Care crisis: Wales 'sleepwalking' into chaos as families hit by 'tax on vulnerability'

Social care in Wales is 'sleepwalking into a crisis' unless a funding system that forces families to 'pay twice' for essential support is ripped up, providers have warned.

The alert comes as Care Forum Wales (CFW), which represents more than 400 care homes and home-care companies, launches a hard-hitting manifesto ahead of the 2026 Senedd elections.

The organisation is urging the new Welsh Government to hold the nation’s 22 councils and seven health boards to account for creating a postcode lottery that can see funding for identical needs differ by as much as £20,000 a year per person.

CFW says national guidance is being ignored, leaving families to shoulder unfair costs while vulnerable older people are denied the financial support they need and deserve – all under the guise of local democracy.

According to CFW, the lack of a national fee model has left many homes and domiciliary care companies struggling financially.

It’s left some providers unable to cover basic costs and relying on third-party “top up fees” from families – a charge they describe as a “tax on care based solely on where people live”.

In a challenge to ministers ahead of the polling, CFW warns that crumbling funding, inconsistent assessments and the collapse of the international recruitment route are driving staff out of the sector.

As a result, extra pressure is being put on the NHS with hospital beds blocked because community care can’t cope.

Let down

CFW chair Mario Kreft MBE said: “A whole generation has been let down since the advent of devolution.

“Essentially, we are campaigning for equality for vulnerable people, many of whom have dementia and cannot speak up for themselves, so they can  have the same funding towards their care, no matter where in Wales they live.

“That’s because we have a situation where two people with the same needs can receive funding that differs vastly - by up to £20,000 a year in the case of health boards and up to £13,000 a year for local authorities - depending solely on their postcode.

“That’s not just unfair – it is indefensible. Families are effectively paying twice for care and that is a tax on vulnerability.

“We don’t need more consultations. The evidence is already overwhelming. We already have a national approach to regulation and a national fee methodology would end the chaos, introduce fairness and transparency and finally reflect the true cost of providing care.

“Partnership should not just be a slogan. It means respecting every voice at the table, working collaboratively and ending artificial barriers that prevent integrated care from working as it should. Without trust and fairness, the system collapses under its own weight."

Meaningless

Kreft continued: “We welcome the commitment to the Real Living Wage but it is meaningless unless the money reaches the frontline. You cannot pay care workers fairly if the fees themselves don’t cover the basic costs of running the service.

“As the former First Minister, Mark Drakeford said, social care is the scaffolding that holds up the NHS.

“When care providers are underfunded, hospitals overflow, waiting lists lengthen and outcomes worsen. Investing in care isn’t optional. It is essential for the future of our health service.

“You cannot build a stable care system on short-term funding. We need core, long-term investment so local authorities can plan properly and citizens know they will receive the support they need, when they need it.

“Rebalancing was never meant to pitch the public sector against independent providers. Yet in some area public bodies are competing directly with smaller homes instead of supporting a mixed economy. That drives up cost and reduces choice for citizens.

“Independent providers deliver extraordinary value for money. They are rooted in their communities, rigorously inspected and often more cost-effective than public provision. But they cannot operate on fees that fail to meet the true cost of care.

“Wales has a similar size population to Manchester. Yet we have 29 different approaches to funding and commissioning care. That is bureaucratic, inefficient and unfair on the people we serve. We need national consistency – and we need it now.

“This is a pivotal moment. The decisions made by the next Welsh Government will shape social care in Wales for a generation.

“We are urging every political party to put fairness, sustainability and dignity at the heart of their plans.

“If politicians fail to act now, they will be choosing crisis by design. This is the last chance to fix a broken system before it fails another generation.

“A civilised nation does not balance the books on the backs of the most vulnerable people. This is a test of who we are as a nation.”