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Care Homes

Mr. Swayne: To ask the Secretary of State for Health (1) if he will make it his policy to allow new care homes to be commissioned before a full inspection takes place while there is a backlog of registrations and bed shortages; and if he will make a statement; [72078]

Jacqui Smith [holding answer 24 July 2002]: The National Care Standards Commission is currently processing three types of registration application; (i) applications made under the previous regulatory authority and transferred to the Commission as a part-processed application; (ii) applications made to the Commission since 1 April 2002; and (iii) applications from existing homes previously exempt from registration. The first two categories of application are treated as a priority.

New care homes cannot operate legally unless and until they have completed the registration process to the satisfaction of the Commission, including the filing of appropriate documentation, reference checking, site visits and interviews to confirm the fitness of the home and its managers. The process can take three to four months and ensures the protection of vulnerable adults and children. A home will be inspected twice per year: once during an announced inspection and once during an unannounced inspection. There is no connection between the time a home completes the registration process and is inspected—this will depend on individual area office inspection programmes.

Tim Loughton: To ask the Secretary of State for Health how much correspondence his Department has received from (a) care home owners and (b) hon. Members with regard to delays in the vetting of care home staff applications by the Criminal Records Bureau. [71042]

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Jacqui Smith [holding answer 18 July 2002]: The Department received eight letters concerning delays by the Criminal Records Bureau (CRB) in processing applications for criminal records checks. Of these one was from a care home provider and seven were from hon. Members.

Measures are being taken to overcome the early operating difficulties experienced by the CRB, which have led to delays in responding to applications for disclosures. We are determined that the CRB will be in a position as soon as possible to meet the high standards of service that it has made clear it will deliver to its customers. The short-term implications for particular service areas using the CRB service are being closely monitored.

Mr. Andrew Turner: To ask the Secretary of State for Health if he will list those care standards for care homes which take effect in each year from 2002. [68444]

Jacqui Smith: The national minimum standards for care homes apply from 1 April 2002, unless otherwise stated in any standard. Those standards which have not already come into force or will not apply to provision which existed before 1 April 2002 are as follows:

However, in the light of continuing concern about the possible impact of certain standards, we believe it is right to look again at those physical environment standards which are the most demanding in terms of changes to the fabric of the home.

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A consultation document was issued on 16 August. This covers national standards for care home for both older people and younger adults (18-65). The amendments proposed in the consultation document would change a number of standards so that pre-existing care homes will not be expected to meet higher standards than those they already meet or met on 1 April 2002.

The standards proposed for amendment are as follows:

In addition, as part of the consultation, we will accept views on other standards that relate to environmental issues. In line with Government policy all national standards will be reviewed within three years of their introduction.

Care Costs

Mr. Burstow: To ask the Secretary of State for Health (1) what arrangements his Department has made to ensure that the cost of a state-funded placement does not exceed the total of the NHS registered nurse contribution and social services department personal care and hotel payment; [71201]

Jacqui Smith [holding answer 22 July 2002]: None. Nurses working in the National Health Service will be responsible for carrying out assessments with their local authority partners. It is for all local health and social care economies to plan how they intend to manage this and the ongoing reviews of people's care.

The Department has disseminated some key principles governing the practice of commissioning nursing care in care homes from April 2003. These are on the Department's website at and are designed to help smooth the transfer during the introduction of NHS funded nursing care. The Department is continuing to discuss with the provider organisations and with NHS and social

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services interests the extent to which these might be further refined. Ultimately, this will be a matter for local agreement according to the principles set out in Building Capacity and Partnership in Care, published in October 2001. The substantial additional resources that the Government has put in to social services has enabled local authorities to increase the fees that they pay for care in care homes, by as much as 10 per cent in some places.

Local authorities continue to be responsible for the nursing care of residents that they support. From April 2003, funding responsibility for care from a registered nurse will transfer to the NHS.

Mr. Burstow: To ask the Secretary of State for Health if he will set out for each year how much of the increase in personal social services funding over the spending periods (a) 1998 to 2002 and (b) 2002 to 2006 is accounted for by an increased allocation for intermediate care. [71194]

Jacqui Smith [holding answer 22 July 2002]: The NHS Plan, July 2000, announced that the development of intermediate care services was to be a Government priority, supported by significant additional investment. Details of the additional funding for intermediate care were given in Health Service Circular 2001/001: Local Government Circular (2001) 01, Intermediate Care, published in January 2001.

Decisions on funding for future years, covered by the Spending Review 2002, 2003–04 to 2005–06, are still being taken. Further details will be announced formally at the time of the local government settlement in the autumn.

Councils can decide how much of the additional funds made available for personal social services in recent years through the standard spending assessment and relevant grants such as the promoting independence grant, carers grant and the building care capacity grant are used for intermediate care. When allocating resources to local councils we aim to leave it to councils to choose how best to allocate these resources taking account of local circumstances and priorities.

Since 1997 we have increased the resources available to social services departments by on average 3 per cent. per annum in real terms; and we will be increasing the level of funding by on average 6 per cent. per annum in real terms over the next three years, 2003–04 to 2005–06.

Mr. Burstow: To ask the Secretary of State for Health (1) what estimate his Department has made of the proportion of state-funded residents falling into each of the three nursing contribution bands; [71197]

Jacqui Smith [holding answer 22 July 2002]: At 31 March 2001, there were 71,845 residents of independent nursing homes who were supported by

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local authorities. From 1 April 2003, a similar number will be jointly supported with National Health Service funding of their care from a registered nurse.

Currently, those who fund their own care have been assessed and approximately 19 per cent. fell in the low band, 58 per cent. in the medium band and 22 per cent. in the high band of nursing needs. Preliminary information from a small survey of 355 residents conducted earlier this year indicates that the nursing needs of supported residents are not dissimilar to these.

Detailed guidance was issued in September 2001 under cover of HSC 2001 17: LAC(2001)26. NHS nurses should have been involved in the assessments of everyone needing registered nursing care since 1 April 2002, including those who need care from a registered nurse in a care home. All health and social care communities should agree the priorities for ensuring that the remainder of assessments and, if appropriate, determinations, are completed. Primary care trusts should assign individuals provisionally to an appropriate band based on the social services care plan and any records of assessment. Trusts and councils will be aiming to have all assessments completed in time for implementation by April 2003.

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