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Ceredigion expands support for hospital discharges and community care

Ceredigion County Council’s Porth Gofal (Targeted Intervention) Team is being expanded to reduce delays for residents who are ready to leave hospital but require care support.

The Council has secured £726,503 in recurring funding from the Welsh Government’s Pathways of Care Transformation Fund, which is being used to recruit additional social care staff and strengthen services that support timely hospital discharge, admission avoidance, and independent living at home.

New roles include social workers, occupational therapists, coordinators, and care assistants, some of whom will be based directly in hospital settings at Bronglais (Aberystwyth) and Glangwili (Carmarthen). These staff will help coordinate complex assessments, provide discharge planning and support, and ensure that care packages are in place for patients who are medically fit to leave hospital.

The funding is also enabling the Council to:

  • Expand Technology Enabled Care (TEC) provision, including 100 assessments commissioned through “Just Checking”.
  • Increase enablement capacity to reduce care dependency and support independence.
  • Develop the Trusted Assessor role to streamline equipment provision and low-level care packages.
  • Offer a range of incentives and retainers to maximise packages with Domiciliary Care Providers.
  • Upskill senior carers and team leaders to improve service flow and reduce delays.

Ceredigion is also investing in preventative measures, such as enhanced occupational therapy support and improved access to advice through the Penmorfa Centre for Independent Living in Aberaeron, helping reduce hospital admissions and improve outcomes for residents.

The Council’s approach promotes a joined-up framework between health and social care, with hospital-based staff facilitating early discussions, guiding families through discharge processes, and supporting complex decision-making.

Councillor Alun Williams, Council Deputy Leader and Ceredigion Cabinet Member for Through Age and Wellbeing, said: "This funding allows us to make real progress in tackling hospital discharge delays and improving community care. By embedding social care professionals within hospital teams and investing in preventative services, we’re building a more responsive and resilient system that puts people’s independence and wellbeing first."

The Pathways of Care Transformation Fund is part of an annual £30 million Welsh Government initiative to support community-based social care across Wales.

For more information on working in social care in Ceredigion, visit: Social Care | Ceredigion County Council Careers


You can find further information on how to access support here: Wellbeing and Care | Ceredigion County Council