The director of a care home in Powys is calling for an urgent investigation into the “shocking and unfair” way that fees are calculated.
Dr Bikram Choudhary, director of the Silvercrest group which has five care homes including the 99-bed Cwrt Enfys in Ystradgynlais, says that the county council is the “worst offender” for paying low fees.
He spoke out after Care Forum Wales, which represents nearly 500 social care providers, presented a “terrible ten” local authorities with Cheapskate Awards for paying the lowest care home fees in Wales amid the coronavirus crisis.
Currently bottom of the heap in terms of funding is Powys County Council who increased the weekly fee for a person in a residential EMI care home for older people with mental frailty by 2.2 per cent to £559.
In contrast, providers in Cardiff – where fees were already higher – will receive £793.48 a week for providing exactly the same level of service, a four per cent increase that works out as £12,192.96 more for every resident than in Powys over the course of a year.
Even in Cardiff, say Care Forum Wales, the fees do not cover the true cost of care and are on average £100 less than the amount paid by people receiving care privately.
According to Dr Choudhary, the level of fees in Powys was so low that Cwrt Enfys, which has 99 beds and employs 150 staff, had suffered a real-terms cut in funding for the past two consecutive years.
He said: “The disparity in fees is shocking and totally unfair.
“Because Powys is so rural we have to pay our nurses more at Cwrt Enfys – the hourly rate is 50p per hour higher than any of our other homes, otherwise we would not be able to staff it.
“We have had lots of issues with Powys and one of them is that they have been grossly underpaying for very many years.
“I have emailed Dylan Owen, the head of commissioning at Powys County Council to ask him how he can justify paying between £67 less than the Welsh average per person, per week for residential care and £112 less for nursing care.
“This year we were dismayed at the 2.2 per cent increase – a real terms increase of around £12 – which again does not take into account the 6.1 per cent increase in the minimum wage and increased food and other costs.
“It also ignores the fact that most councils in wales have increased fees by at least four per cent this year and the year before.
“Unfortunately the gulf between Powys funding and the rest of Wales is again widening to unsustainable levels and hence I stand by my assertion that Powys Council does not value the social care sector or the work that it does.
“Residents in care homes are getting frailer, their needs are more complex and they need more specialist equipment, staff time and attention than ever before.
“The costs of funding this care have not kept up in real terms and Powys are by far the worst offender in this area with a huge gulf in funding between Powys and the Welsh average let alone the highest paying local authorities in Wales. It is a scandal.
“I have written to the council pointing out that this is a real terms cut and asking them if they want me to reduce staffing levels or ration food portions – to date there has been no reply.
“I absolutely support the call from Care Forum Wales for a national action plan and more than that I think we need a full-blown inquiry to sort out this iniquitous postcode lottery once and for all.
“Some of the local authorities are responsible in the way they go about things while others are very willy nilly and show no concern for the sector. They do not value the sector because they do not engage with us.
“I don’t know how long this can go on for before people start screaming blue murder. The current situation is just not sustainable and that’s a big worry.
“We have 22 local authorities and 22 heads of social care and all the rest of the bureaucracy in Wales even though we only have three and a half million people.
“Contrast that with Birmingham who look after 1.2 million people but just one council and one head of commissioning.
“In Wales, we should be making decisions about fees at a national level and there will be variations between different areas but to have a difference of £12,000 a year between Cardiff and Powys for one resident is ludicrous. This is not sensible in any shape or form.”
Backing the call for an inquiry, Mario Kreft MBE, the chair of Care Forum Wales, said: “This mess has come about because the market has been mis-managed by the 22 local authorities in Wales for more than two decades of devolution.
“As the First Minister himself pointed out, the social care sector was in a fragile state well before the pandemic and what we are calling for is an urgent national action because this is about equality and fairness for the residents, their families and the staff.
“During the Coronavirus pandemic we have seen the heroic efforts made by staff right across Wales to shield social care and save lives.
“They have faced real danger and I think the public understands their value more than ever before.
“One of the main purposes of a fair approach to funding of care homes is to ensure people working on the front line get what they deserve and that ensuring they are paid fairly is fed into the methodology that local authorities use to calculate fees.
“We need to build a sustainable care system that will truly be an effective scaffold for the NHS.
“We have a similar postcode lottery in relation to the funding provided by health boards across Wales, so this is one almighty mess with essentially 29 varieties on a theme. It doesn’t make any sense at all.”
“The system is completely dysfunctional and has resulted in the sector suffering years of chronic underfunding since it was introduced.
“We were seeing care homes and nursing homes closing across Wales even before the Covid-19 pandemic.
“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 the 20,000 care home residents across Wales.”