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20 Oct 2009 : Column 185WH—continued
9.58 am
Mr. David Drew (Stroud) (Lab/Co-op): I am delighted to take part in this debate. I congratulate the hon. and learned Member for Torridge and West Devon (Mr. Cox) on choosing this topic. I know his part of the world rather well, but I will not talk about specific areas. However, I should like to put it on record that I was in one of my sheltered units in Sherborne under the tutelage of a scheme manager. I have to say at this point that it has taken me nearly 10 years to use that title rather than "warden". If I get it wrong, I apologise because I am always being told that wardens are now called scheme managers. The unit to which I refer is under the scheme managership of Marilyn Wood. It is an excellent unit that has become a very sheltered scheme. I want to say a few things about that, given the way in which the arrangements have moved on from the days of the traditional sheltered unit.
Stroud is very good in this field, as we have 29 units, which are enormously varied. In many respects, however, my message to my hon. Friend the Minister about the current system is that if it ain't broke, why are we trying to fix it? However, we must also recognise that sheltered accommodation has to move on, and one of the ways in which it should do so is in building more units, which are needed. Recently, the only units that have been provided are either in what I call the not-for-profit sector or, more particularly, in the private sector, whereas to me sheltered accommodation is a function of local authorities and one that they fulfil very well.
I pay due regard to Pauline Simpson, who chairs the United Sheltered Accommodation Panel in Stroud. Somewhat contrary to what the hon. and learned Member for Torridge and West Devon said, it is interesting that in Stroud, people have organised terribly effectively, to the extent that they are pushing the boundaries of participation and consultation. It is certainly not uncommon for 28, even on occasion 29, of the units in Stroud to be represented at that panel. It is a fairly fierce body for anybody going before it, because the people on it do not hold back in saying what they think and they are very clear in their thinking.
The starting point, or backdrop, to this discussion is that Stroud, perhaps like the rest of the country, has been reviewing the role of sheltered accommodation for some considerable time. The current review started in March 2007, which is more than two years ago, and that review was itself conducted on the back of earlier reviews. I think that we need to reach a conclusion about what we want to do. Much of the review process is about establishing where Supporting People fits in the
context of sheltered accommodation. I must say absolutely clearly that Supporting People was a good concept. I say so, because Gloucestershire did peculiarly well out of the early budgetary arrangements for Supporting People. The difficulty was that it was not at all clear how the money would be divvied out, and as the money has been reduced, the allocations have definitely become much more tense and controversial, to the extent that Gloucestershire has had to pay back money, relatively speaking, and it has certainly been capped, which is very unhelpful. This debate is highly pertinent, because in April 2009, we lost the ring fence, which has brought this issue to a head and led a lot of tenants to question how sheltered accommodation will continue to function in future.
I take it as read that sheltered accommodation is appropriate for those who choose it. I deliberately use those words, because sheltered accommodation is not suitable for everyone. However, I become very annoyed when people see it as a historic form of institutional provision, because that is not what it is. It is very good at what it does, and the key to that success is not the buildings but the people involved. The most important person involved is the warden or scheme manager, and if a unit gets a good one, it functions very well.
One of the things that was drawn to my attention by Pauline Simpson of USAP was a report on this subject. The hon. and learned Member for Torridge and West Devon talked about a report by Help the Aged, but the report to which Pauline Simpson referred me was by Pascalle van Bilsen and others. It looks at sheltered housing, and compares it with independent housing, and the discussion section begins:
"The most prominent finding of this study is that two comparable groups of frail elderly people in two different housing conditions differed in perceived quality of life, autonomy and feelings of insecurity; respondents living in sheltered housing evaluated their quality of life more favourably and experienced greater autonomy and fewer feelings of insecurity than respondents living independently in the community."
That sums up the situation. Why do people want to go into sheltered housing? It is not to lose their independence but to protect it, because they get the best of both worlds; they have someone just keeping an eye on them, but they can keep their own room and their own way of living, despite the fact that they are living communally, which I think has an enormous amount to be said for it in older life.
The problem is that much of the accommodation has aged and we must recognise that it is necessary to invest in sheltered units, just as it is necessary to invest in every other unit of accommodation. If Stroud is taken as an exemplar, which I think it can be, many sheltered units are bedsits, which in this day and age are not popular, because of the lack of space. Moreover, there are always issues related to pets and the way in which people think that their home is really a home, rather than something else.
There is also the issue of the age at which people can go into sheltered accommodation-I am always wrestling with that issue. Notionally, people can go in from the age of 60 onwards and I think that that is quite important. For some people, their situation is such that they need to enter into this type of sheltered living at a relatively young age, normally because they have a disability or because they are vulnerable in some way or other. However, that causes some tensions, because there may be a huge age range of people in sheltered accommodation.
We must also consider the suitability of some of the accommodation for people as they become frailer. We need to talk about wet floors and how people can be bathed. All of the facilities, for bathing and for other activities, need to be made fit for purpose, if someone's quality of life is to be kept at such a standard that they want to live in sheltered accommodation rather than seeing it as a trap. There are also issues related to things such as mobility scooters, which in many respects are a pain, but they are absolutely vital for the people who use them. In the area where I live-Sherborne is in Stonehouse, where I reside-mobility scooters are very attractive, as it is a flat part of Stroud. However, if people are not careful, there are mobility scooter motorway wars, with scooters buzzing around. That is great, but each scooter needs to be powered up and kept in an appropriate place, which is not always easy in some of our older buildings.
Turning to the subject of resident scheme managers, there is always tension about availability. It is important to lay down standards that are fair to the scheme managers, but of course back-up is required. My father, who recently passed away, relied on an alarm system in the community, and that system is crucial. What happens when someone falls over? Who picks them up? There are some real tension points in that situation. Is it the ambulance service that picks them up? Is it a requirement that the scheme manager should do so, or is there some other way to deal with that situation? It is a perennial debate.
I am aware that other Members want to speak in the debate, so I will bring my remarks to a fairly speedy conclusion. We have spent long enough reviewing sheltered accommodation, which has a part to play. I certainly welcome some of the material from ERoSH-a consortium on the essential role of sheltered housing-which examines the role of sheltered accommodation in the round. ERoSH is not against floating support per se. There is a gentleman in my constituency called Ron Birch who provides floating support and he himself is quite critical about some of the ways in which we are going, because he believes that floating support is seen as a cheaper option and as a way in which people can try to pretend that they are providing quality support when in reality nobody is providing such support.
Bob Spink: Does the hon. Gentleman think that it would help to inform and improve decisions about sheltered accommodation if there was some more reliable research into the overall total cost of this decision to remove wardens? Establishing that overall total cost would take into account contingent expenses in the national health service and in social services when wardens are withdrawn and floating support is provided, because there is a cost differential in the longer term.
Mr. Drew:
Yes, I agree with the hon. Gentleman. As much as I do not want to see death by review, there is a lack of good qualitative research that looks at costs and some of the reasons why people go into sheltered accommodation. The point that I was going on to make was about how we manage the way in which people exit-I do not mean "exit" in the worst possible way, but literally the way in which people need to move into residential care because they are no longer capable of being nursed. That is why I liked the concept of very
sheltered accommodation, as it was a stepping-stone. However, the issues are not easy, and they must be coped with at an individual level.
We need to get out there and proclaim the value of sheltered accommodation. It must change and be updated, and it certainly needs investment, but the benefits are there for all to see. I congratulate the hon. and learned Member for Torridge and West Devon, who spelled out those benefits much more fluently than I have done, but consultation with those in sheltered accommodation must be a real exercise. It must involve participation, and it certainly must give people-
Mr. Bill Olner (in the Chair): Order. The hon. Gentleman was doing quite well until he took that last intervention.
Mr. Drew: I will bring my remarks to a close, Mr. Olner. We need definitive support from Government and local authorities, and we certainly need the support of those whom we would like to live in sheltered accommodation. That is where we should be going. Let us make sure that we put it on the record, along with the support that exists for it, because it is very appropriate for many of our older people.
10.11 am
Dr. John Pugh (Southport) (LD): I congratulate the hon. and learned Member for Torridge and West Devon (Mr. Cox) on how thoroughly and exhaustively he introduced this topic. I will explain briefly, widening the debate a little, why I am here.
I picked up a lot of additional casework recently relating to tenancy and leasehold issues, many of which centred on service charges and quite a few of which concerned the role of scheme managers. There were complaints and discussions about their availability, the change in service and the cost-in many cases, the increased cost-of the service. It seemed to affect a wide variety of accommodation in my constituency, with a wide variety of clients and providers, ranging from the more traditional model of low-cost sheltered housing to high-cost bespoke luxury developments.
Generally, the picture was fairly simple. It was generally agreed that less was being provided for more. That is annoying, as the hon. and learned Gentleman explained in his initial remarks, to anybody on a fixed budget trying to manage their finances who does not anticipate those finances growing to any extent. If one talks to residents, they often put the cause down to something relatively simple: they blame either the parsimony or the profiteering of the organisation in putting up the charge.
However, when one talks to the organisations themselves-the various housing associations and companies that provide sheltered housing-it gets a little more complex. They talk about tax changes and the changing treatment by Her Majesty's Revenue and Customs of benefits in kind. Some-I must be careful with the hon. Member for Castle Point (Bob Spink) here-talk about the effect of the EU working time directive on the number of hours that wardens in sheltered housing can work. Many, of course, talk about the change in the Supporting People budget, the separation of housing and care costs and the end of local authority ring-fencing.
All those issues are, frankly, out of the range of ordinary tenants and leaseholders. They are simply confronted with the effects. A particularly acute case in my constituency occurred in a housing development run by Anchor housing, a reputable sheltered housing provider, and involved a tenant who was locked out. She happened to be locked out after the on-site warden had finished her hours. Other tenants visited the on-site warden on the tenant's behalf, trying to get her to open up the house, but the warden refused, saying that it was beyond her role at the moment. The tenants went one step further and asked for a key, which was not provided either. In the end, a locksmith had to come all the way from Bolton-that was how the Anchor scheme was supposed to run-to let in the old lady who had waited two hours in the cold to get into her accommodation.
That is not the nature of sheltered housing, which is why the incident attracted a degree of media attention in the national press. I suppose that the case could be seen as the extreme tip of quite a large iceberg. Generally speaking, the pattern is fairly clear. The warden service is changing, sometimes in good ways-wardens now are probably better trained now than they have been hitherto-but generally, there is a switch away from the beck and call model, which had its limitations and sometimes imposed on wardens in ways that were inappropriate, to the less popular remote model. That raises three key issues.
The first is a straightforward consumer protection issue. People choose and budget for a particular care package when they go into care housing, as the hon. and learned Gentleman explained clearly in his initial remarks. They pay for a warden service that is then reduced, or they pay for an on-site service that is then removed, seemingly with limited redress. The possibilities for redress must be explored. Warden service is not the only area in which that can happen. I do not want to make Anchor housing the villain of the piece, but the organisation also goes to residents and says, "You've got a bath now. We are replacing it with a shower whether you like it or not, unless you have a doctor's note." That does not strike me as being in the spirit of sheltered housing.
That brings me to the second issue. Sheltered housing providers need to think hard about their mission. They are identified with a particular product and a particular kind of client relationship. I know that some of the larger ones want to change the nature of that relationship, and are more attracted to the provision of peripatetic care packages than to the traditional role of providing sheltered housing in the understood sense. However, such providers risk becoming more business-like and losing some of their original sense of mission or soul. One thing weighing heavily on people who complain about what sheltered housing provides is the very high salaries paid by some of the bigger housing associations to their chief executives.
The third issue is public accountability. If providers have access to the public purse, how can they account for that better? Ironically, it is the bigger providers that sometimes find it easier to fill in all the forms and assessments for which they are asked. I have Abbeyfield homes in my constituency, as well as a number of smaller providers. They genuinely struggle to deal with
the documentation loaded on them by the local authority, which goes as far as to ask individual clients, including 90-year-old ladies with dementia, what they think of procurement strategies. I have seen the documents; they are wholly inappropriate and make it difficult for smaller providers to prove they are doing a really good job, as is the case.
More bureaucracy is not the solution to any of those problems. The solution, which has been well mapped out in this debate, is to empower the vulnerable citizens who end up in sheltered housing. That might require considering arrangements for advocacy on their behalf, as some of them are not particularly capable of doing so themselves. As was also illustrated by the hon. and learned Gentleman in his opening remarks, we as policy makers must decide what should be provided, or we will simply end up with what we get, not having planned for it. That throws the ball back into the Minister's court, because the call for clear leadership is well supported.
10.18 am
Mr. David Heath (Somerton and Frome) (LD): I, too, congratulate the hon. and learned Member for Torridge and West Devon (Mr. Cox), as well as the hon. Member for Stroud (Mr. Drew) and my hon. Friend the Member for Southport (Dr. Pugh), on not only the content of this debate but the tone in which it has been carried out. It is absolutely right that we seek a consensus on this issue, which affects our constituents, rather than indulging in party political debate. It is not a party political issue.
I am particularly indebted to the hon. and learned Gentleman for securing this debate. Had he not done so, I would have had to, in order to meet my commitments on the matter to the residents of Elizabeth court in Martock, whom I met only last week. I said, "Of course I will try to secure a debate early in the next parliamentary Session." The hon. and learned Gentleman has done me a great service.
The residents of Elizabeth court have a particular concern. They are losing their part-time warden, having lost their full-time warden some time ago. That is not a local government housing scheme, but a housing association scheme that did not derive from council housing. That widens the context of the debate slightly from the traditional question of what a council provides, because the issue concerns all providers.
While talking about my constituency, I ought to mention a case that was well publicised in the national newspapers over the summer. A gentleman in his 80s fell in his home in Holcombe and broke his hip. He was left for some time before being discovered by a neighbour. There was no easy recourse to deal with his problems. That illustrates the exposure of many elderly people. They are anxious, correctly, that if there is an emergency they will no longer have the support they used to have. Four years ago there was an on-site warden who would have dealt with that gentleman's issues.
In 2003, there was a court case in which 20 wardens from Harrow borough council claimed that their conditions fell foul of the European working time directive because they were contracted to work 37 hours per week, whereas they were working for more than 100 hours per week. The court found in their favour and awarded substantial compensation. As a result, concern spread quickly among housing
managers that they could no longer have on-site sheltered accommodation wardens. That is still used as the reason for many of the changes we are discussing.
The changes have now gone well beyond that, because it is often not on-site wardens but part-time non-residential wardens who are being withdrawn in favour of the model described in this debate. Far from the amount of sheltered accommodation being increased, as the hon. Member for Stroud urged, 50,000 sheltered housing units have been lost over the last five years. It is estimated that there are 470,000 units in the country, compared with 520,000 units five years ago. When I say those units have been lost, I do not mean they have been bulldozed, but that the support for residents that provided them with sheltered accommodation is no longer provided. As the hon. and learned Member for Torridge and West Devon said, it is estimated that within three years, 40 per cent. of schemes will have floating support.
Like other hon. Members, I am not critical of local authorities or housing associations that are putting the greatest possible effort into providing support for their residents. There are some for whom floating support is the right answer; I simply argue that it is not right for all residents. For many residents, it creates a high level of anxiety. Like the rest of the population, residents of sheltered housing schemes as a demographic are becoming older and frailer. They are now more likely to lack comparatively young, good neighbours who can come to their aid and support them in difficult times. That is why wardens are valuable. As is so often the case with people who work in social support systems, wardens have sometimes been exploited because they provide added value. They often go beyond the strict terms of their remit. However, that provides not only support, but vital reassurance for residents.
Moving wardens away appears to provide a cost saving for the housing association. However, as the hon. Member for Castle Point (Bob Spink) said, the costs are often simply transferred elsewhere in the system, making the cost saving only an illusion. We have adduced similar arguments in debates on the value of community beat officers. Such officers were never cost-effective in terms of fighting crime, but they are desirable because they provide intangibles such as reassurance for the community. In the same way, rural post offices have high unit costs and cannot be justified by looking just at the bottom line on the balance sheet. However, they provide enormous value to a community that goes well beyond the strict terms of the business.
I have mentioned that we are discussing not just local authority housing but housing associations. The current judicial review is against the withdrawal of warden facilities in non-municipal housing associations. As my hon. Friend the Member for Southport suggested, it is reasonable for residents to expect warden support after they decide to enter such housing. It is a contractual issue because when the housing is bought, the advertisements say that it is sheltered housing with warden support. I have seen such advertisements. The contract they sign is therefore for sheltered housing with warden support. Residents are now being told that the support is being withdrawn unilaterally, without a consequent amendment of contract. We must wait and see what the judicial review says, but I think there is a reasonable expectation.
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