Part of the debate – in the Senedd at 4:52 pm on 19 October 2022.
This report on care home commissioning follows the auditor general's review published in October last year, entitled 'A Picture of Social Care'. This review has looked at the whole social care sector all across Wales and it has identified three key issues and long-standing challenges for the sector. Foremost among these is the need to achieve financial sustainability and funding arrangements. It claimed that progress on addressing challenges had been slow and that the pandemic had made the need for change even more pressing. Indeed, the auditor general clearly stated that, although the pandemic had exposed the fragility of care services across Wales, most of the issues were already in existence to some degree.
Demand for adult social care is likely to increase significantly, which I know both of my colleagues have highlighted. Social Care Wales's population projection platform shows that, from 2020 to 2040, the number of people over 65 who struggle with the activities of daily living is projected to increase to 34 per cent. Faced with these challenges, the committee examined care home commissioning for older people with a view to strengthening the sector and making it more equitable. We looked at the accessibility and quality of provision, as well as variations in funding and issues regarding staff recruitment and retention, which both my colleagues, again, have mentioned.
On accessibility, the committee was guided by the principle of simplifying the process for service users. The auditor general's national summary report said that access to care homes by older people is complex and hard to navigate, which is not fair for elderly people and their families to have to deal with. The Older People's Commissioner for Wales pointed out that the overall quality of care homes was variable and Age Cymru reported issues where care is not available for service users through the Welsh language.
On funding, we tried to find out the reasons for the variation in expenditure on residential care and continuing weekly healthcare costs. Again, to quote the auditor general, public sector funding approaches for different aspects of care can create division amongst partners. The funding landscape for social care is very, very complex and confusing because of the varying streams of funding an individual may be eligible for. I know we all support equality here across every single party that we have here in the Senedd, but we must have equality for the elderly here all across Wales. My biggest concern is that the standards vary, with privately funded patients able to access a much higher quality of accommodation.
On staff recruitment and retention, the committee noted that workers were being lost to the retail and hospitality industries due to a higher level of pay being offered and lower work pressure. Staff were also being lost to the NHS for the same reasons.
To meet these challenges, we've made 13 recommendations, and I'm pleased the Welsh Government has agreed—alongside my colleagues, as they've mentioned this as well—that 10 have been agreed. I would urge you, therefore, Minister, to seriously reconsider your rejection of recommendation 8 specifically, regarding the need for a more proactive approach to sharing information in the interest of transparency and to ensure access to consistent and relevant information.
Our recommendations 11 and 12 on the charging of top-up fees have been sadly rejected. In Wales, although we all talk about equality and fairness for all, it really saddens me to say that it's not apparent in elderly care here in Wales. In evidence, the Older People's Commissioner for Wales says that service users are often unsure about what will incur top-up fees and that the true cost of care is not fully understood as a result. They need to have that in place, Minister. Again, I would also ask you, Minister, to look once again at this matter to provide certainty in charging top-up fees in the name of equality, fairness and transparency going forward.
Therefore, Minister, this report, in its aims, the intention is fully there to make the social care system in Wales more accessible, less complex and fairer for vulnerable individuals and their families. I truly believe it has succeeded in its aims and it has my full support, but the areas that have been rejected must be looked at again as we cannot ignore Wales's increasingly ageing population. Thank you.