Respite Care for Vulnerable Adults: Teesside

Debate between Alex Cunningham and Fiona Onasanya

Monday 12th March 2018 Commons Chamber

[Alex Cunningham]

I thank the hon. Gentleman for his intervention, and I agree with him: the longer people are supported to stay at home, the longer they are not an even greater financial burden on the state. I will develop that theme later.

Such is the crisis in health and social care in our country that our NHS commissioners face difficult choices, and families are very worried that they could be facing a substantial cut in the provision offered to them as the local clinical commissioning groups seek to stretch the limited resources they have to meet an increase in demand for support. The CCG for north Tees and Hartlepool and the South Tees CCG are reorganising the way they provide residential respite care. When I met the north Tees chief executive on Friday, she told me of the need to have needs-based services and the plan to review exactly what each individual needs. I know, and so does the Minister, that we must have equity in the system and meet the needs of each individual, and I do not have a problem with that, but, sadly, the review is being interpreted by the families as a cut in provision, with some believing they could lose up to half their respite nights, which they are very anxious about.

I definitely agree that provision should be right to meet the needs of the individual, but this issue is much greater than that: it is also about the needs of the whole family, and perhaps the CCG should have conducted a needs assessment before deciding on the review. In fact, I have always thought that the respite care was very much for the family— an opportunity to take a break from their caring responsibilities, to recharge the batteries and to prepare to resume what they see as their duties.

The CCG has been at pains to stress to me that its proposals do not necessarily mean that there will be a huge reduction in the number of respite nights, but it recognises things will change for some people and is working with families and piloting different ideas to try and improve provision and reassure them. While I think the CCG could have handled this whole business better and understood more comprehensively the issues from the perspective of the families and the various local authority and joint health scrutiny groups who oppose the plans, I cannot say it is its fault.

[Fiona Onasanya (Peterborough) (Lab)]

In my constituency, a home providing respite care for very disabled and unwell children called the Manor is being closed, and I very much agree with my hon. Friend that this issue should be about the whole child, including the family, and the respite having that night provision gives to the family. In my constituency, that night provision is being entirely cancelled; does my hon. Friend agree that the impact of that must be assessed?

[Alex Cunningham]

I certainly do agree. I opened my speech by talking specifically about this being not just a Teesside issue, but an issue across the country, and it is a tremendous challenge to Government to plan for the future; I will also be developing that later in my speech.

I know that the team members at the CCG dealing with respite and wider provision are dedicated to their jobs and that they too have been distressed as we have gone through this process, and I for one appreciate the strains of dealing with such sensitive issues. They are trying to do their best within what they say are the ring-fenced resources available, although I personally could have hoped that they would have kicked the Government for failing to provide the resources needed.

Currently, respite is provided in two NHS centres of excellence, Aysgarth and Bankfields, but what are they planning to do now? The best of the options available to carers is this perceived reduction in residential care provided by the expert and nursing staff for their family members, and then the provision of a menu of alternative choices, largely without nurses. The choices include beds in care homes, hotel rooms, adapted caravans and even in carers’ own homes. Could we really see a vulnerable adult accommodated in a caravan somewhere and looked after by people in whom their parents may struggle to have confidence? What about the risk assessments for that menu of provision? Who is going to check that all the new people caring for these vulnerable people are both trained and suitable for this role and that the premises are suitable? What respite is it for a carer if they have the respite worker under their own roof? That is not much of a break for the carer or the family member.

To be fair to the CCG, it has promised that there will always be appropriately trained staff to offer the care and support required. Sadly, however, it is yet to provide the families with the reassurance they need, and the uncertainty is torture for them. So much more needs to be done to drive understanding. We also have to ask whether changes that cause such disruption are really appropriate in 21st-century Britain when carers do not know what the future holds. Our provision should be improving, not deteriorating in practical terms nor in the eyes of the carers.