Care Bill [HL]

Baroness Masham of Ilton Excerpts

Wednesday 9th October 2013 Lords Chamber

[Baroness Eaton (Con)]

My Lords, I rise to support Amendments 15 and 23 in the name of the noble Lord, Lord Best. Contemplating the need for changes in lifestyle, managing illness and losing the ability to live independently are very daunting and stressful experiences for many elderly people. The proposals in Clause 4 for local authorities to provide information and advice are crucial in enabling people to have the knowledge they need to make decisions with which they feel comfortable. It does seem that the Bill as drafted has a major omission—the absence of advice on housing options.

I worked as a councillor in a northern metropolitan area for many years. I noticed on many occasions that elderly people were totally unaware of some of the opportunities that were available to protect them. I will give the House one example. An elderly lady asked whether I could help her by getting the electricity board to repair the light on the other side of the footpath across her garden. When I pursued the case, it transpired that because this lady was physically infirm, she was unable to reach her bathroom and lavatory, so she was crossing her garden in the depths of winter to use an outside lavatory. The reason she needed the light was in order to get to it. She was totally unaware of the possibility of making adaptations, with help from the local authority, to provide her with a downstairs bathroom. These kinds of incidents reflect the reality of what elderly people know about in terms of services. It is not good enough to say, “They will find out about them somewhere”. If it was part of this provision, that would be a great advantage to all.

My elderly parents lived at home until they were in their 90s. My father was 96 when he died, and my mother was 95. They were fortunate because I was aware of the adaptations that could be provided for them—small things such as grips, handrails and the like. They enabled my father to cope with the infirmities of my mother and for the two of them together to enjoy independent living. But, as I have said, most elderly people are not aware of this provision. When looking at options for care, most people would not think of asking the local authority about housing options. As a local authority person, I am always cautious of giving extra tasks to local authorities, but I know that this part of the Bill would not create a huge burden because local authorities already provide information about the care-related housing options that are available in their area. The point is that those options are not joined up and they do not come under the provision that this clause as drafted would give. I strongly support the amendments of the noble Lord, Lord Best.

The issue of the shaping of markets under Clause 23 is also important. We are always in danger of the right hand not knowing what the left hand is doing. Criticism is made of departments doing one thing on the one hand and another thing on the other. There is now a requirement on planners to look ahead and make provision for the numbers and types of homes that are needed. Surely the two things should be brought together as indicated and that health provision should advise and direct the planning process in terms of what will be needed in the future. I warmly support both amendments.

[Baroness Masham of Ilton (CB)]

My Lords, I apologise for having only just come into the Chamber, but I have been at an important meeting with representatives from a children’s heart unit. However, this Bill is also important, particularly these amendments. What the Minister gives us assurances about in this House does not always happen on the ground. The matter of housing provision for disabled people has caused aggro up and down the country. People are worried about it. If the Minister can be helpful today, that will do a lot of good.

[Lord Hunt of Kings Heath]

My Lords, I support the noble Lord, Lord Best, in relation to Amendments 15 and 23. Obviously, we welcome the government amendments to which the noble Earl, Lord Howe, will speak shortly, but it seems that the amendments tabled by the noble Lord, Lord Best, point to areas where the government amendments do not really meet the needs. Amendment 15, on making available information about housing adaptations and on specialist and accessible housing as a key requirement of a local authority’s information service, was a clear recommendation of the Joint Committee. The noble Baroness has just illustrated why making such information available is so important. It could be very helpful in terms of avoiding the need for people to receive long-term care. We should not underestimate the challenge people face when simply trying to find their way through the system. We find it complex, so how much more difficult must it be for those with little experience of the care sector and the housing system? I believe that Amendment 23 is critical to the success of the Government’s own housing amendment. It would ensure a three-way integration that would be an explicit part of a local authority’s duty to promote efficient and effective local markets for meeting care and support. It would particularly ensure that it has regard to the importance of adults’ access to suitable living accommodation.

We know that many local authorities are doing this without any prompting from the noble Lord, Lord Shipley, or my noble friend Lord Beecham. I recently came across the housing for an age-friendly city programme. It seemed to be a really good illustration of how, if a recognition of the changing needs and support of older people is at your core, and you supply a range of care and support housing options as an alternative to residential care, it makes the essential connection between, for example, managing a long-term illness and living in the right accommodation, and the importance of extra care housing schemes that enable people to live independently for longer.

I also just came across a One Housing Group initiative in Islington. It is a scheme designed for 14 people who spend a maximum of 14 days in the centre as an alternative to acute NHS admissions. It has a drop-in centre and an emergency helpline, and this crisis recovery house helps 550 people a year. It keeps 87% out of hospital admissions. It was commissioned by the health service but it shows the interconnection between housing and health.

In responding to the noble Lord, Lord Best’s amendments, I hope that the Government might be prepared to reconsider this and come back at Third Reading with further amendments.

--- Later in debate ---

[Earl Howe]

I apologise to my noble friend. I cannot give her a precise answer, but I shall endeavour to do so as soon as possible. I do not think that the guidance will be available before the Bill leaves this House.

[Baroness Masham of Ilton]

Would Amendment 28 be more acceptable if “may consider” were replaced by “shall consider”? There is a big difference between “may” and “shall.”

[Earl Howe]

My Lords, Amendment 28 is in my name and therefore I consider it to be well shaped and well drafted. I am not about to suggest improvements on the hoof, but I shall take the noble Baroness’s suggestion away with me.