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Mrs. Joan Humble (Blackpool, North and Fleetwood): I should like first to say how pleased I am at the interest that so many hon. Members have shown in this debate, many of them drawing on their own experience to take part in it in a constructive manner. The interest shown in the debate perhaps also reflects the fact that now is the time for a new legislative framework.
The hon. Member for West Chelmsford (Mr. Burns) referred to the Registered Homes Act. That legislation was passed in 1984, and much has changed since then. It is now time to look at a new framework, and especially a new national framework, with national standards, so that individuals do not suffer from a lottery of care depending on where they live.
Perhaps that is why the Bill has been so warmly welcomed by so many bodies--local authorities, the independent sector, the voluntary sector; indeed, all agencies concerned with caring for vulnerable people. It is the culmination of a great deal of pressure from many people over a long period of time. It is important that we get it right, because we are talking about the most vulnerable members of our communities. We need to ensure that we are setting the right standards for them and supervising the care that they receive.
In setting those standards, we must first look at the 1 million-plus people who are employed in the care sector and ensure that they are trained, regulated and supported. Therefore, I shall begin with a few comments about the proposed General Social Care Council. The council will at last give social workers the status as a profession that they deserve.
It has always been especially difficult for social workers to project a positive image of themselves and their work, because examples of poor practice when things go wrong are what hit the headlines. The public rarely hear of the hard work, the long hours and the commitment of social workers dealing with difficult people, often in difficult circumstances.
We must also remember that sometimes the wrong decision is made, and worse, sometimes social care staff are involved in abuse and misconduct. Many people are dependent on the care and support given by social workers and other social care staff, who make vital decisions about their welfare. By setting up the General Social Care Council, we will be able to reassure clients that standards have been set, training specified and codes of conduct put in place, as well as giving status to the profession.
I look forward to the council gradually including more groups of care workers in its remit as the educational standards are set and met. It is often care assistants in residential establishments, day centres or domiciliary agencies who deal with vulnerable people, so they need to be drawn into the scope of the regulatory system.
The National Care Standards Commission will allow users, staff and the public to get a much clearer idea of what standards of service and conduct to expect. Many people who approach social services for various sorts of service have little idea what is on offer, what to expect and how to judge the quality of the service. At last, we are to give them information that will enable them to judge the quality of the services offered; to know what they are entitled to; and if it is not offered, to ask why. As members of the public, they will be able to get involved in the debates in which we are engaged in determining care standards. I hope that the commission will actively engage in the process of empowering service users, listening to what they want, and discussing their priorities for social and nursing care.
We have heard much about the need to listen to children. I entirely agree that it is important for the voice of the child to be heard. Equally, it is important that adults with disabilities have a say in the sort of provision that they receive, and that elderly people are listened to, not just for the purpose of setting up the services, but when they have complaints and concerns. I am particularly conscious of the fact that many elderly people do not complain about the services that they receive. They are extremely vulnerable, so we need to encourage them to be directly involved.
I shall comment on the "Fit for the Future?" document, with no apologies to my right hon. and hon. Friends who have spoken about it with passion. I want to pick up on concerns expressed by Opposition Members. It is not just in rural areas, as the hon. Member for Ceredigion (Mr. Thomas) said, that care homes are a vital part of the community.
Many elderly people have come to Blackpool to retire. They come to the Fylde coast to enjoy the sunshine and all that it has to offer, but the time comes when they look for residential care. We have many residential care homes, which I visit. I speak to the staff who work in them and to the residents who are looked after there.
"Fit for the Future?" is an important document and should inform much of our debate. Many of its proposals will improve the quality of life and the quality of care for older people, so we must not dismiss it out of hand. Many of its recommendations for good practice are already being implemented in care homes, but those who run homes in the private sector in my constituency are concerned about the physical standards that homes will have to meet.
Some of those standards will be difficult, if not impossible, to meet. The document acknowledges the need for a realistic timetable for implementation of national standards, and recognises that they will need to be applied with a "certain degree" of local flexibility. That flexibility will be crucial.
In the Lancashire county council area, 71 per cent. of homes will not meet the standard for 10 sq m bedrooms. In the Blackpool unitary authority area, that figure rises to 91 per cent. Fifty per cent. of Lancashire's residential homes and 34 per cent. of Blackpool's will not meet the requirement for 80 per cent. single rooms. That includes a large number of homes offering care to my constituents.
Mr. Michael Jabez Foster (Hastings and Rye): Does my hon. Friend agree that the seaside towns especially will have a problem? Victorian and Edwardian buildings, many of which are listed, will have particular difficulties in complying with the standards, not just in terms of cost, but physically. Does my hon. Friend agree that a light touch will be important with respect to those areas?
Mrs. Humble: I strongly agree with my hon. Friend. Many of the homes that I visit are exactly the sort of establishment that he describes. They are small homes offering fewer than 25 beds and are converted from former domestic residences. Indeed, many elderly people choose them precisely because of the homely environment that they offer. I hope that the Government's final proposals will be sufficiently flexible to recognise the particular local difficulties that areas such as mine and other coastal towns may have.
Mr. Hammond: I know about the star rating system that operates in care homes in the hon. Lady's constituency. Does she agree that it might be better to think in terms of establishing an overall star rating system measuring the overall care experience in a home than to think in terms of mechanistic measures of input, as the Bill seeks to do?
Implementing "Fit for the Future?" as a standard will cause widespread home closures. It will seriously destabilise the care market, and will also reduce the amount of choice for potential clients. All that, however, must be seen in the context of the full commitment of my local care providers--and certainly that of the Lancashire Care Association--to the provision of high-quality care. I see that when I visit homes in the area.
In Blackpool, the commitment to standards and quality has led to a partnership between the local authority and the independent and voluntary sector in the development of an independently run star rating system. Residential
The star rating scheme offers a mechanism for external validation, but it is also a useful management tool for home managers. It offers annual assessment of residential care establishments that highlights both their strengths and their weaknesses, enabling managers to deal with the weaknesses and enhance the strengths. In the first year of the scheme, about half Blackpool's homes have participated and have been awarded stars. A brochure has been produced, which means that members of the public have a much clearer idea of what services are on offer before placing their elderly relatives in homes.
Blackpool council has decided to reward higher standards of care by paying homes more if they have higher star ratings. It recognises that investing in quality sometimes has cost implications, and it is rewarding those who are investing in training and in improving quality. There has been a 3 per cent. increase for two-star establishments, a 4 per cent. increase for three-star establishments, and a 5 per cent. increase for four and five-star establishments in the fees that the local authority will pay. That often leads to substantial additional income for homes, so it is clearly an incentive for investment.
I am sure the Minister will expect me to say this. Yes, sometimes quality does cost--although many aspects of the Bill demonstrate that we can raise standards simply by changing work practices and improving management. I know that substantial additional resources have already gone into social services, and I have seen the results in my constituency. Lancashire county council has invested an additional £750,000 in community care services, and that is now showing on the ground in terms of the assessments that people receive. There is much to be welcomed in the Bill. As I have said, we see examples of good practice locally--certainly in my constituency.