Wales feels the strain as older English people head west

Immigration is a hot topic in Wales, as it has been in many
other parts of the UK during the election campaign. But the locals
of Rhosneigr are not getting hot under the collar about asylum
seekers from Afghanistan or working migrants from Eastern
Europe.

What’s got the tongues wagging in the seaside and rural towns of
north and mid-Wales is the influx of English migrants and the
impact they are having on health and social care services.

Medical and social care professionals in areas such as Anglesey,
Gwynedd, Flintshire and Conwy say the increasing number of English
people moving there to retire is already putting domiciliary,
occupational therapy and nursing home services under pressure.
Combined with an ageing indigenous population, they fear the
situation, unless addressed in the long term, could create a
timebomb the public sector will struggle to cope with.

Despite a lack of hard figures, the issue is being taken so
seriously by some councils and local health boards that they are
carrying out research to establish how many people are moving into
their areas, what their likely health and care needs will be in the
future and how this will change the services they provide.

The beautiful coastline, quaint seaside towns and mountains of
north Wales have attracted tourists for many years. But increasing
home ownership and affluence over the past 20 years have seen an
influx of older people from England moving to their favourite
holiday spots to enjoy their retirement. The majority put their
equity into buying retirement flats or places in private care
homes, which in turn attracts others – both people and developers –
to the area.

Alan Smith, project manager for Conwy Council’s residential homes
review, says there are currently two large developments being built
at Colwyn Bay.

“The last one sold out before it was started. There will be a local
market but the suspicion is that maybe half or more are bought by
people outside the area. We want to do research on this,” he
says.

Nearly a quarter of Conwy’s population is retired, one of the
highest figures in Wales, and this is set to rise to 28 per cent by
2020. Smith says the population is growing by 3,000 a year, with
most of these people aged 50 to 65.

“There is a real trend happening here. It is the 50 to 65-year-olds
who are buying these flats: there is a real inward migration of
that age group,” he adds.

Gareth Llwyd, principal planning officer at Anglesey Council social
services, says the perception had been that it was mainly people
from north west England moving into the area. But now they are
coming from further afield and he says the impact on services is
beginning to be felt.

“Most people coming through the continuing care panel going into
residential and nursing homes are 85 plus, and of those a high
proportion are English-speaking newcomers. A couple might move here
when they are 65, perhaps one of them dies, and by the time the
other is 80 they are becoming more dependent on health and social
care services because they have no family support,” Llwyd
adds.

He says some of these people move into private nursing and
residential homes, of which there has been a large rise since the
early 1990s, but increasingly people are staying in their own homes
longer.

“This has huge implications for our domiciliary care services as we
have problems with recruitment and retention of staff,” says Llwyd.
“Our in-house provision and residential nursing homes and private
domiciliary care agencies are struggling for staff. Traditionally
we’ve had a home care workforce of 300 but we now need 400 in order
to meet the demand.”

Llwyd says that other older people need social services’ help after
moving to the area to live with their children’s families. Anglesey
estimates that by 2016, there will be a 75 per cent increase in the
population aged over 85.

The council also provides day care and lunch clubs for older people
in the area and the influx of English-speakers has made a
difference to the way these services are delivered.

“A lot of these services would have catered for the native Welsh
speaking population but with the influx of [English] people we now
have to cater for the linguistic needs of all the people using
them. For example, all our domiciliary carers are bi-lingual,” says
Llwyd.

Flintshire, in the north west of Wales is also seeing a rise in
older people moving to the area. And the pressure is showing on its
occupational therapy service where the wait for home adaptations,
after assessment of need, is now 18 months.

Lin Hawtin, service and purchase manager for older people’s
services at Flintshire Council, says: “The issue for us is that we
have a lot of people who come into Flintshire and buy their own
properties and as their health deteriorates they need their homes
adapted and that’s where the pressure point is.”

Smith says if the numbers of older people moving into areas like
Conwy and Flintshire carry on growing, then developers should
design flats that can be adapted easily to the person’s needs as
they get older.

“Unless these buildings are set up for people aged 75 plus they
will be unsustainable in the long term and not suitable for older
people. If we don’t do this in a strategic way then it may become a
real problem and put extra pressure on us,” Smith adds.

He says one way around it would be to have a better mix of
supported housing options for older people who do not need
residential care but who can’t – or don’t want to live supported at
home. But this would mean investment on a grand scale.

Hawtin warns that initiatives by the Welsh assembly and by
Westminster, such as fast-tracking people out of hospital care into
the community, are adding to the pressures. “The health performance
targets on delayed transfers of care mean that things that had been
done slowly in hospital are suddenly being done in a care setting.
We have three hospital trusts in Wales and England that refer to
us. We’ve had some one-off money in the past year but there’s very
little we can do with that. There is no new money for capital build
or changing facilities,” she says.

Gwynedd, in the north east of the country, has also seen an
increase in private care homes catering for an influx of people
with learning difficulties and mental health problems placed by
English primary care trusts and social services departments.

“It causes some strain for mental health and primary care services,
and GPs prescribe more [as a result],” a Gwynedd Local Health Board
officer says.

Gwynedd Council says the homes and clients “don’t necessarily” put
it under more pressure but admitted applying the new Protection of
Vulnerable Adults requirements to the homes is stretching staffing
resources.

AGEING ANGLESEY

  • 22 per cent of the population is of retirement age. 
  • 2.3 per cent are aged 85 and over.
  • 50 people per 1,000 of the over 65 population are supported in
    care or nursing homes (compared with the Wales average of
    45.5). 
  • 2,730 people received support from the council’s social
    services department in 2003.
  • 60 per cent of the over-85s living on the island were in
    receipt of this service.

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