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Vulnerable Adults (Residential Homes)

I congratulate the hon. Member for Harrogate and Knaresborough (Mr. Willis)—if I may, I will call him my hon. Friend—on securing an Adjournment debate on this incredibly important issue, which, as he said, will become even more significant, given the demographic changes that are taking place. I also congratulate him on the insight that he gave us when he declared an interest in this issue. On a serious note, however, he will be a great loss to his constituents and the House now that he has decided to retire from Parliament. I think that it was Tony Benn who said that retiring from the House of Commons allows people to take up their involvement in politics again, and I am sure that the hon. Gentleman will follow that view of the world. I agree with the hon. Gentleman's statement about dedicated staff at the front line in our care system. Every day of the week, they do a tremendous job of caring for older and, indeed, disabled people in what are sometimes difficult circumstances. The vast majority do their job in a compassionate, sensitive and professional manner, and we must always put such debates into that context. I also want to use this opportunity to express my heartfelt condolences to the families of those who suffered as a result of the dreadful tragedy at Parkfields home, about which we have heard over the past week. It would not be appropriate for me to comment on the individual case, which is under investigation, as everyone is aware, but our sympathies go to the relatives who have been affected by that dreadful situation. I also use this opportunity to put on record my thanks to Action on Elder Abuse and its chief executive, Gary FitzGerald, for the tremendous work that they have done recently to raise the status and profile of this issue in terms of public policy. Arguably, the debate about elder abuse is where the debate about child abuse was 20 or 30 years ago, and it is important to understand that. Sadly, child abuse has touched the lives of far too many people in our country through the generations, but it is only in the past 20 years that we have started to talk about it openly and to recognise that there needs to be a complete step change in public policy. I suspect that we are in a similar position on the abuse of older people, as the hon. Gentleman implied. Action on Elder Abuse and Gary FitzGerald are our partners in dealing with these issues and they do an excellent job. It is probably right to say that before the Government came to power in 1997, the level of protection and regulation in the sector was appalling. It is interesting that Her Majesty's official Opposition could not even be bothered to send a representative to the debate. Before 1997, we lived in a climate in which regulation was a dirty word, and the whole sector had been deregulated. Indeed, the ring-fencing of community care funding in the early 1990s was a deliberate and very effective way of privatising virtually the whole care sector. Now, roughly 75 per cent. of social care is provided by voluntary and private sector organisations. I do not want to make an ideological point, given that much of the private and voluntary sector does a wonderful and very positive job, but what happened before we came to power was the result of an ideological programme, and part of the ideology of privatisation was the decision not to put in place an adequate regulatory system. When the Government came to power in 1997, we introduced national minimum standards and the protection of vulnerable adults scheme. I understand the hon. Gentleman's reservations about elements of the performance of the Commission for Social Care Inspection, but it has earned a good overall reputation as a regulator, and standards have continued to improve across the sector. That does not mean that we are where we need to be, or that great concern does not continue to exist about areas where performance is simply unacceptable and where the regulator might have been tougher in using its powers. On the whole, however, I want to put on the record my appreciation for the work done by Dame Denise Platt, who leads CSCI, by Paul Snell, its chief executive, and by the many other people who work for the organisation. As the hon. Gentleman said, the Government are introducing a new inspection and registration regime, which will culminate in the development of the care quality commission. The idea is to have a proportionate inspection regime that in some ways has more enforcement powers than the existing regime, and which focuses the new regulator's resources on those providers that give us most cause for concern. In a sense, however, the regulator's role is just a small part of the story of how we not only protect older people, but ensure that the quality of care that they receive is what it should be. I want to do more than protect older people—I want to ensure that they have the greatest possible quality of life, and I know that the hon. Gentleman shares that aspiration. We therefore need to look at the other factors that will improve quality and, in doing so, enhance the protection of older people. The first of those factors is the introduction of the new star rating system—a transparent system in which relatives and older people themselves will be able to make judgments about the quality of individual care. That is moving much further on: from a register that, in a sense, defines minimum standards and accords a home the right to exist because it meets the basics, to an attitude that says, ““Let us be in a position to make judgments about the relative quality of care offered by providers.”” The star rating system will make the sector more transparent and give people far better information on which to base decisions that are often incredibly difficult about their care or that of a family member. The hon. Gentleman will know that I am already committed to a fundamental review of the adult protection framework—the process will begin early in the new year—including assessing whether the ““No Secrets”” guidance has had a sufficiently powerful impact, and considering the case for a stronger regime. I have said that I am willing to consider, in the context of the review of the adult protection framework, the case for new legislation, if that would add value and make a real difference. Too often in this place, we reach for the legislative solution when it does not always add value or make a difference. I and my ministerial colleagues will need to be persuaded that additional legislation is needed for adult protection. I am open-minded about the possibility, but the fundamental review is to take place and I shall be sincerely pleased if the hon. Gentleman contributes to it. We are also committed to further prevalence studies, specifically on the abuse of older people. There was a study earlier this year on the abuse of older people in their own homes, and we now need to consider a broader piece of work on evidence about elder abuse in a variety of care settings. Commissioning is arguably as powerful as, or more powerful than, inspection and regulation, given the daily relationship within the community between the local authority or primary care trust and the care providers. We have made that clear in the context of world-class commissioning. Yesterday we launched our new concordat with local government and the NHS on the profound reform of adult social care in the next three years. A key element of that reform programme will be telling commissioners that they have a responsibility to reward and offer premiums and incentives to care providers that offer quality, dignity and excellence; and that, equally—the message is a tough one—they should take their business away from providers that cannot offer that quality and dignity. Commissioning is no longer about securing minimum standards. We are saying that world-class commissioning should be about securing high standards. The local authority has more of a day-to-day relationship with care providers within communities than any inspection and regulation regime has, given the number of inspections that can be carried out over a given period. Therefore, we must also put pressure on local authorities and primary care trusts regarding their commissioning responsibilities.