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Care Homes

This debate proves to be slightly more timely than I had anticipated—I must thank Mr. Speaker for selecting it for today—as a major report on dementia has been in the national papers this morning. In addition, Prince Charles will this afternoon address a debate on that subject, which will be one of the issues that I discuss in relation to residential and nursing care homes. Care homes have not had a particularly popular image among the general public in the past. The view in the 1970s and 1980s was that they were places that one sent people to as a last resort. They were basically designed to bring profit rather than to provide proper care and services for elderly people. Indeed, my earliest experience of anyone running a care home was in the early 1970s, when I worked for a firm of architects in London, and one of the partners declared that he and his wife were buying a care home. His views about why they were doing it would not have given me any confidence that anyone I knew should reside there. I never spoke to his wife—I am sure that she had a rather different view—but he thought that it was going to be easy money. In the 1980s, there was a vast expansion of care home provision. As in any industry in which there is vast expansion, not everyone who goes into it does so for the right reasons. By the end of the 1980s and early 1990s, the transition of hotels due to the decline of the tourism industry in the south-west led to the small port and fishing town of Teignmouth, where I live, having the highest number of care beds per head of population anywhere in Europe and therefore, I suspect, in the world. Times have changed dramatically since then. The Governments of the 1980s and 1990s regulated harder, and we moved away from the easy option of moving people into care homes to a policy of caring for them in their own homes. The quality of care homes has increased dramatically. Those that might have been a little on the dodgy side in the past have struggled, so I am sure that few exist today. However, that does not mean that the care home sector gets an easy press—one has only to read the sort of headlines that are written about care homes in the newspapers: "Nurse who ran care home accused of murder after seven suspicious deaths"; "Illness kills half the residents at nursing home". And, of course, The Times has run a care home campaign. Most of the care homes that I visit in my constituency are not like that at all. They provide personal care of a high quality, and they care about the residents. The Minister shakes his head; I am not sure whether he disagrees or wants to intervene. Those care homes care about the people who reside in them, but that does not mean that there are no issues to address. They are concerned about how they can provide the high level of care that they seek to achieve. The Government are pressing ahead with improvements. I am sure that the Minister will regale us later, given the opportunity, with all the improvements that have occurred in the past 10 years. I do not wish to steal his thunder, but let me give a few statistics. According to the 2007-08 report of the Commission for Social Care Inspection, in the past six years,""there has been steady improvement in the overall performance of councils in addressing current policy requirements and in regulated care services meeting national minimum standards."" It goes on to say:""There have been some tentative steps to address the new personalisation agenda which have meant more people are able to control and choose their support through, for example, Direct Payments, Individual Budgets and good person-centred assistance…There are some outstanding examples of people's lives being radically improved where they have been able to direct their own support, including those people with multiple and complex needs… However, councils are at an early stage in transforming social care and developments are patchy and vary between different groups of people."" It continues:""People, whether they pay for their care or are publicly funded, are not always getting the individualised help that they need to make decisions about their support which in the long term can be costly to individuals, family carers, councils and the NHS."" I know that a significant number of people do not like direct payment because they find it difficult, but that a number do when the services are there to be accessed. Like other MPs, I am sure, I have people coming to me saying, "Yes, I have the money, but there is no one I can buy the service from," so giving them money is largely a waste of time, because there is nothing for them to spend it on to provide the relevant service.