Part of 1. Questions to the Cabinet Secretary for Health and Social Care – in the Senedd at 2:07 pm on 3 July 2024.
Diolch, Llyr, for that supplementary question. There are two things that you referred to there: there are the care home fees and there are the charges for continuing healthcare, and they are different things, and, actually, they sit in different ministerial portfolios as well, but I'll come to that in a moment. I think the starting point is, and you will understand and appreciate this, that we provide funding to local authorities that goes into their rates support grant, and they determine how that funding is then allocated to all of their services, including social care, and that includes the provision for care home provision. The statutory responsibility is theirs to make sure that they're meeting the care and support needs of their local citizens, and it's for the local authorities to set and agree their own fee rates for the provision of homecare placements on that annual basis and to publish these.
What I would say, however, is that local authorities are encouraged to work within the 'Let's agree to agree' framework, and I don't know if the local authorities that you're referring to are doing that. But they are encouraged to do that when setting care home fee rates, because that includes working in partnership with providers to understand costs, and then rates are then set using a fee methodology that is used either by the local authority at local authority or at regional level. So, that is the approach to setting care home fees and why there is, sometimes, inconsistent care home fee setting across each local authority, because each local authority will set their own.
However, you asked, then, the question about what we're doing to try to resolve that particular issue. What we can't do is we can't tell local authorities how to spend their money—that's in the rates support grant; they determine what that spend looks like. But what we have done is developed a new code of practice. So, we've got the national framework for commissioning care and support, which is currently laid before the Senedd, and it's intended that that will come into force in September. Now, the national framework is going to be setting the principles and the standards for commissioning practices aimed at both reducing complexity and facilitating national consistency of commissioning practices and rebalancing the commissioning focus on quality of outcomes. So, what I would like to see is that, when that national framework comes into place later in the year—we're hoping that that will come in in September time—that will give an impetus to having more consistency of approach, not only in practice, but in actual care home fee setting as well. I would like to see that being rolled out fairly quickly, and that local authorities engage with that, and that we see, as I say, the consistency of both practice and fee setting.