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Mr. Rosindell: Will the Minister give way?

Ms Blears: No. I have a few more comments to make and I am not in a position to give way to the hon. Gentleman.

My hon. Friend the Member for Hornchurch mentioned that Havering council is undertaking a review of its care homes. I know he is concerned about doing that. It is clear that it wants to ensure that in future it is able to meet care standards and to provide the highest quality care for local people, with privacy and dignity. I understand that it will establish four new resource centres that will be capable of meeting people's care needs—there will be not merely accommodation but activities. The centres will try to ensure, however, that people are looked after properly in the community.

I understand that the council is developing innovative packages of care for local people. It is being creative and imaginative in trying to ensure that people are given a reasonable quality of life in residential care. Many of us have visited care homes, and I am sure that some of us have expressed concern on occasion that sometimes there is little activity for people in such settings. We should ensure that people are engaged in proper activities. It is crucial that they should be able to get out and about and live a full life.

In some areas, bed occupancy in care homes is extremely high. I am aware that in London and the south-east there is a shortage of care home accommodation. I understand that nationally there are still some vacancies in the care home sector. The picture is

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not uniform. However, I am aware of the stresses and strains on residential care in some areas. That is why discussions have been taking place with providers to try to ensure that we can pay them the appropriate sums and give them the certainty that they can plan their provision so they can look forward to a future in which they can provide high quality care for local people.

I am encouraged that last year about 5 per cent. more households received intensive home care packages, compared with the previous year. That tells me that we are beginning to see a shift from simply residential care to supporting people at home. In many instances, it is intensive care. For example, it is possible for a home-care worker to be arranged to visit someone perhaps three times a day, six days a week for four weeks, to try to ensure that someone who has had a fracture is given intensive support when they first go home. That will enable that person to re-establish their routines, including cooking and shopping. Such individuals will be able to begin to look after themselves again.

It is crucial that the workers who help the elderly in such circumstances try to ensure that they get those elderly people to regain their self-confidence. Often, after an elderly person has had a fall, there is a loss of self-confidence and he or she no longer wants to venture out. Eventually, it is necessary for the individual to go

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into residential care because of what has happened to them. That is not necessarily the result of illness or physical things that go wrong.

It is vital that we try to ensure that elderly people, as far as possible, are encouraged to retain their independence. We must try to give them as much choice as possible in determining how and where they receive care. We are able to pursue a range of initiatives because we have put extra funding into the system to try to ensure that we do not have one size that fits all. We want elderly people and their families to be involved in considering options and in making decisions that are right for themselves.

We will probably see a reduction in reliance on traditional care homes. There will probably be a move towards domiciliary care packages and independence. We have a hugely challenging agenda. I have tried to set out the considerable amount of extra resources that the Government are providing in all stages of the care system and all stages of NHS care.

The motion having been made after half-past Two o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.

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