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Care Homes

There is a role that must be filled in adult care and there are issues with how county councils or unitary authorities are inspected. The dilemma is whether to support homes that need assistance by putting resources into them or to support the more expensive homes, which tend to be run better, although I do not want to cast any aspersions. The dilemma is whether local authorities want those homes to survive and flourish. That is true of Gloucestershire, where the authority is taking legal action over the loss of one of its stars. There is a huge role for local authorities, but my argument is about whether they can dispense that role as well as they could and should. When a legal process is entered into, the clock cannot be turned back easily. Homes that could stay in place and provide a valuable service are sadly driven out for all sorts of reasons. My last point on the inspection process is that it is quite closed; everybody knows everybody else. With the best will in the world, care homes know their inspectors and the inspectors know the home's background. That may not always be healthy. Specialist homes have not been mentioned. We are talking mainly about older people, but care homes contain many other people with different disabilities. My worry is that when one discipline takes the lead, the other disciplines tend to hide from their funding responsibilities. If there is a health-led funding arrangement, adult and children's care tend to hide from their funding responsibilities. I am dealing with a sad case of somebody who is disabled from the neck down. He is in great need of educational help and is very bright, but he can receive no help to get to the local college where he could carry out a course of study. That is belittling for him and unfair. I hope that the Minister will say how we can get more joined-up thinking and action. I will finish on a positive note. For the last 20 years, I have been involved in the Standish project, which hopes to turn a former hospital site into an integrated care setting. In future, there must be better partnership between the public, voluntary and private sectors to run genuine integrated care. There are good examples, such as Horsfall House in my constituency. Sylvia Morris and Chris Booth, a local GP, saw that there was no care home facility and so provided it. It offers a genuine continuum of care that provides for people who are fit and able but in need of TLC, through to those with care needs who need to be in an intensive setting. I believe that that is the future. The issue is how we get there and who will fund it. We would all agree that there is a huge onus on the person who is being cared for and their relatives to provide the lion's share of the funding, unless they are entirely reliant on the state. That can be unfair and can leave people with dilemmas about how much they are prepared to pay, where they are prepared to send their relative and who they are prepared to pay.