Frail elderly people in North Wales are being forced out of their communities because of a stand-off over funding their care.
That’s the warning from Kevin Edwards, managing director at the Meddyg Care Group, who says Betsi Cadwaladr University Health Board (BCUHB) is refusing to cover the true cost of the services provided at his care homes in Porthmadog and Criccieth.
Mr Edwards says because he won’t accept the fee BCUHB is offering, the health board is not recommending relatives send their loved ones to his homes.
As a result, he says, people needing to go into a care home could end up going to homes miles away from their family, friends and neighbours.
In a bid to find a way forward, Mr Edwards is urging BCUHB to adopt a nationally recognised toolkit for care funding called CareCubed, which is used by councils and takes into account the true cost of care in individual homes.
Mr Edwards said his local authority, Gwynedd Council, used the CareCubed software to set their care fees, and he was puzzled why BCUHB didn’t do the same when they set their new fees.
Mr Edwards said: “CareCubed provides wholly transparent costings, it’s a totally open book.
“The issue we have with BCUHB is they are not using any formally recognised costing toolkit, and that’s a fundamental issue.
“Because we won’t accept their base cost, they are not recommending our homes to the families of Gwynedd.
“They are saying to the families ‘go and find a home which does accept our fee’ – and that home could be 60 miles away from where their loved one lives.”
Mr Edwards said the difference cares homes in rural Gwynedd needed, and the fee the health board was willing to pay, was between £40 and £80 per week for each resident.
He said: “The point is, NHS care should be free to people who need it in their local area, but people are being forced to go out of area because homes in rural Gwynedd will not accept the basic fee BCUHB are prepared to pay.
“BCUHB are not giving families their first choice of local nursing home and they are forcing them to go further afield.
“They are basically forcing people in the final years of their lives away from their families and out of their communities, all because of, potentially, £40 a week.”
Mr Edwards said it was important residents who needed to go into care homes were housed as closely as possible to the communities they lived in.
He said: “They need to be with their friends, in their local community.
“For example, we provide care through the medium of Welsh but if people go to a home further away, that might not be the case.
“And it makes it more difficult if they are further away for relatives, friends and neighbours to drop in and see them. We want local people to stay in their local community.”
Mr Edwards added: “BCUHB do the costings on their fee, in my view, on the back of a fag packet.
“It doesn’t seem to matter if my home is in Porthmadog and my cost base, because of the rural setting, is significantly more expensive to run – we still have to accept this base fee.
“For example, how can our costs in a rural setting be the same as a home in an urban setting, somewhere in the middle of Rhyl, Llandudno, or Wrexham for instance?
“Our recruitment issues for example are wildly more challenging than at those other homes, so our costs are more, and that’s why our home are more expensive to run.
“One size does not fit all, unfortunately.
Mario Kreft MBE, chair of social care champions Care Forum Wales, said it was vital to allow residents to live in care homes in their own communities.
He called for the health board to adopt a properly recognised methodology to determine fees.
Mr Kreft said: “One of the most important things for families is the location of the home where their loved ones will be living.
“The vast majority of people choose a care home in a community where they want to be in, it’s so important.
“This issue highlights what we are facing in North Wales, and that’s a health board which has been promising methodology for more than a decade.
“They should be meeting government guidance on this, and it’s outrageous that they are not.
“It’s causing further anxiety to future residents and their families, it’s delaying discharges from hospitals and it is seeing people being taken to parts of the country they don’t want to be in.”
Mr Kreft said the issue also highlighted a north/south divide in Wales regarding funding for social care.
He said fees paid by authorities in South Wales were higher than what authorities in North Wales provided.
He said: “What is it about North Wales that people are treated as second class by the health board?
“The health board is there to care for them.
“But we still have a situation in North Wales where a health board is behaving out of step with South East Wales for example.
“Basically the health board here wants the standards that Cardiff pays for, but they don’t want to pay what Cardiff pays.”
