Social Care

Huw Merriman Excerpts

Wednesday 16th November 2016 Commons Chamber

[Mr Hunt]

I am more than happy to work with people of all parties to come to a sensible consensus. The one thing that unites all the major parties is a commitment to the NHS and social care system. With respect to the other issues, it is not just about rooting out poor care. It is also about something that the hon. Member for Worsley and Eccles South mentioned earlier—giving a career structure to people who work in the care system and giving them recognition. That is why in April last year we introduced the care certificate, which is based on achieving 15 standards. It is a voluntary system, but the CQC inspects against it, so there is a strong incentive for care providers to get their staff enrolled for the care certificate. I pay tribute to the work done by Camilla Cavendish, who did a lot of thinking and had a long-standing interest in this issue in her time as a journalist and at No. 10, and on whose proposals we are basing our work in this area.

[Huw Merriman (Bexhill and Battle) (Con)]

I am grateful that my right hon. Friend has mentioned the CQC and also touched on wages. When I met the south-east director of the CQC, it was clear that there is an issue of staff not being paid properly and then moving around the care home sector for a small amount of extra money, which is vital to them. Does my right hon. Friend agree that the living wage will stop that occurring and result in more people staying in jobs for longer?

[Mr Hunt]

That is a very important point. We have heard suggestions that the Government have been about words, not action, but the national living wage will do an enormous amount to help keep people in jobs for longer and help them to start to think about their jobs as a career, with potential progression into other parts of the health and care system, such as nursing. I commend my hon. Friend for the work that he does on this in Sussex.

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[Huw Merriman (Bexhill and Battle) (Con)]

My constituency has one of the highest rates of over-65-year-olds. They comprise 28% of my constituents, compared with the national average of just 17%. Indeed, the town of Bexhill has more 85-year-olds per head of population than any other part of the UK. Given those statistics, adult social care is a key driver in the success of our local public services. Not only is it directly relevant to the wellbeing of many of my elderly constituents, but it determines the ability of all my constituents to gain rapid access to their hospital and GP. It also determines the amount of money that is diverted away from other local public services, such as education and transport.

I want to touch on two issues where there is more to do to improve social care. First, of 35 care homes in my constituency that have been rated by the CQC, none has been rated outstanding and only six have been rated good. The remainder require improvement or are inadequate, and they have six months to turn performance around or they may be closed. If our local schools were failing in the same way, there would be outrage. That our often vulnerable residents, who are often without a voice, are being subject to that standard is a national disgrace that I do not believe should be tolerated, and I welcome the Government’s tougher approach to the inspection regime.

Having met the CQC to get behind the reason for the failure of those inspections, I believe that much of it is down to the design of care home buildings, many of which, because of their age, cannot easily be adapted from traditional residential homes for the elderly into modern care facilities. More people can use technology to enable them to stay in their own homes, so care homes tend to have a higher proportion of patients who have complex health needs.

Many homes are failing CQC inspections because they cannot demonstrate that they can evacuate residents in an emergency, and they do not have the right spatial design to keep residents active and engaged. The state of our care homes means that not only do residents not have the best wellbeing, but when individuals have to stay in hospital, authorities may be unable to discharge them back to care homes because no places are available if those homes are failing the inspection regime and are thus out of bounds. That leads to bed shortages in hospitals and to expensive longer stays.

There is an alternative. I recently attended the opening of a new state-of-the-art apartment block in Bexhill that offers shared ownership and rentals to the over-60s, some of whom are local authority-supported. Residents live independently and share in-house restaurants and amenities, which are also open to the public. For younger residents, it feels like any other smart apartment block with its mod cons. Crucially, however, the building offers facilities and care packages, so that as residents get older, they can access care but remain in their apartments. They can arrive at 60, and the design allows them to remain there for life. It is an excellent model for the future, but it was possible only because our county and district councils provided land and funding for our amazing housing association, AmicusHorizon, to build out.

Across our constituencies, land is being developed for housing. Every developer is required to provide infrastructure such as schools, GP surgeries and other public amenities. Care homes are private businesses, however, so there is no requirement to provide them. Since 50% of our care home patients are funded by the state, I suggest to Ministers that they fold in a requirement for developers to provide land or section 106 moneys to enable housing authorities and care companies to deliver the innovative new accommodation that will take people to their last days. Such accommodation should be part of the design as much as a school or a GP surgery is.

The second issue pertains to the joining up of our NHS and local authority social care providers. Much has been made of sustainability and transformation plans and of integrating adult social care and clinical care. I therefore congratulate East Sussex County Council and our NHS team in East Sussex, which have recognised that the £200 million of savings required from the STP and the delivery of a better care package can be better achieved if they join up and work together. Their “Better Together” project is designed, in their words, to

“spend £850m wisely, not saving £200m badly.”

To deliver that programme, our local team is implementing a single point for health professionals to access support, integrating social and community care under one management structure, offering frailty practitioner support for the over-75s for early intervention and putting prevention teams together for high-risk members of our community. The results thus far have being encouraging for adult social care: the number of clients going under early intervention watch has increased by 20%; early intervention has kept people out of hospital; 77% of clients have remained at home following early intervention; and there has been a notable reduction in the number of falls. I highlight those issues because they are key drivers for the improvement of social care.

The delivery by the Government of an extra £3.5 billion is welcome. However, it is crucial that we question the operating model in social care. To do so will not only make resources stretch further, but deliver the ideas and innovation that will improve the lives of those who rely on social care in their latter years.