An organisation that represents care providers in Wales has dramatically quit a group set up to discuss fees.
The decision by Care Forum Wales (CFW) to resign from the North Wales Care Fees Group comes amid claims that the region’s councils are “deprioritising care” even though they have been given more money by the Welsh Government to pay for it.
In response local authorities said the rates were set based on inflation, sector costs, the allocation from Welsh Government and consideration for council tax bills for local ratepayers.
The group includes representatives of each of the six local authorities in North Wales, the Health Board and Mary Wimbury, the chief executive of CFW.
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A recent investigation by CFW revealed that the fees paid by local authorities in the North are up to £11,000 a year less per person than those on offer from one local authority in South Wales.
They say the issue was brought into sharp focus when Torfaen Council announced big increases in their rates – 17 per cent for residential care and 25 per cent for nursing care.
The increases at North Wales councils ranged from 4 per cent to 14 per cent depending the authority and type of care. UK inflation is currently just over 6 per cent.
It means that a 50-bed care home in Torfaen will receive £546,000 a year more for providing residential EMI care than a similar sized home in Anglesey, Wrexham and Flintshire for exactly the same levels of care.
In the cases of Denbighshire and Gwynedd, it equates to an extra £494,000 a year and £444,600 more than a home in Conwy.
The fees paid in Torfaen are also well above the rates paid for care in Swansea, Pembrokeshire and Neath Port Talbot.
According to Ms Wimbury, the group’s work on setting fees was “completely disregarded” despite council leaders and chief executives emphasising the need for higher pay rates for staff.
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The North Wales leadership board of council leaders and chief executives had recognised that social care was underfunded and had written to the Welsh Government to raise the issue.
In the resignation letter to the North Wales Care Fees Group, Ms Wimbury said: “However, it appears all North Wales local authorities are currently deprioritising care in their own spending, with fee increases in general not coming close to matching what the sector needs to meet inflationary pressures.
“We are continually told that is all local authorities can afford yet we see percentage increases in fees significantly lower than the increase those same local authorities are seeing in in their Welsh Government settlement – it would therefore seem clear that this is because other areas for spend are being prioritised.
“For some years now there seems to have been a significant disparity between fees paid in North Wales and those in South East Wales in particular and this is starkly highlighted by Torfaen, who have undertaken a detailed exercise this year to understand providers true costs which have led to increases of between 17 and 25%.”
They said all fee increases in North Wales were between 6.21% and 7.4% despite local authorities receiving a settlement of between 8.8 and 9.5% from Welsh Government. The group said it meant that the fees paid to privately-run care homes were still well below the rates paid by other counties
Around two thirds of all care providers costs related to staffing and one of the main problems was that the formula being used by councils to calculate fees was not allocating sufficient staffing hours.
Ms Wimbury added: “Given the complete disregard so far in setting this year’s fees of the work undertaken by the North Wales Care Fees Group to start to rectify the issues in current fees we can see no point in continuing to participate, particularly when such participation is used by local authorities to legitimise the fees set.
“The group has not conducted any meaningful engagement since November and, despite the impression given in some local authority’s fee notifications, did not take a final decision on the formula for this year.
“We feel instead the group has been disregarded and its existence used to limit local discussion and engagement with providers and obfuscate the decision making process.
“We will therefore be withdrawing from the Group unless or until there is an absolute assurance from those in leadership positions across North Wales that our concerns will be taken seriously.
“We are aware that an increasing number of providers are also voting with their feet and setting their own fee rates to match their actual costs.
“We would remind local authorities that for the rate they set to be legal, it must be possible to generally source care in their area for that cost.”
CFW chair Mario Kreft said: "The main problem at the moment is that we have an unjust postcode lottery of fees as a result of having 22 local authorities and seven health boards often doing their own thing, creating a totally dysfunctional system.
“The public have a right to know why people are worth so much more in some parts of Wales than they are in North Wales.
“I fully support the words of the First Minister when he spoke about the fragility of the social sector even before the pandemic began. What Torfaen has done is about sustainability for the future and they have shown the way forward to the rest of the councils and health boards who commission services.
“In the meantime, we were seeing care homes and nursing homes closing across Wales even before the Covid-19 pandemic and sadly, yet predictably, we are now seeing even more closures. It is hard to see how many care providers can continue in business with fees at this level and they really represent an insult not just to the staff but also to many of the 20,000 care home residents across Wales.”
What councils said:
Conwy council: "We have acted in accordance with the North Wales regional approach with regards to fees set for Residential and Nursing Homes for 2022/23.
"Every year a Regional Fees Group reviews the fee setting methodology based on inflation and other increases in costs. We then determine provider fees by taking into account the financial settlement from Welsh Government and the need to keep other essential services operating effectively.
"We continue to work with care providers, including those who indicate that fees are not sufficient, and we look at exceptions to the fee model based on individual circumstances where necessary.
An Anglesey County Council spokesperson said, “We have worked with other authorities and to identify a procedure for setting fees. The recommended percentage is consistent with the procedure and this year’s increase will be between 6.84% and 12% depending on the nature of the care. We recognize that the recent period has been extremely challenging and we remain committed to working with the care sector.”
Wrexham council said: "Wrexham Council has acted in accordance with the North Wales regional approach with regards to fees set for Residential and Nursing Homes for 2022/23. Where providers indicate that these fees are not sufficient we remain happy to meet with them to consider their individual costs, and consider whether exceptions to the fee model should be made given their individual circumstances.
"The fee model provides a basis for setting our fees and these principles are set alongside the resources allocated to us from Welsh Government and setting a council tax that is reasonable in the current climate. We are of the view that this is a reasonable and appropriate basis.”
A spokesperson for Denbighshire County Council said: “The Council appreciates the work of independent sector care home providers and their staff and this has been heightened by their work undertaken throughout the pandemic.
“The Council takes a number of factors into account in determining what it pays providers, including the need to keep other essential services operating effectively, while taking account of the financial settlement from Welsh Government and the level of Council Tax.
“Every year a Regional Fees Group reviews the fee setting methodology, taking account of inflation and other increases in costs.
“It is then up to each individual Local Authority, as well as the Local Health Board, to consider the results in setting their fees.
“Denbighshire County Council has acted in accordance with the North Wales regional approach with regards to fees set for Residential and Nursing Homes for 2022/23 and continues to work closely with care providers.
“This includes meeting with providers who indicate fees are not sufficient, working with them to consider their costs and looking at exceptions to the fee model where necessary.”
