Cwestiwn ysgrifenedig WQ93458

It is for local authorities to determine how the funding they receive through the Revenue Support Grant is allocated across the services they have statutory responsibility for. This includes the planning and securing of care and support for local citizens which includes care home provision. On an annual basis local authorities set, agree and publish their own commissioning fee rates for services including care homes.

The Welsh Government publishes a toolkit (Let’s Agree to Agree) to assist commissioners and providers of residential care for older people with the process of seeking agreement on the cost of care. Although local authorities are not statutorily required to use the toolkit, it is recommended as good practice and they are encouraged to work in line with the framework when setting care home fee rates. This includes working in partnership with providers to understand costs and rates are set by using a fee methodology which is used at the individual local authority or wider regional level. The National Commissioning Board also provides methodologies to support local commissioners with fee setting.

While there are clear benefits from using the toolkit, the use of a national methodology tool does not mean that a consistent fee rate will be implemented across local authorities. This is due to several variables including return on investment and land values that differ per area.

Care home fees and their associated methodologies have been one of a range of areas we have considered throughout the development of the National Framework for the Commissioning Care and Support in Wales.

The National Framework will be established through a statutory Code of Practice, which will apply to the commissioning of care and support by statutory partners – local authorities, health boards and NHS trusts.

Two of the commissioning standards specifically aim to improve how costs and fees are agreed and implemented. Standards 7 (Understanding the costs of care) and 8 (Setting fair and sustainable fees) require statutory partners to be transparent and consistent when setting fee rates ensuring that they are assessing fair and sustainable costs of care and support and ensuring public value. Statutory partners must demonstrate that they understand the full costs of directly provided and contracted care in their area and must work collaboratively to understand fair and sustainable costs of delivering care to inform decisions relating to fee setting.