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20 Oct 2009 : Column 191WH—continued


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We have very few minutes at our disposal, so I will close to allow others to speak. I say simply that there must be alternative ways of delivering a better service for those who wish to see a physical presence. I will not prescribe the alternatives, but one that comes readily to mind was instituted many years ago when I was the leader of Somerset county council. Then, there was a movement from institutional care to so-called care in the community. We developed core and cluster systems that provided a resource to a group of people living in houses. That is not quite the same as sheltered housing, but perhaps such a system could be provided by long-term care establishments under contract, to give at least part-time warden support for sheltered housing schemes that goes beyond the simple emergency response and call-up systems being proposed.

We need to look at the consultation process and the kind of executive decisions that are too often being taken for the good of the residents, but without their agreement.

Mr. Bill Olner (in the Chair): Order. The hon. Gentleman should give his party's spokesman an opportunity to contribute.

Mr. Heath: I am very happy to give way to my hon. Friend.

10.28 am

Sarah Teather (Brent, East) (LD): Thank you, Mr. Olner. It is a pleasure to serve under your chairmanship for the first time.

I congratulate the hon. and learned Member for Torridge and West Devon (Mr. Cox) on securing the debate. This issue is of extreme interest to many people up and down the country. I congratulate him on the tone with which he opened the debate. He was careful to ensure that we understood that he was saying not that floating support is always wrong, nor that wardens are always right, but that the key point is consultation. We must ensure that residents in sheltered accommodation get what they need and that their views are listened to and taken into account.

The hon. Member for Stroud (Mr. Drew) spoke of the complexities of the support that is needed in sheltered housing schemes and the dangers of appearing to follow cheaper models. The hon. Member for Castle Point (Bob Spink), who is no longer in the Chamber, pointed out that the cheaper option might not always be cheaper in the long term. My hon. Friend the Member for Southport (Dr. Pugh) spoke about changes in the models for warden schemes, even where they continue.

My hon. Friend the Member for Somerton and Frome (Mr. Heath) spoke about what happens when wardens are not in place; for example, people might fall and be unable to access support. That reminded me of what happened to my grandmother 20 years ago. She was living in sheltered accommodation that had wardens when she fainted and broke her shoulder. Unfortunately, she lay on the floor for the best part of eight hours, so it is not always the case that, where wardens are in place, people are prevented from being left in a vulnerable position for an extended period.

As I listened to the opening remarks of the hon. and learned Member for Torridge and West Devon, I was reminded of a consultation meeting with Age Concern
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that I attended just last week. Age Concern has been running a series of focus groups with elderly people to look at the Government's Green Paper, "Shaping the Future of Care Together." It wants to make sure that local politicians understand what older people think about the questions posed in the Green Paper and that we understand what older people feel most strongly about.

What struck me most particularly about the comments of the people on the group in Brent was what was said about their complex needs and how meeting those needs allows them to remain independent. The issue is not always about practical elements of support, for example, meals on wheels or adaptations to homes; it is often about emotional support. People on the group in Brent spoke about the extent to which depression is under-reported and under-diagnosed in older people and how daily emotional contact is essential if they are to remain independent. Once depression sets in, it often has a knock-on effect on many other aspects of physical well-being and someone's ability to remain in their own home.

Dr. Pugh: My hon. Friend is making an excellent point about the specific nature of consultation and how it can be tailored to individual circumstances. One consultation pattern is for large housing associations to consult at national level and ignore the variants in establishments across the country. In such a situation, consultation has taken place, but it is not the right kind of consultation-with the residents on site.

Sarah Teather: I agree. My hon. Friend makes an excellent point-I was actually going to make it myself-about the nature of consultation and the importance of good practice. I am always a little cynical when central Government lecture either local councils or housing associations on what qualifies as good-quality consultation because they are often just as poor at producing decent consultation, and they almost inevitably fall into the trap that national consultations bear no relationship to local needs, as my hon. Friend has just mentioned.

By highlighting the issues that the Brent Age Concern group raised with me last week I was making the point that consultation needs to be sensitive, because to get at the issues relating to personal contact, and the kind of personal contact people need, requires sensitively framed questions. The questions in consultations are often framed in such a way that people feel unable to give the answers that they want to give, and they feel unable to express their needs. In terms of the support that they would like, even in relation to one-on-one support from a particular support worker, local residents have said to me that day centres and group activities can often be as important as practical issues. All those matters are part of the mix that needs to go into any kind of funding to support people in sheltered accommodation.

I accept the point made by the hon. and learned Member for Torridge and West Devon, which other hon. Members also mentioned, that elderly people have often made decisions about their life on the basis that support and a live-in warden is provided-for example, they may have decided not to live with their family.
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That is why the type of consultation I have mentioned is absolutely vital. The Help the Aged report that the hon. and learned Gentleman cited in his opening remarks suggested that before a decision is made to remove a warden, it should be put to a vote of local residents. That seems to be an example of good practice, which I hope housing associations and councils will consider following. It is perhaps most important that any changes introduced are given time and are not brought in overnight. All too often there is a three-month consultation and a month later, the warden is removed. Someone who is vulnerable needs longer to adapt, even if the proposed changes might be better in the long run.

I strongly encourage the Local Government Association, and perhaps also the Department for Communities and Local Government, to produce a piece of research on good practice in consultations. In addition, I strongly encourage all housing associations and councils to get involved with their local organisations, whether Help the Aged, Age Concern or older people's forums, to ensure that any questions asked in a consultation are properly framed around local need.

The Help the Aged report also suggested that the Tenant Services Authority should have a role to play. I think that it has a role in holding local providers to account if they fail to live up to good standards of consultation. I hope that it will set up a clear independent complaints procedure for tenants who are unhappy with their support services, rather than just for those who are unhappy with their housing management.

On consultation, it is undoubtedly the case that because housing management and social care are provided by different packages, it can be confusing for elderly residents to work out exactly what is on offer. The Help the Aged report recommended that the Government should consider providing retirement housing as a coherent package, and I hope that the Minister will respond to that point in his closing remarks as I would be interested to know whether the DCLG has any plans to provide housing in a more coherent way.

Ultimately, the question is whether it was the right decision for the Government to end the ring-fencing of funding for the Supporting People initiative. Unfortunately, when people are unhappy with what is happening on the ground, it is easy for the immediate knee-jerk reaction to be to bring back ring-fencing for a particular funding scheme. However, that is not the answer. I am no more confident that central Government will provide the right kind of care for people in a particular area than I am that local government will. In fact, local government is more likely to be held to account by local residents when it gets things wrong-it is far more difficult for people in a residential or sheltered care scheme to hold the Minister to account if he decides that a particular care package is appropriate for a residential home than it is for people to bang down the doors of their local council.

We know that we face great financial difficulty over the next five or possibly even 10 years in relation to public spending, but it is important that ending ring-fencing does not become an excuse for phasing out funding or squeezing budgets, and that local councils do not end up getting the blame for what is, in essence, the removal of money by central Government.


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10.37 am

Mr. Paul Goodman (Wycombe) (Con): It is a pleasure to see you in the Chair, Mr. Olner. This has been an expert and calm debate that has been mercifully free of the party political rancour that sometimes disfigures these occasions. The reason for that lies in the contributions of all hon. Members to date, and in the fact that the tone was set from the start by my hon. and learned Friend the Member for Torridge and West Devon (Mr. Cox). I congratulate him on securing the debate, during which he reminded us that we all have sheltered housing schemes in our constituencies. I think that the hon. Member for Southport (Dr. Pugh) said that he had an Abbeyfield scheme; I have one in my constituency, too.

At the start of the debate, my hon. and learned Friend acutely and sensitively tried to focus the minds of hon. Members on the psychology of the older people who use sheltered housing. In some cases, the older people concerned will have perhaps recently lost a relative, be separated by a long distance from their children if they have any-their children may work elsewhere-and may not have easy access to their grandchildren. They may therefore suffer from the loneliness and depression to which the hon. Member for Brent, East (Sarah Teather) referred. Of course, the warden is important in such situations because, in many cases, they can take the place of a family member. Because wardens fulfil that function, they sometimes-perhaps often-work well above the literal demands made on the time for which they are paid, as the hon. Member for Somerton and Frome (Mr. Heath) reminded us. It is quite right for hon. Members to highlight the role of wardens.

My hon. and learned Friend the Member for Torridge and West Devon said that he was not here to defend, per se, the application of any particular system. I have read both the Help the Aged report and the remarks of Imogen Parry of ERoSH-the Essential Role of Sheltered Housing, which is the national consortium of sheltered and retirement housing. It is worth noting an important point that she made in that organisation's assessment of what is taking place. She said:

this is the key point-

If there is a single word that sums up this debate, it is "consultation". As the Liberal Democrat spokesperson, the hon. Member for Brent, East, has just reminded us, consultation should be carried out in the right way, sensitively and with face-to-face contact whenever possible. Imogen Parry has said that the Help the Aged report, "Nobody's Listening", which I have seen,

Members have mentioned the legal challenge involving more than 40 authorities that is being carried out by the solicitor, Yvonne Hossack. My hon. and learned Friend indicated that a key issue relates to arrangements entered into by older people, perhaps including the older people to whom he directly referred, and the feeling that the
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arrangements were later altered arbitrarily and unfairly. As a distinguished lawyer, he knows that will be a matter for the courts, so I shall not go any further down that road. Instead, I shall ask the Minister a few questions.

As the Liberal Democrat spokesman indicated in her remarks on ring-fencing, with which we agree, it is important to strike the right balance between localism and what national Government should properly do. My hon. and learned Friend painted a picture of huge social change, with the move towards floating wardens, without the Government having any grip on the matter at the centre or providing adequate guidance. I have three quick questions for the Minister. First, are the Government making any central assessment of the great social change to which my hon. and learned Friend referred? Obviously, we do not want what the hon. Member for Stroud (Mr. Drew) rightly called death by review, but we want to be sure that the Government have a grip on the issue, including a grip of costs.

Secondly-this question arises directly from the Help the Aged report-what could the Government do to tackle complaints? What guidance could they give local authorities? As the report has made clear, older people in sheltered accommodation, who have not necessarily been consulted about change, are vulnerable and there is a question about where they should go if they have a complaint. Should they go to the local government ombudsman or to the housing ombudsman? What is the Minister doing to ensure that the complaint process is more streamlined? What are the Government doing to ensure that the local government and housing ombudsmen in particular work together better on the issue, just as the local government and health ombudsmen are being encouraged to do by the Government?

Finally, I have a brief question about advocacy, which has been raised by the hon. Member for Southport and others. What plans do the Government have to make recommendations to local authorities regarding advocacy services, or to put such services in place themselves, to allow older people who may not have been properly consulted to make their case to the housing association or the local authority?

I congratulate my hon. and learned Friend again on having secured this important debate.

10.45 am

The Parliamentary Under-Secretary of State for Communities and Local Government (Mr. Ian Austin): It is a pleasure to serve under your chairmanship, Mr. Olner. I know what a great interest you have taken in these matters, both as an MP since 1992, and prior to that as a local councillor.

I, too, congratulate the hon. and learned Member for Torridge and West Devon (Mr. Cox) on securing the debate. He is well known for his expertise on this issue and for his commitment and dedication to campaigning for better services for older people, not only in his constituency but across the country.

I echo what several hon. Members have said about the tone of this debate. They have raised a series of important issues that I shall try to address. I hope that they understand how seriously the Government take the housing and support needs of all elderly and vulnerable people, whether they live in their own homes, with family or in supported housing such as sheltered or
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extra care schemes. I want to pay tribute to all those who provide care for older people, whether in sheltered schemes or in their own homes. I echo what hon. Members have said about wardens and the heroic work that they do, and I pay tribute to all those who provide floating support in the community, thereby enabling people to stay in their own homes, as many wish to do.

The Government's aim is to ensure that our vulnerable and older citizens get the best housing and support services that can be made available locally in the most effective way. In February 2008, my Department published "Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for Housing in an Ageing Society", in which we set out how sheltered housing is often a positive choice for older people who want to remain independent, but who value that little bit of support or shelter and the sense of security and community that such a scheme can provide. We said in that document that

As the hon. and learned Member for Torridge and West Devon has pointed out, it is for local authorities to decide how best to design and commission such services. We all agree that local authorities are best placed to identify the services that are required to meet the needs of their local areas and to balance local priorities. We are not in the business of dictating to local authorities or service providers the detail of what local services they should provide and how to do so, or in micro-managing the delivery of those services. However, we are equally clear that in developing and commissioning local services, local authorities should take into account the views and experiences of local service providers, local people and especially of service users.

Consultation and needs assessment are critical, both to ensure that any changes in services are effectively managed and reflect the wishes of service users, and to enable local authorities to meet the needs of all service users. That was emphasised in the Supporting People strategy paper, "Independence and Opportunity", which the Department published in 2007. One of the strategy's most important features is the emphasis that it places on keeping service users at the heart of the delivery of housing support.

The importance of needs assessment and consultation with service users is also enshrined in the quality assessment framework for the Supporting People programme, which was introduced in 2003 and sets out the standards expected in the delivery of Supporting People services. One of its five core principles is client involvement and empowerment, which demonstrates the importance the Government place on that issue. It also identified methods of evidencing achievement and has been a successful practical tool for ensuring continuous improvement in services delivering housing and related support over the past five years. It was reviewed last year to bring it up to date and further emphasise the need for high-quality, individually focused services that aim to improve outcomes for service users. The majority of administering authorities continue to use the QAF, and there is evidence that other services across authorities, such as adult social care, are adopting it as a standard tool to measure the quality of services provided.


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