English: 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.
Welsh: Nawr, wrth ymweld â'r cartrefi hyn, gwelais angerdd staff ynghylch gofalu am eu cleifion a'u preswylwyr, ac roeddwn yn falch o wrando ar sut y maent hwy - y bobl sy'n gweithio yn y sector - yn meddwl y gallem wneud mwy i ofalu am gartrefi gofal. Daw hyn â mi at y ffordd gyntaf y gallem hyrwyddo cartrefi gofal: cyfathrebu. Mae dementia yn gyflwr sy'n effeithio ar allu ieithyddol, felly gall peidio â darparu gofal drwy gyfrwng y Gymraeg arwain at rwystredigaeth a cholli urddas a pharch. Rwyf wedi cyfarfod â staff Cymraeg eu hiaith mewn cartrefi gofal, ond mae Comisiynydd y Gymraeg a Chymdeithas Alzheimer Cymru wedi tynnu sylw at y ffaith nad yw gofal ar gael yn Gymraeg bob amser oni bai fod rhywun yn gofyn amdano. Ni all hyn fod yn iawn, felly hoffwn eich gweld chi, fel y Dirprwy Weinidog, yn rhoi mwy o gynlluniau ar waith i gynorthwyo cartrefi i ddatblygu gallu i wneud cynnig rhagweithiol o ofal yn Gymraeg - drwy gyfrwng y Gymraeg. At hynny, mae gwir angen edrych ar wella cyfathrebu rhwng cartrefi gofal a byrddau iechyd ac awdurdodau lleol. Er enghraifft, dylem edrych ar ddigideiddio cofnodion cleifion. Mae'n wir fod gennych system wybodaeth gofal cymunedol Cymru, ac rwy'n derbyn y gallai gweithredu'r system TGCh newydd ar draws awdurdodau lleol a byrddau iechyd helpu i sicrhau gwybodaeth hygyrch, ond beth am gartrefi gofal? Eglurodd un rheolwr wrthyf y byddent yn elwa'n fawr o allu cael gwybodaeth am eu cleientiaid oddi ar system y bwrdd iechyd - yr un cleientiaid ag y maent yn gofalu amdanynt yn ddyddiol - er mwyn diwallu eu holl anghenion, gan gynnwys eu hanghenion iechyd. Nid Llywodraeth Cymru sy'n goruchwylio cynnwys platfformau rhyngrwyd y byrddau iechyd, ond mae ganddi'r gallu i osod lefel gliriach o ddisgwyliadau. Gallai hyn olygu bod cartrefi gofal yn cael gafael ar wybodaeth yn haws mewn gwirionedd, gan arwain at wella'u gofal. Ffordd arall o gryfhau'r cysylltedd rhwng iechyd a gofal cymdeithasol yw drwy weithredu ar alwadau gan Age Cymru am ddyletswydd i gydweithredu yn hyn o beth. Rwy'n cytuno â'r sefydliad, ac yn credu y gallai dyletswydd fynd gryn dipyn o'r ffordd tuag at hybu ansawdd gofal i bobl sy'n cael eu trosglwyddo o gartref gofal i leoliad ysbyty ac fel arall. Cefais fy syfrdanu mewn gwirionedd o weld y gall cleifion adael eu cartref gofal am fod rhaid iddynt fynd i'r ysbyty, a bod angen llawer mwy o ofal arnynt wedi iddynt ddychwelyd. Mae'r angen am ddeialog gryfach yn amlwg wrth ystyried digwyddiadau fel staff cartrefi gofal nad ydynt yn cael gwybod pa drefniadau adsefydlu a roddwyd i'w preswylwyr yn yr ysbyty, cleifion sy'n cael eu rhyddhau i gartrefi gofal heb unrhyw wybodaeth o gwbl, a staff cartrefi gofal na ofynnir iddynt am wybodaeth bwysig, megis sut y mae unigolyn yn nodi eu hangen am doiled ac a ydynt yn hoffi yfed o gwpan penodol, gan gyfrannu at sefyllfa lle mae rhai cleifion yn dychwelyd i gartrefi o'r ysbyty mewn cyflwr llawer gwaeth na phan aethant yno. Clywais - wyddoch chi, peth syml fel dannedd gosod yn mynd ar goll yn yr ysbyty. Felly, mae cleifion yn dychwelyd i gartref gofal heb eu dannedd gosod - rhywbeth mor syml ac angen mor sylfaenol, ond mor bwysig, fel y nododd Angela Burns yma yn gynharach ar ofal iechyd deintyddol. Mae gan staff cartrefi gofal gyfoeth o wybodaeth a allai drawsnewid gofal rhai cleifion yn yr ysbyty. Fodd bynnag, fel y dywedodd Age Cymru, mae ffiniau proffesiynol presennol yn milwrio yn erbyn ymwneud staff cartrefi gofal, a hyd yn oed yn erbyn rhoi gwybod iddynt ar lefel sylfaenol iawn sut mae eu preswylydd tra bydd y preswylydd yn yr ysbyty. Mae yna doriad - pan aiff preswylydd i'r ysbyty, ychydig iawn o ddeialog sy'n parhau wedyn gyda'r cartref gofal. Cyfrifoldeb y cartref gofal yw cysylltu â'r ysbyty. Ni all hynny fod yn iawn. Mae'n rhaid i hyn newid a rhoddwyd camau ar waith i sicrhau bod GIG Cymru yn cydnabod gwerth y cyfraniad y gall staff cartrefi gofal ei wneud, a chymaint y maent yn malio am eu preswylwyr eu hunain. Mae wal o'r fath wedi bod yn destun pryder o ran hyfforddi staff hefyd, sy'n dod â mi at ffordd arall y gallem wneud mwy i gefnogi cartrefi gofal. Mae ar Gymru angen tua 20,000 yn fwy o bobl i weithio ym maes gofal erbyn 2030. Nawr, rwy'n sylweddoli eich bod wedi cydnabod hyn, ac nid yw ond yn deg fy mod yn cydnabod y gwaith sy'n cael ei wneud i ddenu, cadw a recriwtio staff yng Nghymru fel rhan o ymgyrch Gofalwn Cymru. Fodd bynnag, gellid cyflawni mwy drwy edrych ar yr hyfforddiant a ddarperir i staff nyrsio. Mae sefydliadau wedi sôn wrthyf am yr angen i sicrhau bod hyfforddiant nyrsys yn cynnwys profiad yn y GIG ac yn y sector gofal cymdeithasol. Cafwyd y rhaniad hwn rhwng y ddau ers gormod o amser; mae angen eu dwyn ynghyd. Er enghraifft, dylem annog lleoliadau nyrsio mewn cartrefi gofal, gan y gallai hynny helpu i fynd i'r afael â diffyg croesbeillio rhwng sgiliau nyrsio a sgiliau gofalu. Mae pobl yn tybio na all nyrs ond hyfforddi mewn ysbyty. Nid yw'n wir. Gallent ddysgu llawer o sgiliau drwy hyfforddi mewn cartrefi gofal mewn gwirionedd. Hefyd, ni allwch wadu nad oes llawer y gellir ei ddysgu mewn cartrefi gofal, gan fod llawer ohonynt yn fwrlwm o weithgaredd. Yn wir, mae ganddynt botensial i fod yn ganolfannau cymunedol pwysicach fyth. Rwyf eisoes wedi cael cadarnhad ysgrifenedig fod byrddau iechyd yn cael trefnu clinigau galw i mewn mewn lleoliad heblaw lleoliadau'r GIG, a'u bod yn gwybod bod rhai cartrefi'n awyddus i agor y rhain i'r gymuned leol lle y gallant wneud hynny, megis cynnal clinigau therapi mewnwythiennol, clinigau profion gwaed. Mae'r syniad hwn yn sicr yn werth ei ystyried. Gallai cydweithrediad o'r fath sicrhau gwerth am arian, yn enwedig i'r defnyddiwr gwasanaeth lle byddai'n rhaid iddynt deithio gryn dipyn yn bellach fel arall nag i gartref i weld nyrs. Mae gweithwyr proffesiynol cartrefi gofal wedi'u hyfforddi'n dda, a lle mae ewyllys i wneud hynny, dylai fod yn rhan o genhadaeth Llywodraeth Cymru i sicrhau bod ffordd i gartrefi gynnal y clinigau hyn a gwneud tasgau y mae eu staff yn fwy na chymwys i'w gwneud. Er enghraifft, mae'n chwerthinllyd fod rhai aelodau o staff cartrefi gofal wedi gorfod aros am oriau i feddyg teulu fesur tymheredd a phwysedd gwaed, ac mae'n dorcalonnus fod rhai cartrefi'n gorfod aros yn hir pan fydd rhywun yn cwympo. Dylem i gyd gefnogi staff i wneud darlleniadau o'r fath, gan edrych ar uwchraddio modelau sydd wedi'u profi megis pecyn cymorth I-Stumble gwasanaeth ambiwlans Cymru ar gyfer cartrefi gofal. Mae synnwyr cyffredin yn dweud y byddai cynyddu'r ymyriadau clinigol sydd ar gael mewn cartrefi yn lleihau'r angen i anfon cleifion i'r ysbyty yn y lle cyntaf, neu'r angen i alw am ambiwlans neu feddyg teulu, felly dylai Llywodraeth Cymru fwrw ymlaen â hyn. Daw hyn â mi at fy awgrym olaf ynglŷn â sut y gallem wneud mwy dros gartrefi gofal. Gwn am gartref lle mae'r awdurdod lleol yn talu i breswylydd gael aros yno, ac o ganlyniad i ddirywiad yn eu hiechyd, bydd y ffioedd yn cael eu talu yn awr gan Fwrdd Iechyd Prifysgol Betsi Cadwaladr. Mae'n frawychus deall y bydd llai o arian yn cael ei dalu i'r cartref er y bydd yn darparu gofal mwy dwys. Mewn gwirionedd, mae'r bwrdd iechyd yn talu llai nag y mae awdurdodau lleol yn ei dalu yng ngogledd Cymru, gan osod un cartref gofal ar y trywydd i fod £155,000 yn waeth eu byd yn eu cyllideb eleni, oherwydd y gwahaniaeth rhwng ffioedd awdurdodau lleol a ffïoedd gofal iechyd parhaus. Mae'n amlwg fod yn rhaid i chi geisio sicrhau y telir cost wirioneddol y gofal i gartrefi gofal, ac yn bendant, dylech geisio sicrhau o leiaf fod y ffi gofal iechyd parhaus yn cyfateb i'r ffi a delir gan awdurdodau lleol. Yn ddiamau, dylid ystyried hwn yn ateb tymor byr, oherwydd credaf fod angen adolygiad llawn o'r modd y cyllidir cartrefi gofal, ac mae ei angen yn awr. Serch hynny, byddai camau o'r fath tuag at ariannu cynaliadwy a theg yn hwb i gartrefi'r sector preifat sy'n teimlo fel pe baent yn cael eu cosbi dro ar ôl tro. Ddirprwy Weinidog, mae'n bryd inni ddechrau dangos ein gofal tuag at gartrefi gofal a rhoi camau ar waith, camau fel y rhai a amlinellais heddiw, i ddangos ein bod o ddifrif, a bwriad Llywodraeth Cymru i helpu i sicrhau dyfodol cadarnhaol i gartrefi mwy na 15,000 o bobl yng Nghymru. Diolch.