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Hywel Dda: Working together for care home residents

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Health and social care partners and Independent Care Home Providers in West Wales are working together to ensure people with COVID-19 are treated with dignity and respect and involved as much as possible in decisions about their care and treatment whether they are in a hospital or care home.

Care homes are a central and essential part of frontline services in West Wales, in particular by ensuring and supporting the health and wellbeing of the most vulnerable of the population. Many of our care settings are facing significant challenges and supporting care staff in these settings has never been more important. We recognise that this is a time of great anxiety for families of residents and the care homes who provide such outstanding care throughout this unprecedented time.

Hywel Dda University Health Board and County Councils in Carmarthenshire, Ceredigion and Pembrokeshire are working together to support care homes and deliver the best possible care to vulnerable people in a timely and appropriate way.

This means a wide range of key workers from doctors, nurses, health care support workers, carers, assistants, cleaners, transport workers, managers and volunteers are all playing their part in planning, advising and providing the care older people need, taking account of their wishes.

Across our communities, we are seeing examples of exemplar working from clinicians supporting and providing direct care in the care home setting. This can involve hospital clinicians collaborating with GPs and community teams and also the transfer of residents into hospital when needed. Technology is also being utilised in many care homes so that they can maintain contact with District Nurses and GPs in a timely manner.

Jill Paterson, Director of Primary, Community and Long Term Care, said: “We are working really hard as a whole Health and Care Community, with the shared goal of providing the best care for residents of Care Homes , preventing further spread of the disease, and protecting the safety of care givers.”

Dr Sion James, Deputy Medical Director at Hywel Dda, added: “General Practice and Community teams across the Health Board are offering continuing and increased support to patients in our care homes.  We are working as a team across Health and Social care to provide care for this important vulnerable groups.  GP Practices are contacting care homes on a daily basis to ensure that residents are getting the care they need.”

Jake Morgan, Statutory Director of Social Services in Carmarthenshire said: “This is an extraordinarily challenging time for our care workforce who are on the front line dealing with this pandemic. Over the last few weeks we have been able to offer our care homes additional financial support, advice and protective equipment to support them in carrying out their critical role. We will continue to do all we can to support care staff doing a remarkable job in these challenging times.”

Eifion Evans, Chief Executive of Ceredigion County Council, added: “We are working very closely with our Health Board colleagues in ensuring we maintain the required services to our most vulnerable in a safe and timely manner throughout this period. We also thank and acknowledge our heartfelt gratitude to each and every one supporting the health and social care sector in Ceredigion.”

Geriatrician and Consultant Physician at Prince Philip Hospital, Llanelli Dr Andy Haden, has recently had experience of working closely with a Llanelli care home where a number of residents were affected by COVID-19.

He explained: “In the past few weeks I have been working closely with a care home affected by the disease, as it can be serious in that setting. Myself, Palliative Care consultants and Specialist and General Nurses and Local Authority staff have been supporting people in the Home.

“What has been really important is an individualised approach where we do the right thing for the person affected, and we ask them what their wishes are, of if they cannot speak for themselves, seek help from family or carers. For some people that will mean ensuring they come into the hospital and for others it will be support at the end of their life in their home environment where they are comfortable and cared for with compassion and dignity.”

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Health board provides assurance to local residents following Llanelli lockdown restrictions

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Following the introduction of temporary lockdown measures in the Llanelli area the health board is moving to reassure local communities that they can still access hospital and community healthcare services, including urgent care.

The health board is continuing to focus on providing these essential services and patients should access Prince Philip Hospital if they have an urgent care need or a scheduled clinic appointment.

Planned operations continue to be prioritised based on clinical urgency (including patients with cancer and other urgent care needs) and people should attend these if they have a confirmed admission date.

These measures apply to people with appointments at Prince Philip Hospital (regardless of where you live), and for people living in the Llanelli restricted zone. Arrangements are also continuing with access to primary care services – please phone your doctor’s surgery, dentist or optometrist to find out more and follow instructions at your community pharmacist.

All GP practices and a number of community pharmacies are continuing to offer the flu jab by appointment – again please check arrangements with these providers locally and make sure you keep your appointment if you’ve been offered one.  If you do not have an appointment arranged and you are in one of the “at risk” categories, please contact your GP Practice to check on the arrangements for this year.

Visiting continues to be restricted at all Hywel Dda University Health Board hospitals and these must be pre-planned and agreed with the sister/charge nurse. 

The exceptions to this arrangement are:
One parent/guardian at a time to visit their child
For birthing mothers – only one birthing partner
Patients considered to be at the end of life or receiving palliative care. 

We have also introduced local exemptions to this where you can visit if you are supporting someone with a mental health issue such as dementia, a learning disability or autism, where not being present would cause the patient to become distressed. 

In all cases we are urging patients to continue to follow infection prevention and control guidance, as well as use of face coverings and maintaining social distance.  Further information and updates about local lockdowns can be found on the Welsh Government’s website here.

Mandy Rayani, Director of Nursing, Quality and Patient Experience at Hywel Dda, said: “It’s really important that people living in areas affected by the new lockdowns know that they can still access services in the same way as they have been able to for the last few months.

“At the same time, it’s also important that people choose the right healthcare service for their need so that our hospitals can manage the extra demand that we always face at this time of the year.

“We will continue to prioritise urgent and emergency care, including planned operations based on clinical urgency, and I’d also like to remind people that arrangements are in place at a local level for community services such as GPs, pharmacies, optometrists and dentists.

“If you do need to attend a healthcare setting please remember to follow guidance on hand hygiene, face coverings and social distancing and please contact the senior sister or charge nurse if you want to find out about visiting relatives in hospital.

“Remember, COVID-19 is a serious disease which is sadly having real and tragic consequences for many people and families. We will endeavour to do all that we can to keep our communities safe and we’d like to thank the public for their patience and understanding as we continue to work through these new arrangements.”

Remember – if you or any member of your household develop symptoms of COVID-19 it is important that you self-isolate and do NOT attend any appointments or visit our sites.

If you have symptoms (raised temperature, new persistent cough OR loss or change of smell or taste) please book a test as soon as possible. You can do this via the UK Portal here

Any Llanelli residents having problems booking a test can contact us on 0300 333 2222 or via covidenquiries.hdd@wales.nhs.uk
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Police appeal for witnesses after 20-year-old pedestrian tragically killed on A40

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DYFED-POWYS POLICE is appealing for witnesses to a fatal road traffic collision on the A40 west of Carmarthen on Saturday (Sept 26) in which a 20-year-old man, a pedestrian, lost his life.

The police have asked The Pembrokeshire Herald to publicise this appeal.

A spokesman for the police told this newspaper: “At around 9.40pm, a white VW Transporter was in collision with a pedestrian on the A40 westbound, near the junction of Llangynog, Carmarthen.

“The pedestrian, a 20-year-old male, died as a result of his injuries.

“It appears the pedestrian had left his vehicle, a black Seat, following a single-vehicle collision further along the westbound carriageway shortly before.

The police have asked that if anyone has any information on either or both collisions, or may have been travelling along the A40 at the relevant time, please contact the serious collision investigation unit, quoting reference DPP-20200926-339.

This can be done by email: contactcentre@dyfed-powys.pnn.police.uk, by phone on 101 or by text: If you are deaf, hard of hearing, or speech impaired text the non-emergency number on 07811 311 908.

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Llanelli becomes a Covid-19 ‘health protection zone’

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RESIDENTS in a large part of Llanelli are being put under new local restrictions in a ‘health protection zone’ following a rapid increase in Covid-19 cases in the area.

The town is seeing a concentrated spread of cases compared with other parts of Carmarthenshire – in the last seven days, 85 positive cases have been identified in Llanelli (151.6 per 100,000 of the population) compared to 24 cases in the rest of Carmarthenshire (18.1 per 100,000 of the population).*

Public Health Wales officials are expecting numbers to continue rising over the coming week.

Carmarthenshire County Council and Hywel Dda University Health Board have worked with the Welsh Government and Public Health Wales to agree the temporary restrictions at sub-county level to try and halt the spread of the virus.

As of 6pm on Saturday September 26, 2020, residents living in defined parts of Llanelli will not be able to visit anyone else’s home, or accept visitors into their home, unless they have a ‘reasonable excuse’ such as providing care for a vulnerable person.

They should not arrange to meet indoors with anyone who they don’t live with, and travel in and out of the ‘health protection zone’ will also be limited – people should not leave the area or travel into the area unless it is essential. Travelling in and out of the zone for a holiday is not considered a reasonable excuse.

People are being asked to wear face coverings anywhere where they cannot maintain a two-metre distance from other people, including collecting children from school, in addition to the rules which already require them to wear a face covering in indoor spaces like shops and on public transport.

All indoor and outdoor visits to residential care homes have also been suspended.

Students may still travel into and out of the ‘health protection zone’ to go to school or college.

People living in the defined area of Llanelli must work from home, and employers must take all reasonable steps to support staff to do so.

Indoor public spaces such as leisure centres should only be used by people living in the defined area.

Shops will remain open, but people living outside the defined area of Llanelli should avoid travelling to visit them and shop in their own locality wherever possible.

The specific wards covered in the defined area of Llanelli are:

  • Bigyn
  • Bynea
  • Dafen
  • Elli
  • Felinfoel
  • Glanymor
  • Hendy
  • Hengoed
  • Llangennech
  • Lliedi
  • Llwynhendy
  • Tyisha
  • Swiss Valley

Although the pattern of increased positive cases is overwhelmingly concentrated in the Llanelli area where the restrictions have been strengthened, the whole of Carmarthenshire has now been put on alert, with a warning that the tighter restrictions may be extended if cases continue to spread.

Everyone – including those in the defined areas of Llanelli – is being urged to follow the national guidance around social distancing, good hygiene, self-isolation, testing and face coverings.

Leader of Carmarthenshire County Council, Cllr Emlyn Dole, said: “It is worrying to see how sharply the number of positive cases has risen in the Llanelli area, and action has had to be taken to help stop the spread and break the chain of infections concentrated in this area to prevent a whole county lockdown.

“We must all do the right thing, follow the advice and protect each other. In parts of Llanelli, we’re asking people and businesses to make even greater sacrifices – we fully appreciate the impact this will have, but there is no other way. We must stop the spread.”

A mobile testing unit has been set up in Llanelli to manage the increased demand by local residents who have any of the Covid-19 symptoms – either a high temperature, a change or loss to taste or smell or a new continuous cough.

Reporting of positive cases in the town is fully expected to rise during the next two weeks with the increase in more targeted testing. But this is a positive indicator that cases are being identified and control measures put in place.

Chair of Hywel Dda University Health Board Maria Battle said: “Our local community has given us such tremendous support during the past few months. To protect the health of our people, including the most vulnerable, and to ensure our NHS resources are available to provide people with the care they need; we need the help of our Llanelli population and wider community now more than ever before. Whilst hospital admissions have not yet increased again for COVID cases, we have seen a sharp rise in positive cases in the community, and in time this is likely to have an impact on hospital admissions. The very best way we can support each other and those we love, is to follow local restrictions, minimise our contacts, practice good hygiene and self-isolate and book a test if we have any COVID-19 symptoms.”

Increased testing capacity for residents in Llanelli is available by appointment at the following locations:

  • Parc y Scarlets Car Park B, accessed via Trostre Retail Park, in Llanelli
  • The Ty’r Nant site (next to KFC), Trostre, Llanelli
  • The Carmarthen showground (signposted in both directions off the A40)

There should be no reason for Llanelli residents to travel excessive distances for a test, as there will be tests available in Llanelli and Carmarthen. Tests should be booked via the UK Portal. Any Llanelli residents experiencing difficulty booking a test locally via the UK portal can instead email covidenquiries.hdd@wales.nhs.uk or by calling 0300 333 2222.

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