Thank you very much, Madam Principal Deputy Speaker. I welcome the opportunity to contribute to the debate. I thank the mover of the motion and the mover of the amendment.

I understand the frustration that many have expressed regarding the pace of reform in our social care system since 'Power to People' was published in 2017. I take this moment to emphasise that progress has been made, particularly in the context of significant external pressures and challenges that have impacted on the pace of reform.

Since the publication of the report, there has been sustained commitment to transforming our social care system. Several initiatives to address the systemic issues identified in the 'Power to People' report have moved forward. First, my predecessor, Robin Swann, consulted on proposals to deliver the vision outlined in 'Power to People'. The public consultation took place during 2022. It set out proposals to address the issues facing social care and to put in place tangible actions to create change that would significantly improve services. The post-consultation report was published last year. That consultation was by no means the end point; rather, it represented the groundwork necessary to ensure that the reform process was both sustainable and transformative in the longer term.

As Members have noted, one of the most significant developments since that consultation has been the establishment of the social care collaborative forum. The forum has provided a vital space to bring together a wide range of stakeholders, including front-line staff, care providers, policymakers, union representatives, regulators, representative bodies and service users. The forum's aim is to develop short-term solutions to alleviate immediate pressures and longer-term strategies for sustainable reform. Through that collaborative effort, key policy development priorities have been identified, and work is under way to address some of the most pressing challenges.

One of the first actions taken forward by the forum was to map the reform of adult social care consultation proposals against the forum work streams to ensure that, where we can, the reforms are delivered. Some of them will be delivered more quickly than others. Some will require legislative change. The vast majority will require additional and sustained investment to ensure that they make the transformational changes envisaged by the 'Power to People' report.

Through the work of the forum in 2023-24, we have implemented early review teams in the trusts, with a view to developing a regional model to monitor and review service users' home care needs and packages of home care, with almost 1,100 home care hours being recovered and allocated to cases of unmet need. We have also implemented improved digital solutions in trusts to more effectively manage the change in home care packages. We have sought to better promote social care as a valuable career choice by delivering the Making a Difference promotional campaign to showcase the value and diversity of social care, which includes the podcast series, 'Care to chat?', video stories showcasing the value of social care and digital posts about social care. Work in 2024-25 will focus on building a sustainable workforce, on improving commissioning and contracting arrangements and on developing improved partnership working.

One of the critical recommendations in 'Power to People' was the urgent need to address the social care workforce crisis, and significant steps have been taken to prioritise that. Although we continue to experience challenges, the sector has been prioritised for funding in recent years. The development of the social care workforce strategy also marks a considerable achievement by laying the foundations for addressing recruitment and retention issues in the sector. The strategy is central to resolving many of the workforce challenges that we face. It sets out a clear path to attract, train and retain the skilled staff necessary to deliver high-quality social care. The strategy focuses not just on immediate recruitment but on long-term development, offering a framework that recognises the importance of ongoing development and career progression for social care staff. Those measures are crucial, given the critical role that the workforce plays in delivering front-line care and in supporting those in need across the health and social care spectrum.

Some Members have said that not enough is being done on delivery and that we continue to consult rather than implement. The implementation of the workforce strategy will commence by the beginning of next year, and I am confident that the strategy will address many of the concerns that Members have raised about recruitment, retention, recognition and, indeed, remuneration. Additionally, initiatives to improve staff well-being and to ensure fair pay are ongoing, and those initiatives will undoubtedly have a positive impact on addressing staff shortages over time.

Work is ongoing through the social care fair work forum to build a case for change that seeks to highlight the potential impacts and benefits to be realised by raising wages in the social care sector to a real living wage. Although significant challenges remain, the collaborative work involving the Department of Health, the social care collaborative forum and workforce representatives has been instrumental in bringing us closer to a more sustainable workforce model. The forum's supporting carers work stream is currently commissioning a regional evaluation of the outcomes of the implementation of the Caring for Carers strategy from 2006. Work is due to begin shortly, and, on completion, my officials will identify relevant learning and key findings to inform the future strategic direction.

Cross-departmental work is also ongoing to consider how we can work collaboratively across government to address the issues identified in 'A New Deal for unpaid carers in Northern Ireland' from 2023. The current 'Care Standards for Nursing Homes' and the 'Residential Care Homes Minimum Standards' documents set out the requirements for registration and inspection of providers by the Regulation and Quality Improvement Authority (RQIA) to ensure that there is a consistency of approach and that residents, families and providers have a clear understanding of the standards that they can expect to receive or provide. People living in nursing homes have specific and sometimes complex needs, which usually arise from their own healthcare requirements. It is therefore important that the standards reflect the most recent developments, guidance, policy and procedures in order to ensure the provision of a safe and effective service with the appropriate quality of care.

I accept that the standards need a comprehensive review to ensure that they are fully reflective of best practice, learning and guidance and that they are relevant to the current environment in which the care sector operates. A working group, chaired by my officials, has been established to undertake a review of those standards. That review will involve ongoing collaboration and engagement with relevant social care stakeholders to ensure that there is clarity between what is considered to be best practice and what will be measured under the inspection frameworks. An initial exercise has been completed to identify potential gaps and revisions that may be necessary. My officials are considering next steps to revise the standards. Those revised standards will require consultation, and Members will have the opportunity to consider them in due course.

Members have also raised the issue of VAT recovery, and, as I have said previously, significant work is under way to consider the nature of that change, any potential operational, legal and regulatory implications and associated resources that may be required to allow for the recovery of VAT by independent care homes in Northern Ireland. A project manager and dedicated legal resources have now been appointed to drive that work forward as part of the wider review of the care homes contract. Legal colleagues have advised that it is not going to be possible to separate the issues of VAT reclamation from the wider review of the contract. Concerns have also been raised about the potential impact on smaller care homes, which may not be in a position to reclaim VAT, and that is being considered as part of the review. Officials also continue to liaise with counterparts in Great Britain, at departmental and local authority level, to gain a better understanding of the implementation and outworking of the VAT reclamation. It is paramount that any changes to the contractual arrangements between trusts and providers be reflected in the HSC care homes contract. The current HSC care homes contract that sets out the terms and conditions under which trusts commission services from care home providers has been in place for several years now and requires substantial revision.

As we move forward, I remain committed to tackling health inequalities and ensuring that social care reform remains a priority. By addressing these iniquities, we can build a system that not only provides high-quality care but does so in a way that is fair and equitable, ensuring that all individuals, regardless of their circumstances, have access to the services that they need when they need them.

My Department annually reviews the regional tariff rate for residents placed in residential care and in nursing home care, and the regional tariff rate is compiled on the basis of a breakdown of the costs of care. The amount that the rates are uplifted by each year takes account of increases to statutory uplifts to the national living wage and a range of other factors. It is important to note that, separate to establishing the regional tariff rate, independent care providers are responsible for setting their own care home fees. Top-up fees, also known as third-party charges, are set by the independent care home providers at a level that they deem to be appropriate to reflect market prices. Neither my Department nor the health and social care trusts have any role in setting or calculating those fees. I do, however, recognise that the tariff rates may not be fully reflective of the true cost of care, and work is under way within the social care collaborative forum to consider how the commissioning and contracting of care home provision across Northern Ireland is currently delivered. Finally, a finance task and finish group has been established within that work stream to review existing finance issues. As part of that work, consideration is being given to the regional tariff, third-party top-up fees and enhanced care rates. The group will also consider the inclusion of clauses provided for enhanced care within the tariff.