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Care Homes

First, I congratulate the hon. Member for Teignbridge (Richard Younger-Ross) on securing the debate. I thank him for raising a very important issue and for putting it on record at the beginning of his speech that external bodies have recognised that the Government are pressing forward with improvements across the board on support and the quality of care. I shall say more about that in a moment. I also thank hon. Members on both sides of the Chamber who have contributed to the debate. Hon. Members come to these debates with a lot of passion, because the subject often affects them, their families and, of course, their constituents. Those experiences inform our desire to do more and go further. I shall take this opportunity to applaud the great efforts by regulators, such as CSCI, by care home providers, by nursing home providers, by people who provide domiciliary care and by staff, who have done a huge amount to raise standards in social care. I agree that there are still areas that are in need of improvement, but there has been continuous improvement in the quality of care since we introduced new regulatory arrangements in 2002. By the way, today is world social work day. I mention that in case hon. Members were not aware of it. It is a good opportunity for all of us to recognise the central role that social workers play in supporting individuals, families and communities. They do a very difficult job. The values that underpin the role of social work are central to the values that underpin our society. That applies not least to our desire to pursue personalisation—ensuring that services, whether in a care home, nursing home or out in the community, are tailored to meet the needs of individuals. This issue applies to adults of working age as well as older people. Sometimes debates about care focus only on older people. We know the pressures in that respect, the demographics and so on, but I want also to emphasise—this relates particularly to the social care Green Paper—that we need a social care system for the 21st century that meets the care needs of working age adults with learning disabilities, physical disabilities and so on, as well as of older people who have retired. Those challenges will not arise at some distant point in the future; they are with us now. The ageing population is one of the most profound social changes of our time. It is fantastic that we are all living longer—11 years longer on average than we were many years ago—but that makes demands of and puts pressure on our system, not least in respect of funding and quality of care. Building a consensus about the future of the care and support system presents a significant policy challenge not only for the UK Government but for every nation in the world that is grappling with it. I agree with the hon. Member for Sutton and Cheam (Mr. Burstow) that an ageing society is not a decaying society. He is right to emphasise the positive aspects of becoming older. The fact that we are living healthier and more active lives, as well as longer lives, should be celebrated. I am talking about older people as active citizens, having more choice and control. However, when care needs arise, care needs to be provided in a way that supports people to maintain that independence and to have that choice and control. Before I talk about the detail, I want to emphasise, in relation to the social care Green Paper, that because of the pressures, the changing expectations and the transformation of social care that is going on today, we need a radical rethink of the care and support system. The Green Paper is the vehicle for that debate, and it will be published soon. That will be an opportunity for us to have these debates in the way in which the hon. Member for Eddisbury (Mr. O'Brien) has requested. I want to put on record again the deferred payment scheme. People can go to their council and ask that they do not have to sell their home in their lifetime to pay for their residential care. They can defer that payment, if they approach their local authorities. That is an important point that the hon. Gentleman often misses out in his contributions. Standards have been a key theme throughout the debate. The hon. Member for Leeds, North-West (Greg Mulholland) reminded us of the 169 homes that failed the inspection by CSCI. No one should have to have the experience that was described in a home. I agree with him about that. I will add, though, that although those 169 homes failing the inspection is unacceptable, it is good that 10,208 other care homes are not providing a service of that kind; they are providing a service that does meet the standard that we would expect. The performance of care homes measured against all national minimum standards has shown improvements each year since those standards were introduced. In 2007-08, care homes for older people met on average 82 per cent. of the standards, compared with 72 per cent. in 2004-05, which is a big improvement. Care homes for younger adults met on average 85 per cent. of the national minimum standards, compared with 76 per cent. in 2004-05. We all recognise the work of CSCI and providers in bringing about those improvements. I am confident that the new Care Quality Commission, which the hon. Member for Teignbridge mentioned, will continue where CSCI left off. I understood the point that my hon. Friend the Member for Stroud (Mr. Drew) made about inspection and the inspection process, but it is vital that we continue to drive forward and improve standards in our care system. In 2008, 82 per cent. of homes for older people met or exceeded the national minimum standard for hygiene and infection control, compared with 77 per cent. in 2006 and 66 per cent. in 2004, so work is going on and improvements are being made. Current regulations require care homes to ensure that staff are adequately trained. Hon. Members have mentioned the key issue of training. The regulations and the registration requirements being prepared now will include similar provisions. The CQC, as a regulator, will have a role in inspecting against those, as well as enforcing compliance. The hon. Member for Sutton and Cheam has mentioned the nutrition action plan. Nutrition is another element of care quality in homes. I have seen examples of excellent practice on nutrition, such as printing menus in pictures so that people can easily identify the food and then want to eat the food that they can see, but clearly more needs to be done. The nutrition action plan delivery board was launched by my predecessor, my hon. Friend the Member for Bury, South (Mr. Lewis). Its chair is Gordon Lishman. It has been meeting for the past year, and it is due to give me a full report in about a month's time. I shall examine the report and make decisions on its findings. Staffing issues have been raised. I appreciate the concerns about immigration, but I do not think that the new points-based system will mean that care home providers cannot recruit enough care workers. Our policy objective is to be more reliant on the domestic labour market.