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Wales told to reduce complex care home funding

The Welsh Government has been told to reduce the complexity of care home funding in a new report.

Public sector watchdog Audit Wales says that public-sector funding can create division among partners and that information on the quality of commissioning is “patchy”.

The report makes four recommendations for commissioners of older people’s care home placements:  

  • Reduce the complexity of the funding responsibilities across partners
  • Clearly describe and communicate how pooled funds should operate across partners
  • Require strengthened scrutiny arrangements and accountability of Regional Partnership Boards
  • Develop a framework for outcome-based performance reporting, which links to policy ambition and the seven well-being goals for Wales.

The report notes that across Wales, the costs of care-home commissioning for older people run into several hundreds of millions of pounds each year and many thousands of people are affected.

Other findings include that the governance and operation of Regional Partnership Boards is maturing but structures are extensive and complex and their accountability needs to be strengthened. Also, that there is inexplicable variation in expenditure on residential care and continuing healthcare costs, and perverse incentive for commissioners of care due to different charging caps.

These are recommendations for the Welsh Government to consider as it looks to take forward actions in response to its Rebalancing Care and Support White Paper, says Audit Wales.

Some key facts on care-home commissioning:

  • There are 677 care homes in Wales, 263 of these provide nursing care
  • 96 of these are local authority run care homes
  • 16,144 over 65s were receiving adult care-home services from local authorities in 2018-19
  • In 2019-20, local authorities spent £297 million on nursing and residential placements for over 65s in Wales.


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