Care Homes

Debate between Nick Smith and Norman Lamb

Thursday 1st May 2014 Commons Chamber

[Nick Smith (Blaenau Gwent) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the Oban House care home and the Government’s policy for safeguarding residents in care homes.

[The Minister of State, Department of Health (Norman Lamb)]

The images that we saw on our screens last night were truly disgusting. No one deserves treatment like that. The family and loved ones of care home residents should not have to endure that. Poor care is completely unacceptable. Everyone should receive the highest standards of care delivered by well-trained and compassionate staff. We are committed to making that a reality and to preventing abuse and neglect. We are putting in place, through reform of the Care Quality Commission, a range of measures to improve the regulation of care homes, to hold to account providers that are responsible for unacceptable care, and to improve the quality of social care.

The chief inspector of social care at the CQC is putting in place new rigorous inspections carried out by specialist inspection teams. New fundamental standards of care are being introduced as requirements for registration with the CQC, which will allow the CQC to prosecute providers—and their directors—that are responsible for unacceptable care. We are introducing a new fit-and-proper-person test for directors of companies that provide care, which will allow the CQC to remove individual directors. The care certificate is on track to be introduced in March 2015 and is currently being piloted by employers. That certificate will include compulsory training. The CQC is being given the power to produce ratings of care providers that will provide a fuller picture of the quality of care than mere compliance with minimum standards.

A new statutory duty of candour on providers of care is being introduced, which will place a legal requirement on organisations to be open with patients about serious incidents. We are introducing a new offence of ill treatment and wilful neglect—one for an organisation and one for individuals. It will apply not just to those who do not have capacity, as is currently the case, but to all users of health and adult social care and all health and adult social care settings. A consultation on the new offence ended on 31 March, and we are now considering the responses. We aim to bring forward legislation at the earliest opportunity.

[Nick Smith]

I thank the Minister for his statement. The majority of residential care providers provide good, if not excellent, care. However, many of us across the country will have been sickened by the contemptible and callous treatment of elderly people in the Oban House and Old Deanery homes that we saw on “Panorama” last night. When we were shown the many calls for help from Yvonne Grant that were ignored, I, for one, railed against her so-called carers.

I acknowledge that the Care Bill will improve the safeguarding of elderly care home residents, but residents and their families need to know that their voices of concern are heard and acted upon when they feel that care is poor. The CQC needs to be up to the job. I met the CQC two days ago and felt that its engagement with residents and relatives could be much better. Can the Minister assure the House that the CQC will have the staff and expertise to carry out all the necessary inspections, including on the financial viability of care homes? Will he ensure that there is effective monitoring of care homes between inspections so that if there is high staff turnover, for example, that will be flagged up? Can he tell the House what training will be required for care homes staff? Will it be on the job and, if so, for how long?

Although it is right that care workers are held to account for their actions, senior managers should also shoulder their responsibilities. The Government failed to support my amendment to the Care Bill, which would have introduced an offence of corporate neglect. That would allow the prosecution of a care provider if the culture they set is a contributory factor in abuse or neglect. Police Operation Jasmine identified that sort of corporate neglect in south Wales. Will the Minister look again at the proposal in order to promote the care we all want for our loved ones in the place that they call home?

[Norman Lamb]

I thank the hon. Gentleman for his urgent question and his supplementary questions, which are absolutely legitimate and important. I agree that it is incredibly important that we recognise that there is a lot of great care out there, with incredibly dedicated care workers doing a very difficult job, often in difficult circumstances and without great pay. It would be awful if they were all tainted by the actions of a few.

I am pleased that the hon. Gentleman recognises that the Care Bill can make a difference and improve standards. It allows for the introduction of a care certificate so that everyone will be required, for the first time, to have compulsory training and meet a standard of competence before undertaking unsupervised care work. Part of that will be on the job, as I think is right for such work, but it is essential that people meet that standard.

The hon. Gentleman made the essential point that relatives, loved ones and the users of services themselves need to be heard. One thing we have done in that regard through NHS Choices is introduce the ability for anyone to comment on care services in a care home or in domiciliary care and to put their comments online, so that there is no hiding place for unacceptable standards of care. People’s comments and the judgments of the CQC will be available for everyone to see through the NHS Choices website.

I hope I can reassure the hon. Gentleman in relation to his amendment to the Care Bill. I totally agree with him about the importance of being able to prosecute for corporate neglect, which we will address, but in a different way. We are introducing fundamental standards of care that every care provider, and indeed every NHS hospital, must meet in order to be registered with the CQC. Where those standards are not met and there are serious failures, and where there is culpability because of corporate neglect of the sort he describes, the providers will be prosecuted. The CQC will have the power to prosecute not only the company or trust, but individual directors. This is the first time that that has been made possible. The existing regime is flawed, because the CQC must first serve a notice before anything can be done, and if the company complies with the notice it cannot be prosecuted, which is hopeless. We are removing that so that we can move straight to prosecution, as was the intention of his amendment.

Care Bill [Lords]

Debate between Nick Smith and Norman Lamb

Monday 16th December 2013 Commons Chamber

[Nick Smith]

My hon. Friend makes a good point.

I was struck when speaking to victims’ families in south Wales that although many were regular or even daily visitors to their loved ones’ homes, they were not informed about bedsores or concerns that their relatives were not eating or drinking properly—such concerns were just brushed aside. Yes, individuals must be responsible for their actions, but what was uncovered was institutionalised neglect, with instructions on cutting back on food and incontinence pads coming from the top.

I am pleased that in Wales the First Minister has agreed a review of Operation Jasmine, led by Dr Margaret Flynn, who wrote the excellent Winterboume View hospital report. Although it will not report in time to amend this Bill, I hope the Government will consider any additional measures that that crucial review may highlight because we know that such issues are not just a problem for Wales. Information supplied by the House of Commons Library shows that, in 2011-12, 65,580 allegations of abuse of vulnerable adults aged 65 or over were made at different locations in England. Of those, 29,555—about 45%—were alleged to have taken place in care homes. This is a big national issue.

Looking to the future, we must improve the law on wilful neglect. If a patient does not die from poor care and does not have a loss of capacity under the Mental Capacity Act 2005, guidance from the Crown Prosecution Service states that a criminal offence is difficult to identify. Given that, respected groups such as Age UK support the proposal that organisations—not just employees—found to have contributed to abuse or neglect in a care setting should be liable to criminal prosecution.

[Norman Lamb]

The hon. Gentleman is making some serious points. Does he welcome the fact that the Government have consulted on a change so that we introduce fundamental standards of care, and that those providers of care—the organisations, and indeed their directors—can be prosecuted for failures of care? That has not been possible until now due to a flawed regulatory system.

[Nick Smith]

I welcome that but I am not sure it goes far enough. I think the issue needs to be teased out further in this debate and possibly in the Bill Committee.

Oral Answers to Questions

Debate between Nick Smith and Norman Lamb

Tuesday 15th January 2013 Commons Chamber

[The Minister of State, Department of Health (Norman Lamb)]

We plan to publish our policy document on sexual health and HIV shortly. Improving sexual health is very important for individuals and communities.

[Nick Smith]

Can the Minister explain why the sexual health policy has been delayed for almost two years? Does he accept that this delay is affecting the ability of PCTs to deliver effective sexual health services?

[Norman Lamb]

From April, local authorities will be responsible for commissioning services. Because we have seen this really impressive increase in funding for public health, local authorities will have the ability to maintain and indeed improve sexual health services for their local communities. That is something of which we should be proud.