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Ms Ann Coffey (Stockport): I very much welcome the setting up of the National Care Standards Commission for the regulation and inspection of adult and children's services in the independent and public sectors. My brief remarks are on standards.
The current standards for the registration and inspection of children's homes cover several important matters, such as the physical environment, staffing, staff training and health and safety. I hope that during future consideration of standards for children's homes, careful thought will be given to establishing standards for the care and control of young people placed in such homes.
I do not underestimate the challenging and difficult behaviour presented by some of those young people, nor the problems experienced by staff in maintaining control and providing care. Children's homes take some of the most difficult and disturbed young people, some of whom went into care for the first time because their problems were unmanageable in their own homes. Local authorities choose placements with those problems in mind.
The progress of those young people is subject to regular review by social workers. Too many children leave the care system with poor skills; they have low educational achievements and are often extremely angry. The care system should not be merely a holding operation; it should give added value to children's lives. Sadly, that does not happen for a majority of children. In essence, that is the problem we face.
The commission should examine the care and control that is provided by those homes. It could consider how the homes deal with such matters as absconding, incidents involving the police, exclusions from school, truanting or problems with neighbours--all of which are problems of control. It could also examine the activities and structures in the homes, as they not only cope with problems but give added value to young people by providing a high standard of care and support.
Standards for the physical environment and for staffing are designed to provide care and control. However, unfortunately, that objective has often been lost. To ask the commission to consider care standards in relation to outcomes for the young people in those homes would firmly re-establish that relationship.
I welcome the requirement for children's homes of fewer than four children to register. I thank my hon. Friend the Member for Wakefield (Mr. Hinchliffe) for his kind remarks. At worst, the loophole was open to unscrupulous providers; at best, it failed to provide proper safeguards for children and young people, who were often placed many miles away from their local authority. It is good news that, after the Bill receives Royal Assent, the Children Acts will be amended to require such homes to register immediately with a local authority. That shows the Government's determination to improve care standards in children's homes.
The requirement for the regulation of independent fostering and adoption agencies is welcome. For a long time, their position has been unclear; they have operated in a legal grey area, because fostering regulations allowed local authorities to delegate some of their responsibilities to such agencies. The relationship between local authorities and agencies has varied. Some agencies have suffered because of local authorities with attitude.
The recognition of such agencies will give foster parents a choice of agencies. I hope that will encourage all agencies to improve their support to foster parents, who have a difficult and challenging occupation.
I welcome the fact that local authority fostering and adoption services will be subject to inspection. There has been widespread concern about children waiting in the system for a decision on their future and about the length of time it takes to find permanent families, including adoptive families. Figures show wide variation between local authorities in the percentage of children placed for adoption; in the length of time that children wait in care; and in the number of breakdowns in the care system experienced by children.
The organisation of services varies widely. In some local authorities, dedicated, specialist teams deal with adoption, while in others, social workers provide such services among their other responsibilities. I do not know whether those different forms of organisation affect the figures--it would be interesting to find out.
As well as the introduction of standards for fostering and adoption agencies, I hope that other factors will be considered--for example, the length of time that children have been in foster homes waiting for a decision on their future; the length of time that children wait before adoption; the number of multiple placements; the number of breakdowns; and the number of complaints from foster parents. Such matters reflect the service that is provided. An improvement in fostering and adoption services, as part of better overall planning for children, is fundamental to the provision of permanent homes for children.
It is important that the system gives the best possible care to the young person or child who enters it. Children should feel cared for. To feel that nobody cares is a lonely experience for an adult; for a child, it is devastating. In setting standards, the Bill will ensure that care is a positive experience for children. That is long overdue. The Bill is much to be welcomed.
Mr. Andrew Rowe (Faversham and Mid-Kent): The Bill brings together many of the interests that I have pursued during my time as a Member of this place. The hon. Member for Wakefield (Mr. Hinchliffe) was kind enough to recall my campaign for a variety of improvements in personal social care, including a campaign for a general social work council. When we were in government, I had many an argument with Ministers about the importance of such a council.
It is a pity that for so long proposals excluded workers in that field. I always argued that a social work council should be something like the Michelin guide, so that people's skills could be noted as they acquired them, rather than waiting for some unspecified period when people would be deemed to have sufficient qualifications to be allowed to register. That was a shame.
The Bill demonstrates that the quality of care is absolutely vital. One of the distressing features of public care--whether for the elderly or, more important, for children--is the fact that the care providers change so fast. The vulnerable people who most need stability are frequently confronted by a change of carer. Most young people in care are subjected to more changes in the person who is supposed to look after them than I would have been able to cope with at that age.
In parenthesis, I suggest that it would be a better investment of public money sometimes to provide security and affection to the young people who are in long-term care than to provide the same sum later for the police, prisons and young offenders institutions. I feel strongly that we sometimes consider the problem the wrong way round. We should invest in the relatively small number of young people in long-term care so that we can compensate them for the instabilities and miseries that they have endured. Community Service Volunteers, of which I am
I am very pleased by the proposal for a children's rights director even though I would have preferred a children's rights commissioner. I have always believed that a commissioner was the right way forward, as does the NSPCC of which I am a trustee.
I hope that as the United Kingdom Youth Parliament--I have the honour to be the chairman of its steering committee--emerges from its birth pangs, it will grow into a serious representative voice for young people. If we can make it as inclusive as we are desperately trying to do, it will become a sounding board on which Ministers and Government organisations will be able to test their ideas. We should make the Youth Parliament as information technology sensitive as we can, so that Government proposals can be put into a language that young people are able to understand. We will then be able to float our ideas by them. At present, most of our provision for young people is made in complete ignorance of what they themselves would choose.
It is vital that we improve the training and recruitment of care staff. One of the paradoxes of public provision--especially low-paid public provision--is that as the employment figures improve and unemployment falls, the difficulty of recruiting and retaining good-quality staff in the caring professions becomes much more acute. The Bill provides a remarkable opportunity for the Government flamboyantly to turn their back on age discrimination.
Many people--mostly, but by no means exclusively, women--have long experience of caring for a relative. When that relative dies or is taken into long-term permanent care, those people often want to use their caring skills in return for a part-time or full-time wage. Many of them will have an instinctive sympathy, as well as age parity, with the people for whom they care. Many of the problems of respect that the Secretary of State mentioned in his speech will solve themselves because such carers will deal with their near contemporaries. We do not do nearly enough to make caring attractive to those of our older citizens who would like to do it.
Another element of training has been extraordinarily mishandled. I used to get extremely angry with Conservative Ministers--I am happy to get equally angry with Labour Ministers--about the way in which we have mishandled the national vocational qualification. The whole point of the NVQ, as I saw it, was to authenticate skills that people had acquired in practice. For example, if they had learned to turn someone so that he would not get bed sores, to feed someone who could not feed himself or to wash someone with a disability, those skills could be accredited through the NVQ.
However, in the traditional British way that has lasted for at least 100 years, academics have tried to get hold of the system and turn the qualification into the equivalent of an O-level or something similar. They have tried to make the qualification more academic, which is nonsense. In an occupation in which 80 per cent of people have no recognised qualification, we need to recognise the practical skills that they have and on which they can build in part-time, day-release or other studies. We would then have more people with qualifications.
I am also interested in the costs that will result from the Bill. It will be expensive if it is to work, and all of us want it to work well. However, the idea that changing names and changing structures will enable us to find the money to make it work well is pie in the sky. If 60 per cent. of agencies already do not carry out their inspection responsibilities because they do not have the resources to do so, can we be certain that the new agency will carry out all its inspections and that it will have the money to do so?
If we are to have much better and more effective training for a higher percentage of caring staff, they will expect an enhancement in their pay. If they receive that, it will increase costs enormously. Therefore, it is essential that the purchasers of residential care and domiciliary services pitch what they are prepared to pay at a rate that will bring providers into the market. Whether they are local authority providers or private providers, purchasers of domiciliary and residential care increasingly squeeze the sums of money that they are willing to offer. That is a dangerous game.
I was sorry to hear in some exchanges a continued suspicion of the private sector. That is a shame, because in this area, above all others, the record of the public authorities has not been very good. The many scandals in children's homes, in particular, and in many local authority and publicly provided residential homes for elderly people clearly demonstrate that the nature of the provider is by no means a guarantee of good service.
In the private sector, many small homes have typically been set up by couples who felt stultified by the constraints of the public sector. They worked for public authorities or for the national health service and felt that they were not able to do many of the things that they would have liked to do for their patients or clients. Therefore, they left and set up a home with the firm intention of providing better care than they would have been allowed to provide in the public sector. To belittle what they do or to imply that they are in it only for the money is a shame.
The Bill should provide a real breadth of vision. I wish to provide an example that is continually forgotten but that arises from one of the campaigns with which I have been associated. Many problems would be greatly reduced by a serious programme of building lifetime homes. A great new welter of houses is to be spread across the south-east, built by private developers. They must not be allowed to claim exemption from new building regulations that have, at last, been passed and state that there must level entry at front doors, that one must be able to turn in the hall and so on.
If one allows houses to be built with steps up to the front door, narrow doors and windows too high to see out of when one is in bed, the demand for residential care will again be exaggerated. When estates are being modernised, lifetime houses should be built. There is a lamentable lack of imagination and drive when it comes to making sure that homes meet minimal requirements and are accessible for people with disabilities and those with growing frailties.
The new system suggests that we could make much more use of volunteers. I remember Peter Smallridge, a former director of social services in Kent, saying that one need only put up a notice outside a home saying
However, we want more than that. We want better links with the education service, whether formal education, such as further education and adult education, or informal education, such as the university of the third age. One of the worst things that happens to people when they go into residential homes is that they switch off. It suits the stretched staff for them to watch "Neighbours"--not taking it in, but just sitting there--rather than being stimulated by new interests. I hope that the new dispensation will lead to such stimulation.
I have some minor queries. Who will be responsible for the accuracy and timetabling of checks on staff? At the moment, checking to find out whether a member of staff is fit to look after children, boy scouts and so on takes so many weeks that an employer loses that person in the process. That is terribly important, as is the fact that nursing agencies that are to be regulated should take care to ensure that nurses are working for an appropriate period. At the moment, nurses with a mortgage to pay sign up with a nursing agency; they become exhausted on NHS wards and exhaust themselves even more until they provide an inadequate service to patients and staff.
I conclude with the point made by my right hon. Friend the Member for South Norfolk (Mr. MacGregor). It is important that the inspections relate to the quality of care, not the size of the bedside table.