A Powys care homeowner is so disillusioned with the unfair postcode lottery system of residential care funding in Wales that he’s calling for an urgent investigation.
After spending 14 years battling for change, Doug Leach, who runs the Bryngwy care home in Rhayader says he is fed up with the chronic underfunding of social care.
Mr Leach wants an inquiry into the way residential homes receive widely differing fees from local authorities and says sweeping changes are needed.
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.
Mr Leach feels driven into the ground by an unjust system in which care homes in some areas receive much higher fees from their local authorities than those in others.
He said: “For a 24-bed home like ours at Bryngwy that’s a quarter of a million pounds a year. It just doesn’t make sense that some homes should receive so much less than others for delivering the same vital service. It’s scandalous, we’re talking about people, individuals who need our support and yet we are held to the same standards as homes in Cardiff.
The inequities of the system had clouded his experience of working in the care home sector.
He took on Bryngwy 14 years ago in 2006 with a desire to provide a valued service. But he said he has been battling the system since day one: “It has been one problem after another putting us in a constant position of playing catch-up.
“The government – whether it be Westminster or the Welsh Assembly – is always making an elaborate show of saying it is working to resolve the problem, but no funding ever comes through to us at the sharp end.
“I have appealed to the council and even gone as far as taking them to a judicial review but so far it has all been in vain.
“We received zero increase in fees in 2019 and this year only a modest increase of two per cent. Meanwhile the national living wage has gone up by six per cent and our costs are rising.
“I had to borrow money to install a new lift at £30,000 and additional capital expenditure on the building came to £60,000.
“In Powys we are at the very bottom of the funding scale and it ultimately affect the level of service we can provide for our residents.
“Now on top of the fragile state that the sector was already in we have dealing with the nightmare of COVID-19. The numbers are there for everyone to see. Why isn’t the Welsh government tackling this unfair, outdated system?”
According to Mr Leach, the only fair solution is realistic, viable fees agreed on in consultation with care homeowners and agreed nationally.
“At the moment it makes no sense,” he said. “I have another care home in Carmarthen, a council which is also towards the bottom of the fees table, but the amount paid to us per resident by that local authority is over £55 more than that which is paid to us by Powys.
“Our costs and provision of service are the same in both homes. How can it be that one authority pays us so much more than the other? It does not make sense and it is not fair on our residents or their families.”
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.”