North Wales MS Mark Isherwood has this afternoon expressed concern regarding the Welsh Government’s response to a report on Care Home Commissioning and called on Ministers to ensure that the voices of service users are heard in moving Care Home Commissioning for Older People forward.
A Debate took place in the Senedd today on the Public Accounts and Public Administration Committee (PAPAC)’s report on Care Home Commissioning, which was published on 1 September 2022 and made several key recommendations with the aim of making the system equitable for all.
As Chair of PAPAC, Mr Isherwood, expressed concern that “while the Welsh Government has accepted most of our recommendations, its response appears to raise questions about their understanding of some of the issues, despite these being spelled out in existing Welsh law and guidance”.
He added:
“It is therefore concerning that the response is indicative of the slow pace of policy reform in these areas and, specifically, the implementation of the Social Services and Well-being (Wales) Act 2014.
“We recommended that the Welsh Government should consider the voices of service users when considering policy reform in this area, where the lived experiences of residents is essential evidence as part of any reform process.
“Unfortunately, the narrative accompanying the acceptance falls some way short of the Committee’s recommendation and the provisions of the Social Services and Well-being (Wales) Act 2014 itself, which mandates a co-productive approach whereby ‘individuals and their families must be able to participate fully in the process of determining and meeting their identified care and support needs through a process that is accessible to them’. This is in contrast with the consultative approach described in the Welsh Government’s response. Genuine co-production of public services with users and communities is not about consultation with stakeholders after a policy has been developed.”
Mr Isherwood said the Committee is disappointed the Welsh Government has chosen to reject three recommendations, in particular on top-up fees.
He said:
“We were deeply concerned about the nature of these fees and the way they are communicated to service users.
“The Committee heard evidence about how top-up fees were being misapplied to service users, meaning that our most vulnerable citizens were faced with costs for basic services.
“We strongly disagree with applying top-up fees for accessing basic services and rights, and concluded that more should be done to tighten the rules around these top-up fees, along with a new independent redress system to allow decisions to be challenged.
“Unfortunately, the Welsh Government chose to reject these recommendations, stating that clear guidelines are in place, as part of the Continuing Healthcare Framework, prohibiting top-up fees for basic services. However, the Committee has been told by sector experts that these damaging practices continue to occur. The Welsh Government’s guidance on this matter is not working and is unclear for service users and providers.”
He added:
“The Committee urges the Welsh Government, in the strongest terms, to urgently review this matter and, as part of that review, to work with users and the organisations who represent them, such as Care Forum Wales, Age Cymru and the Older People’s Commissioner, amongst others, to develop a new approach to top-up fees that works for the social care sector and, more importantly, its users.”
Mr Isherwood highlighted that the Welsh Government also rejected the Committee’s proposal about mandatory information sharing across the care home sector, with a particular focus on service user experience and satisfaction.
He concluded:
“The Committee will continue to pursue these issues with the Welsh Government.”
ENDS