Will the Cabinet Secretary commit to reviewing the disparities in local authority care home fees which may be contributing to poor standards of care and difficulty in staff recruitment and retention?
The statutory responsibility to meet the social care needs of local populations sits with local authorities, local health boards and NHS trusts as the commissioning authorities. They are required to agree and set fee rates that meet the outcomes that matter to people and well as ensuring public value.
To support local commissioners, the Welsh Government in 2018 commended the ‘Let’s Agree to Agree’ guidance and toolkit to support commissioners and providers with the fee setting process but since then the National Framework for Commissioning Care and Support has been developed. This came into force in September 2024 and has established national principles and standards to guide commissioning practices including fee setting and procurement activities. These national standards require that commissioners understand the costs of delivering care and set fair and sustainable fees.
The Framework also provides guidance on paying the Real Living Wage (RLW). Since 2022 Welsh Government has provided funding with the Local Government Settlement to support our commitment to pay social care workers the Real Living Wage, though ultimately it is the responsibility of the care commissioners and providers to ensure that funding is passed on to those it is intended for. We know that paying the Real Living Wage is an important factor in sustaining a reliable workforce, and we are working with local authorities to understand their intentions and challenges with implementation of the RLW through the allocated funding provided within the Local Government Settlement.
We recognise that there will be differences in fee rates across Wales and the National Framework therefore requires the need for transparency and consistency when setting fee rates and collaborative working to understand fair and sustainable costs of delivering care including factors such as geography, organisational context, land values, return on investment, care and labour market conditions and fair work policy (pay, terms and conditions and progression frameworks).
The National Framework aims to standardise the commissioning process whilst still allowing commissioners the necessary flexibility and variation in practices to meet their specific local population needs. It also recognises that the pursuit of consistent methodologies and benchmarks should not detract from local democracy and local decision-making on price determination and requires commissioners to take account of the impact of their commissioning and procurement activity on the sufficiency and the quality of care and support services and on market stability.