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30 Oct 2002 : Column 977—continued

10.23 pm

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I congratulate the hon. Member for Twickenham (Dr. Cable) on securing this debate, which is clearly topical and important. All hon. Members want the best for our older citizens, and their treatment is crucial in any civilised society. For that reason it is vital for people to be able to depend on the quality of care homes, and the best way to ensure that quality is through a sensible regulatory regime. I am therefore pleased to have the opportunity to discuss that regulation.

The hon. Gentleman began by bringing to the attention of the House the article on the front of today's Evening Standard, which claims to have carried out an investigation into a care home in Birmingham. The paper's reporter was in the Alexandra nursing home for three weeks, and alleges that she uncovered a catalogue of abuse and neglect.

I make it clear, on behalf of the Government, that care homes for older people look after some of the most vulnerable people in our society. That is why the Government set up the National Care Standards Commission. The commission has been given the power to ensure that poor standards are a thing of the past and together with it, we are committed to tackling the abuse and neglect which sadly still take place in some of our homes today. It is important to point out that we provided local authorities with #300 million, half of

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which has been used to support the care homes sector. More than #9 million of that money has been allocated to Birmingham city council.

I shall meet the hon. Gentleman on the historical point with which he began. In the 1980s there was a huge expansion in the number of care homes, when uncapped social security money was available for publicly funded people entering residential care. Money flowed from the public purse into the care home sector. Indeed, it was the Conservatives, then in power, who sought to limit severely that unplanned and uncontrolled growth. In those days, entry to a care home was not based on need or user choice, but was driven by providers in the independent sector, which led to the unnecessary and completely avoidable admission of many older people and others into institutional care.

Until 1993, the care home market was not strongly regulated. There were registration and inspection processes, but they were nothing like as robust as those which the Government have put in place. The system of standards introduced by this Government replaced a system in which care homes were regulated by about 250 local authorities and health authorities, each applying its own standards. The old regulatory system had been criticised for many years for lacking independence, consistency and coherence. In the absence of proper checks of individuals and homes, the most dreadful abuse was perpetrated. It was not by any means confined to the independent sector but was very significant in the public sector during the 1980s and 1990s. Indeed, independent providers themselves have been the strongest lobbyists before and after the introduction of the 1990 Act to remove regulation from local control and introduce a level playing field for independent and local authority provision. They have argued strongly for consistency through the use of national standards. It is this Government who have answered those concerns. We have gone one step further than our predecessors and created a regulation body wholly independent of local health and social care agencies.

The hon. Gentleman asked a number of questions about the National Care Standards Commission, which is rightly independent of the Government—it would be wrong for me to attempt to tie its hands at the Dispatch Box. I heard what the hon. Gentleman said about seeking a meeting with the commission to draw these matters to its attention, and I do not doubt that members of the commission will read Hansard tomorrow, and the issues that he has raised can be addressed. However, I am advised that the nature of the allegations mean that legal action may take place so I must be careful about what I say.

Under the Care Standards Act 2000, we made the National Care Standards Commission responsible from 1 April 2002 for regulating—registering and inspecting—all care homes. The commission is part of the Government's programme for modernising social care, particularly for improving quality and protection for people in care services. It is a major non-departmental public body, independent of government.

The commission's main aim, rightly, is to drive up the quality of services and improve the level of protection for vulnerable people in our society, by the regulation of social care and independent health care services.

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The commission has taken over the regulatory responsibilities of local authorities and health authorities.

We believe that people's safety and well-being are paramount. The new standards will ensure that poor-quality care is a thing of the past. They give care home owners a clear idea of the standards that they have to meet to gain and maintain registration, and users and their carers know what they can expect as a minimum. At the outset, we were aware of concern shown by care home owners that they would struggle to meet some of the standards. That is why we decided that the more challenging standards need not be implemented until 2007, and providers will be given realistic timetables to meet them.

However, we went further than that—the Government also issued comprehensive statutory guidance to the commission setting out the supportive way in which the standards should be applied. The guidance indicates that the standards should be used to help guide care homes on action that they can take to improve their services. Most importantly, the guidance also states that the commission should consider whether care homes could fulfil the needs of service users without making environmental changes to meet the standards. The guidance particularly covers the issues of room size, lifts, baths and shared rooms and has been welcomed by the major associations representing care homes.

The hon. Gentleman spoke eloquently about the problems at the Lynde House care home. I have every sympathy with the concern of the relatives of the residents of Lynde House nursing home to ensure that their relatives are properly cared for, and that where failures in care are identified, those responsible are brought to account. However, I hope that the hon. Gentleman will understand that I am unable to comment in detail on complaints about the running of individual care homes, such as Lynde House. It is not that I intend to be unhelpful in this regard, but the responsibility for ensuring the quality of care provided by care homes lies clearly with the regulator, and proceedings against an individual for neglect or abuse is a matter for the courts.

Until April this year, nursing homes were regulated under the Registered Homes Act 1984 by the health authority in which they were located. Responsibility for considering complaints about nursing homes rested primarily with the relevant health authority as the regulator and the health services ombudsman. I understand that Lynde House was first registered with

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Kingston and Richmond health authority in 1996. Kingston and Richmond's regular inspections led to recommendations being made to the home owners, who complied with those recommendations.

As a result of on-going concerns expressed by relatives of the residents of Lynde House, Kingston and Richmond health authority commissioned an independent inquiry into the home. The McLaren report was published on 21 August. Kingston and Richmond health authority was dissolved in April 2002, and responsibility for the findings of the McLaren report falls to Richmond and Twickenham primary care trust and the South West London health authority.

How we care for vulnerable people is a matter that we consider to be very important. That is why we introduced the Care Standards Act 2000 to improve the regulation of social services, including care homes. Under the Act, the National Care Standards Commission now regulates all care homes in England. Although the commission has no jurisdiction over the McLaren report, it has completed its first inspection of Lynde House. The commission's inspection report was made available to the residents and relatives of Lynde House on 18 July at the regularly scheduled residents meeting. Action plans have been agreed with Lynde House to address the issues that have arisen out of the inspection, and time scales have been set for requirements to be met. That should ensure that residents receive appropriate good quality care that meets their needs.

The commission will, of course, be monitoring Lynde House on an on-going basis, and we would expect it to take swift action to deal with any failures by the home. I understand that the National Care Standards Commission, the local strategic health authority and primary care trust are also working together to ensure that lessons are learned from the events at Lynde House. I hope that this sorry episode can be brought to a satisfactory conclusion for all those involved.

In conclusion, I stress that we have ensured that the introduction of the standards will safeguard and maintain high quality care homes. The emphasis will be on ensuring people's safety and not on instantly de-registering—

The motion having been made after Ten o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.

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