that there are toolkits that have been developed, such as the one by Professor Sue Jordan, and I think that it would make absolute sense to develop this toolkit to be used as a matter of routine in every care home, in every setting where an elderly person is being looked after. So, it's a matter of routine, the work has been done, we know about Professor Sue Jordan's work and other work that was presented to us, and I think that would be a clear way ahead for the Welsh Government.
Welsh: Diolch ichi am fy ngalw i siarad am yr adroddiad pwysig iawn hwn. Rwy'n aelod o'r Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon a chredaf mai dyma un o'r adroddiadau pwysicaf a gynhyrchwyd gennym. Fel llawer o rai eraill yn y Siambr hon rwy'n siŵr, ddydd Sadwrn dathlais ben-blwydd y GIG yn 70 oed yn fy etholaeth gyda stondin a cherdyn pen-blwydd i'r y GIG yn yr Eglwys Newydd yng Ngogledd Caerdydd. Roedd yn brofiad gwych, oherwydd roedd pobl yn ciwio i'w lofnodi, roeddent mor frwdfrydig ynglŷn â'r GIG, roedd pobl yn dweud wrthyf fod eu bywydau wedi'u hachub ar dri achlysur a siaradodd pobl eraill am weithio yn y GIG ers 40 mlynedd, ac roedd yn fore calonogol iawn mewn gwirionedd. Roedd cymaint o straeon am ofal gwych, ond drwy'r holl amser hwnnw yn ystod y bore, ni chlywsom unrhyw hanesion am bobl oedrannus mewn cartrefi gofal, neu bobl hŷn yn cael gofal gan y GIG, a chredaf mai dyna un o'r pwyntiau allweddol - na all y bobl hynny ddweud eu straeon wrthym, a dyna pam y mae'r adroddiad hwn mor bwysig. Mae angen inni siarad ar eu rhan gan na allant siarad drostynt eu hunain. Mae angen inni glywed lleisiau cleifion ac mae angen inni ganfod beth yw anghenion gofal y bobl sydd yn ein gofal. Credaf fod Lynne, pan oedd hi'n siarad, wedi crybwyll 'ymddygiad heriol' fel ffordd o ddisgrifio'r ffordd y mae pobl yn ymddwyn, ac unwaith eto, rwy'n teimlo'n amharod i ddefnyddio siarad o'r fath. Ond y peth pwysig yw darganfod beth yw gwir anghenion pobl, y dull sy'n canolbwyntio ar yr unigolyn, a pheidio â rhagnodi meddyginiaeth sy'n gwneud dim ond eu tawelu i bob pwrpas. Clywsom rai ymholiadau a oedd yn peri pryder a'r un sy'n aros yn fy meddwl yw'r dyn yn y cartref gofal a oedd yn gyson yn taro ei ben yn erbyn drws gwydr. Yn hytrach na gofyn am bresgripsiwn ar gyfer cyffuriau gwrthseicotig, darganfu gofalwr ei fod yn taro ei ben ar y drws oherwydd ei fod yn gallu gweld drws tŷ gwydr y dymunai fynd allan iddo, oherwydd ei fod wedi bod yn arddwr, a garddio oedd ei hobi wedi bod ar hyd ei oes. Teimlai y byddai'r lle hwnnw'n hafan ddiogel. Dyna enghraifft sy'n aros gyda mi o ran sut y mae'n rhaid inni edrych ar yr unigolyn ac nid cymryd yr hyn a allai fod yn ddim ond ateb hawdd. Roeddwn am siarad ychydig am yr argymhellion gan y pwyllgor ac ymateb y Llywodraeth. Roeddwn yn mynd i ddechrau gydag argymhelliad 3, i atgyfnerthu'r hyn a ddywedodd y Cadeirydd yn ei gyflwyniad mewn gwirionedd, oherwydd fe wnaethom argymell y dylid datblygu offeryn rhestr wirio safonol i'w ddefnyddio gan staff iechyd a gofal cymdeithasol i nodi achos ymddygiad heriol. Mae cryn dipyn wedi'i ddweud eisoes am yr ymadrodd 'derbyn mewn egwyddor' a sut y mae hynny'n rhywbeth y gobeithiaf y gallwn symud oddi wrtho, ond gwn fod y Llywodraeth yn dweud yn ei hymateb, 'nid ydym yn ystyried bod datblygu un rhestr wirio safonol yn briodol.' Ni allaf ddeall y rheswm dros beidio â datblygu offeryn safonol, oherwydd derbyniwyd argymhelliad 6, lle mae'n dweud 'Dylai monitro meddyginiaethau fod yn rhan allweddol o arolygu cartrefi gofal, a bod Arolygiaeth Gofal Cymru yn mandadu tystiolaeth wedi'i dogfennu'. Felly, ni allaf weld pam na allwch gael offeryn safonol i'w ddefnyddio ar gyfer pob cartref gofal, pob lleoliad lle mae'r unigolyn wedi bod. Byddai'n rhoi offeryn i staff allu gwirio pob posibilrwydd a gwneud yn siŵr nad oeddent yn rhagnodi rhywbeth pan oedd rheswm arall dros yr ymddygiad, megis y ddannodd, neu broblemau gyda'u golwg - wyddoch chi, llawer o bethau sy'n peri gofid. Cyfeiriodd y Cadeirydd at y dystiolaeth a gawsom gan yr Athro Sue Jordan o goleg gwyddorau dynol ac iechyd Prifysgol Abertawe, sydd wedi datblygu'r offeryn proffil adwaith niweidiol i gyffuriau a gafodd ei brofi ac y dangoswyd ei fod yn lleihau'n sylweddol y meddyginiaethau gwrthseicotig a ddefnyddir. Cynhaliwyd adolygiad gan gymheiriaid ar yr offeryn ac mae wedi bod yn llwyddiannus iawn. Rwy'n meddwl nad oes unrhyw bwynt mewn ailddyfeisio'r olwyn; gwyddom fod yna becynnau cymorth wedi'u datblygu, megis yr un gan yr Athro Sue Jordan, a chredaf y byddai'n gwneud synnwyr perffaith i ddatblygu'r pecyn cymorth hwn i'w ddefnyddio fel mater o drefn ym mhob cartref gofal, ym mhob lleoliad lle mae unigolyn hŷn yn cael gofal. Felly, mae'n fater o drefn, mae'r gwaith wedi'i wneud, gwyddom am waith yr Athro Sue Jordan a gwaith arall a gyflwynwyd i ni, ac rwy'n meddwl y byddai honno'n ffordd amlwg ymlaen i Lywodraeth Cymru.