Elderly People: Abuse

Lord Turnberg Excerpts

Wednesday 14th May 2014 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, I, too, am grateful to the noble Baroness, Lady Cumberlege, for raising this important issue. We cannot say we have not been warned about abuse of the elderly. Numerous detailed reports have been published over many years, and we have not neglected to talk about it in your Lordships’ House either. The Government’s response to the Francis report on the Mid Staffs affair was well meant and the Care Bill we passed last week is very helpful, but to my mind, neither of them is aimed at the right targets, nor are they sufficient. They both place far too much emphasis on inspection and punishment for wrongdoing, which of course is essential, and far too little emphasis on measures to prevent bad behaviour happening in the first place.

It is possible that we do not recognise often enough how difficult and taxing, both physically and mentally, the job of caring for elderly people really is. Quite apart from the nature of the job of feeding, toileting and cleaning physically disabled people, many of whom may be mentally disturbed and sometimes resistant or even aggressive, we have to face the fact that these jobs are spectacularly underpaid and underappreciated. They are not appealing jobs and they attract only very specific types of people: those who are dedicated to caring, angelic individuals who are devoted to looking after others. We are fortunate that there are many who fit into that category, but we should not take advantage of these remarkable people by giving them such poor recognition and little to bolster their self-esteem. No wonder there is a high turnover and absentee rate. Job satisfaction depends on being appreciated and there is no doubt that, where carers are appreciated, those who they are caring for gain the benefit. So what can we do to attract carers, and having done so, give them a sense of esteem and job satisfaction?

First, we must pay them better. Jobs in care homes are among the lowest paid anywhere. I fear that the profit motive of some care home operators may be just too strong and the low wages on offer will put off many whom we want to bring in. Also, local authorities are so cash-strapped now that, after a 30% drop in their funding, their services are clearly failing to keep up with rising demand. Poorly funded and understaffed services, leading to rushed overworked carers, are hardly conducive to the sort of care we aspire to.

Secondly, there is then the problem of a lack of professional training and qualification for care workers. We have gone some way along that route, with the help of the noble Earl and with a recognition that training should be an essential part of these posts. However, we are still some way off offering registration to allow care workers that self-satisfaction that comes with belonging to a qualified profession. We have been trying for some time in this House to correct this anomaly and I have no doubt that we will hear more about this topic.

Thirdly, there is the big problem of poor supervision in care homes and hospital wards. There seems little doubt to my mind that a well qualified, competent and active person supervising care at that level is of enormous benefit. These people are the key element in the mix leading to high-quality care. However, here again, recruitment to these posts and retention of people in them is dependent on making them attractive. Nursing sisters in charge of hospital wards should be recognised as having career-grade posts, so that these nurses are not attracted by the prospect of promotion off the ward after a year or so. They should be rewarded appropriately.

Finally, it is good to see in the Care Bill a duty on local authorities to investigate accusations of abuse. However, again, this is after any abuse has occurred and it is rather more important for those commissioning services to take greater care in ensuring that standards for the care that they commission are up to scratch. I look forward to the noble Earl’s response.