Kevin Brennan (Cardiff, West) (Lab): I congratulate my hon. Friend the Member for Caerphilly (Mr. David) on securing this debate, which involves an extremely serious issue that is understandably a cause of great concern for his constituents. I also congratulate him on his speech, in which he outlined what has happened in a particular care home in his constituency. Notwithstanding the fact that part of my reply will concern technical matters, he is right to display his indignation and passion about what has happened to older people in that care home. Following devolution, the case is, of course, primarily a matter for the National Assembly for Wales, but I pay tribute to my hon. Friend for the assiduous way in which he has served the interests of his constituents by drawing the matter to the attention of the Government and of the House.
Taking good care of our older people is particularly important in Wales, where we have a higher concentration of older people than the rest of the UK. Around 20 per cent. of the population in Wales is aged over 60, which is higher than the percentage of over-60s
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in the UK population as a whole. Over the next 20 years, demographic changes will significantly alter the balance of the population. The number of people over 60 in Wales will increase to 28 per cent. of the population, and the number of people over 85 will increase by more than a third. That relates to the issues that my hon. Friend has raised todayin particular, care homes that look after people with dementia.
People are progressively living longer and more healthy lives, which means that they will require more care, support and services at key points and that those services must become more personalised and integrated. The National Assembly has delegated full operational responsibility for regulatory actions and decisions regarding care homes to the Care Standards Inspectorate for Wales, and decisions taken by the CSIW are in line with standards set by the National Assembly. At a UK level, the Government have enabled the introduction of those standards, which are enforced by the CSIW in Wales and by the Commission for Social Care Inspection in England, through the Care Standards Act 2000 and the Health and Social Care (Community Health and Standards) Act 2003. The aim of those standards is to raise the quality of care and the level of protection for vulnerable people.
I agree with my hon. Friend that few things are more despicable than the treatment of older people that he described in his speech. Older people have often worked hard all their lives, and they need care and support in their later years. My hon. Friend tacitly indicated that the vast majority of care homes provide a good service, but the influence of a few bad eggs in the system extends beyond the direct suffering that he has described by spreading apprehension among older people and their families about using a residential care home. I am sure that he agrees that it is important to note the good work that is done in many of those homes. I am satisfied that the system is robust enough to deal with the abuses that he has described today.
In respect of the case to which my hon. Friend refers, concerns had been expressed and there had been high levels of inspection by the CSIW stemming from those concerns over a period of time. The CSIW issued a notice of decision to cancel registration when it was decided that the registered provider had failed to make any significant improvements. The company involved, Puretruce Healthcare Ltd., appealed against the decision and, although the care standards tribunal upheld its appeal, it also stated that the CSIW was entirely justified in making its original decision to withdraw registration.
My hon. Friend asked how it is possible that a decision can be made on the basis of the current situation in the home rather the situation that pertained prior to the registration being withdrawn. The position is that under previous legislationthe Registered Homes Act 1984the tribunal would take a decision based on the situation in the setting at the time that the regulatory authority took its decision. However, under the Care Standards Act 2000, the care standards tribunal considers whether the decision taken by the regulatory authority was correct at the time, as it agreed that it was in this case, and then takes a decision on the basis of the current situation.
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I understand my hon. Friend's concern about that approach, but its intention is clearit is based on the fact that the sudden closure of a care home, even one where standards have not been adhered to in the past, can have a very disruptive impact on vulnerable older people. I understand that there are no plans to change the existing regulations and legislation in the way that my hon. Friend has requested, but I assure him that his words will be noted and considered very carefully by Ministers following this debate.
Although the National Assembly sought a review of the Care Standards Tribunal outcome, I have to inform the House that this week the tribunal turned down that request. It did, however, set stringent requirements for the care home to demonstrate that it will meet the required targets in future. Every two months, the provider has to supply the CSIW with a report from an independent consultant in health and social care services stating that the home is making progress against set targets and meeting the necessary requirements. The tribunal report also stated that this was most likely to be the home's last chance to put its house in order.
In this instance, the Government's and the National Assembly's regulatory framework for care has been brought into action. Following rigorous inspections of a failing home, action was taken which is now being enforced. I know that that is not what my hon. Friend wants, but it is very different from the days when such homes were left unchecked and were able to continue to place residents at risk by providing inadequate care.
Any neglect or abuse of older members of our society, be it physical, mental or even financial, is an outrage. In addition to improving regulation and inspection services, there is an undeniable need for robust policies to help and protect older members of our population. With that in mind, I am happy to say that this month the Commissioner for Older People (Wales) Bill was introduced in the other place, and received its second reading on 14 June.
Mr. Dai Havard (Merthyr Tydfil and Rhymney) (Lab): I am listening with interest, because I share the council area with my hon. Friend the Member for Caerphilly (Mr. David). I think the Minister is saying that, although the regulations have been drafted and applied with good intentions, they contain a loophole that is being exploited in the way described by my hon. Friend the Member for Caerphilly. If the regulations are not to be changed, can the issue be raised during debate on the Bill?
The proposed commissioner for older people will play an important role in ensuring that throughout the many relevant devolved services older people's interests and rights are taken into account. The commissioner's role will in general be to ensure that the interests of older people in Wales are safeguarded and promoted, as well as influencing policy and service delivery across devolved fields. The commissioner will also have an important part to play in implementing the National
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Assembly's agenda of tackling age discrimination wherever it occurs, promoting positive images of ageing and giving older people a stronger voice in society.
Under the Bill, the National Assembly can make regulations giving the commissioner power to help an older person to make a complaint. It could be to the Assembly, to a regulated service provider in Wales, or to bodies such as local authorities, health boards and trusts. Depending on the circumstances, the commissioner might also offer financial support to help the person meet the costs of pursuing the complaint. In practical terms, that means that the commissioner could help older people to make complaints about the service that they were receiving in care homes in Wales, such as the one referred to by my hon. Friend. The commissioner could help in the making of representations to the CSIW, as well as helping the person to make the complaint.
Mrs. Madeleine Moon (Bridgend) (Lab): Having worked as a care standards inspector, and having been responsible for the investigation and consideration of a number of complaints including "protection of vulnerable adults" investigations of abuse in care homes, I fear that this is a circular route. People who already consult the inspectorate make very serious complaints, such as the one that was investigated at the care home cited by my hon. Friend the Member for Caerphilly (Mr. David). It may then be acknowledged that the investigation has found that abuse took place, that standards in the home have fallen well below those specified in regulation, and that the performance of staff has been unsatisfactory. Yet a care home that has been given enough rope to hang itselfthat has been given several opportunities to improvecan be told at the tribunal that at the last possible opportunity it has improved, and can continue. How will the new opportunity to complain to the commissioner be of benefit unless the commissioner can overrule that final clause?