Care Forum Wales Manifesto 2026

Care Forum Wales represents over 400 private and third-sector providers of regulated social care in Wales, including nursing homes, residential homes, domiciliary care agencies, and supported living services. Our members can only succeed if the people in their care receive high-quality support, and if providers can recruit and retain skilled, committed staff. This manifesto sets out the urgent actions needed from political parties ahead of the 2026 Senedd elections, and beyond, to support a fair, sustainable, and high-quality social care sector.

CARE FORUM WALES | MANIFESTO

Contents

Care Forum Wales represents over 400 private and third- sector providers of regulated social care in Wales, including nursing homes, residential homes, domiciliary care agencies, and supported living services. Our members can only succeed if the people in their care receive high-quality support, and if providers can recruit and retain skilled, committed staff. This manifesto sets out the urgent actions needed from political parties ahead of the 2026 Senedd elections, and beyond, to support a fair, sustainable, and high-quality social care sector.

Introduction

True Partnership

Care Must be Fair

Delivering on the Real Living Wage

Fix the Visa

Parity for Social Care

Common Sense in Rebalancing Care

Value for Money in Social Care

Accountability

Touch on any title above to take you to the relevant page

CARE FORUM WALES | MANIFESTO

TRUE PARTNERSHIP

FAIR CARE FOR ALL

Partnership isn’t a slogan — it’s how we deliver better care. Care Forum Wales believes that integrated care only works when every voice is valued. A truly integrated care service can be achieved by: • Recognising and respecting the value brought by all parties across health and social care to the lives of the people that we serve. • Supporting all parties and treating them fairly.

different partners can or can’t offer to new models. • Giving equal opportunities to access funding, with shared risk and accountability. • Enabling challenge to be made safely. • Making decisions collaboratively and transparently. Above all, partnership must serve the needs and rights of Welsh citizens and not any single ideology. By working together, we can translate words into action.

Every person in Wales deserves the same standard of care and the same right to choose who provides it. Yet funding varies dramatically depending on where someone lives, creating inequality that

Commissioners have the discretion to prioritise care. We invite them to use it wisely. The absence of a national fee methodology has created a system where some people in Wales, and their families, are effectively paying twice. Due to the unequal rates set by local authorities, many care providers can’t cover their costs and are forced to request third party top-up fees. In Care Forum Wales’s view, this is a tax on care that some people experience simply because of where they live. Wales urgently needs a consistent, transparent approach to funding care. The National Office for Care and Support is a big step forward and we urge Welsh Government to introduce a national fee methodology as opposed to consulting on the need for one. Toolkits like “Let’s Agree to Agree” already exist. Let’s populate them with consistent data and build a fairer, more sustainable sector together. We believe this is a pivotal opportunity to shape a fairer, more sustainable care system. By working together, we can simplify fee setting, strengthen trust between providers and commissioners, and ensure funding reflects the true value of every person in our care.

undermines dignity and choice. We invite partners to work with us to change this.

There are massive inconsistencies with funding across the whole spectrum of care, but older people’s residential and nursing care offers a clear starting point for reform. A national fee methodology could identify the true cost of care, reducing the inequalities that currently exist. Disparities of over £10,000 per person per year exist between local authorities. Health board funding is equally inconsistent. Some Continuing Health Care [CHC] rates are lower than Funded Nursing Care [FNC], despite higher needs. A minority of health boards regularly under-assess people as needing FNC as opposed to CHC which risks safety and denies people their right to free healthcare. This must be addressed. Care should be based on needs, rights and choices — not postcode or politics.

• Removing artificial boundaries to collaborative working, such as by making assumptions about what

CARE FORUM WALES | MANIFESTO

DELIVERING ON THE REAL LIVING WAGE

FIX THE VISA

The social care sector in Wales relies on international workers due to ongoing challenges in recruiting locally. We reject the former Home Secretary’s claim that care workers lack skill. This work demands both expertise and compassion, qualities that cannot be taught and are not universally found. International staff consistently demonstrate a strong caring ethos and are a valued part of our workforce. Employers do not recruit internationally to save money. They invest significant resources in the process and are now required to pay international staff more than the RLW promised to domestic workers. They do so because these individuals have the right values and skills, and because there are not enough local workers to meet demand. Wales faces a demographic challenge, with an ageing population and a shrinking working-age population. The shortage of care workers is especially severe in rural areas. Recent policy changes, including restrictions on dependants and stricter recruitment conditions, have led to a sharp decline in international applications.

Our workforce is our greatest strength. Care workers are skilled, compassionate and essential to the wellbeing of our communities. The Real Living Wage (RLW) is a vital step toward recognising their value, but it must be properly funded to make a real difference. We welcomed Welsh Government’s commitment to the Real Living Wage, but we’ve been calling for a long time for a better way of assessing and delivering funding across Wales. Some local authorities and health boards “include” RLW in fee uplifts but that means nothing unless the total fee meets full operating costs. Without a clear and consistent funding mechanism, the promise of fair pay will continue to fall short.

Care workers deserve more than praise. They need pay and conditions that reflect their responsibility and professionalism. Until funding supports this, recruitment and retention will continue to suffer. We invite Welsh Government and commissioners to work with us urgently to resolve this problem. By identifying the funding required and ensuring it reaches the frontline, we can turn the principle of fair work into a shared reality. Let us make the Real Living Wage a success for care workers, providers and the people they support.

The closure of the visa route has worsened this trend and risks driving away existing staff due to increasingly negative messaging from Westminster. We should celebrate the contributions of international care workers, especially their dedication during the pandemic. Concerns about modern slavery and illegal migration should not be conflated with legitimate recruitment. The UK Government must take responsibility for preventing abuse of the system without penalising ethical providers and the people who rely on their services. We call on the Welsh Government to follow the example of the Scottish Government by taking over direct sponsorship of the international visa for social care workers to support ethical recruitment and help address the workforce shortage. We also call for better oversight of public sector commissioning practices. Cost- driven models can allow inexperienced or unethical organisations to enter the market, undermining quality and safety.

CARE FORUM WALES | MANIFESTO

PARITY FOR SOCIAL CARE

A COMMON-SENSE APPROACH TO THE REBALANCING AGENDA

We support the Welsh Local Government Association’s call for equal status between social care and the NHS. This means parity of esteem, recognition, and investment. Campaigns like We Care Wales are vital in raising the profile of the sector, but more must be done to ensure care workers feel like equal partners. Too often social care funding comes in the shape of grants, particularly for preventative models, innovation and to support the rebalancing agenda. Grant- based funding is not sustainable. It does not meet the urgency or scale of the challenge. We call on the Welsh Government to move beyond rhetoric and commit to a fairer share of funding for social care, delivered through core funding so that local authorities can commission regulated care services that support people in the community and allow the NHS to focus on clinical care.

Social care is essential to the health system. As former First Minister Mark Drakeford said, it is the scaffolding that holds up the NHS. It prevents unnecessary hospital stays, supports independence, and ensures better outcomes for individuals and communities. Social care and health services are deeply interdependent. When social care is underfunded, hospital beds are occupied by people who would be better supported in the community. This leads to poorer outcomes and longer waiting times for those with clinical needs. Despite clear evidence that investing in social care reduces pressure on the NHS, funding remains inconsistent. Health boards often under-assess needs or underfund providers, shifting costs to individuals or local authorities and contributing to delayed discharges.

The rebalancing agenda was meant to strengthen and diversify care provision, ensuring long-term sustainability and reducing reliance on any single provider. It aimed to support models that deliver added social, economic, and cultural value. However, in practice, it risks creating instability. In some areas, public bodies use their control over funding and placements to compete directly with independent providers. This often results in higher costs and fewer referrals for small providers, many of whom are family- run and operating at a loss. Instead of supporting a mixed economy, this approach can push providers out of the market and reduce choice for citizens at a greater cost.

Rebalancing should be about collaboration, not replacement. Most care businesses in Wales are motivated by care, not profit, and deserve fair treatment. Public investment must be used to build capacity across the sector, not to create monopolies or disadvantage ethical providers. We invite the Welsh Government and local authorities to work with providers to create a stable and diverse care system. This includes fair funding, transparent commissioning, and consistent workforce standards. Mixed messages around regulation and the promotion of unregulated roles such as micro carers risk creating a two-tier system that undermines public confidence and safety. Let us rebalance care with common sense, shared purpose, and mutual respect.

CARE FORUM WALES | MANIFESTO

VALUE FOR MONEY

ACCOUNTABILITY

We call on the Welsh Government to recognise the value for money delivered by independent care providers and to urge Westminster to reverse the decision to include commissioned services in the rise in employer National Insurance contributions. Most care organisations in Wales are small and medium-sized enterprises proven through inspection to provide safe, high- quality services. They are rooted in their communities, contribute to the local economy, and deliver social value through their work. Providers need a reasonable return to reinvest, maintain reserves, and manage financial risks, especially in a sector where staffing costs make up the majority of expenses. Current fee models are unsustainable, and care homes are closing faster than new ones are opening. This affects not-for-profit providers as much as private ones.

Independent care is often more cost- effective than public provision with some councils such as Swansea County Council charging significantly more for in-house provision than they pay commissioned providers, costing the taxpayer hundreds of thousands of pounds more each year. Care homes also deliver nursing care at a lower cost and in more appropriate settings than hospitals. Without them, the health service would struggle to meet demand. The introduction of public inspection ratings makes it even more vital that care homes can be judged against what is commissioned. We call on Welsh Government to take steps to incorporate ‘value for money’ into the assessment criteria for Care Inspectorate Wales and to reflect performance against what is commissioned. We stand ready to work with government to build a fair, sustainable care system that delivers quality and value for the people of Wales.

In a country the size of Manchester, it is neither efficient nor fair to have 22 different approaches to implementing social care legislation. Local variation should not come at the expense of consistency or the rights of vulnerable citizens. We call on Welsh Government to ensure local authorities are held accountable for their decisions and that the voices of people receiving care are properly represented. Where councils work in partnership with providers, relationships are stronger and fees more realistic. Budget pressures are real, but the variation in funding across Wales shows that care is also a matter of local priorities and trust. Too often, guidance such as the National Commissioning Framework and Let’s Agree to Agree is ignored. Some councils impose contracts and fees without engagement, relying on vague claims of local difference while excluding the voices of older people in care homes.

We urgently need a national fee model. The evidence is clear and consultation has taken place. What is needed now is action and enforcement. Funding intended for the sector, such as support for the Real Living Wage, must reach providers. Too often it is absorbed into general budgets. We call on Welsh Government to protect care funding and ensure it reaches frontline services, reducing the risk of provider closures and service disruption. Let us work together to build a fair, transparent, and accountable care system that puts people first.

If you have any questions relating to this Manifesto, please contact

Care Forum Wales Bromfield House Ellice Way Wrexham Technology Park

Wrexham LL13 7YW

01978 755400

enquiries@careforumwales.co.uk

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