The evidence from this chapter highlights the considerable challenges older people have faced over recent years. There is a clear need for a different approach by partners, whereby older people are supported to live independently in their own homes for as long as possible. A lack of suitable accommodation solutions (for example, for people experiencing dementia), barriers in terms of accessing services and inadequate support for carers have all been identified as obstacles to living and ageing well.

As the number of older people in the region increases, we are seeing a rise in the prevalence of factors such as loneliness and isolation. Ongoing barriers in terms of transport remain a significant problem, along with digital exclusion (particularly during the pandemic). These challenges require a collaborative, co-productive, regional approach to improve prevention, assessment and ongoing support for older people in West Glamorgan.

To address the gaps highlighted in this Chapter, the following will need to be progressed:

• Home First Programme:
  • Development of a consistent regional D2RA model as defined and mandated by Welsh Government
  • Admission avoidance through the promotion and delivery of a range of wellbeing and prevention focussed
  • Development of a consistent regional D2RA model as defined and mandated by Welsh Government
  • Admission avoidance through the promotion and delivery of a range of wellbeing and prevention focussed services where appropriate and relevant alternative provision exists.
  • Earlier facilitation of discharge from hospital in a timely manner once an individual is clinically optimised therefore reducing acute hospital lengths of stay
  • Improved flow across the health and social care systems
  • Enhanced service user focussed outcomes and experience
  • A reduction in reported harm
  • A reduction in those needing long term care and / or support or placement.
  • Further work is required to capture the voices of those using services. Co-production and creativity will be key drivers for change, not just for organisations but also for people.
• Assistive Technology/Technology/Digital Inclusion: Building on the research, we must ensure that there is sufficient capacity continuously built in to any future delivery of services by partners that are technology based. Research is telling us not to leave anyone behind and to factor in those who are not yet digitally included.
• Community Transport: Based on research where people struggle from rural areas to access services, it is to provide easy transport to critical health and social care services if the capability doesn’t allow for a digital solution.
• Access to Services: Developing digital services for the majority will be a benefit for non-invasive treatments but the solution should not be used to replace services, but be offered as an alternative until such times as the population are comfortably using.
• Demand for Services in Welsh: There is a need to capture more intelligence on the offer of services in Welsh and actual take up.
• Community Support: Based on the population increases in the over 65s category, services must be encouraged to build in preventative services earlier on in the life journey of adults. This needs to be built on the services that the third sector currently provide and need to develop further.
• COVID-19 created increased need from people for support. This included people who had been hugely self-sufficient prior to the pandemic. But the pandemic presented practical challenges, including access to food and prescriptions and emotional challenges, particularly around mental health, social isolation and loneliness. The Third Sector has a hugely important role because they are trusted in communities. Making better use of these links means the public sector can reach more people, more effectively.
• Self-managed Care/Person-centred Care: Prevention should be the focus and more services developed in the community are needed. Data supporting these initiatives needs to include improved profiling and forecasting.
• Ageism: A move away from ageism and placing people in certain age categories.  Services should be developed and catered for around need.
• Advance and Future Care Planning: Resources need to be in place earlier in order to support individuals and their families in planning for all aspects of their care, including ‘end of life’.
• Adaptations: Smart Homes but also adaptations to existing homes to make them fit for the future for people who are living longer and getter older to encourage independence.
• Social and Community Participation: Statutory partners should encourage and support the community involvement that has seen an improvement from COVID-19. The Third Sector has to be encouraged to develop the networks and community resources to add that social value to communities and to encourage use of preventative measures to enable communities to help each other.