Care Forum Wales Manifesto 2026

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.