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Nursing and Residential Homes

Part of the debate – in Westminster Hall at 10:59 am on 3rd April 2001.

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Photo of Simon Hughes Simon Hughes Shadow Spokesperson (Home Affairs) 10:59 am, 3rd April 2001

I absolutely accept that point, which was the second issue that I wanted to flag up.

There were two local concerns in December, January and February. One was connected with the private Southwark Park nursing home in Southwark Park road, Bermondsey, which is near where I live, and the other related to Tower Bridge care centre, which is run by Southern Cross Healthcare and has been open for two or three years. I received a letter from the chairman and chief executive of Southern Cross Healthcare, Mr. Moreton, which raised the issue to which the hon. Gentleman referred. I shall quote from the letter because it concerns a proper issue, which also arose in a local authority context. Mr. Moreton stated:

"You will remember that you attended the formal opening of the above home in October 1998 . . . As you are no doubt aware, over the last two years since the home opened, various factors have contributed to the deterioration of business conditions for the care home sector, and it is extremely worrying that, still, local authorities are not increasing fees to the necessary rate of inflation we are experiencing due to such things as the minimum wage, working time directive, minimum standards etc.

I am extremely concerned that we are not likely to achieve the very necessary local authority fee increases that we require this year to meet these exceptional costs. While I applaud many of these initiatives, given that employment conditions are substantially improved, the reality is that without the necessary fee increases we will face some difficult decisions.

In the case of Southwark, they are paying way behind the going rate for fees and I just hope our representations to them will be heard as we need to pay the right rates to get the right staff, otherwise care starts to deteriorate and that we will not allow. We have had an offer for Tower Bridge for another use and although this is not the way I want to go we are giving it serious consideration. This situation is clearly ridiculous given the need for the beds in the area.

Our current request is for a 6 per cent. increase, which is not at all unreasonable given the exponential growth in costs we will realise this year." The letter ended with a plea for help, which is one reason why I am here today. It was a plea not only on behalf of that particular nursing home, which was also where the alleged assault happened, but on behalf of the whole sector.

At the meeting held in March, there was intensive debate about another nursing home called D'Eynsford House, Camberwell, which is a nursing and residential home run by Age Concern, Southwark, situated in Ms Harman. As far as I am aware, the council currently proposes to withdraw placements and funding because it cannot afford to pay for the home. Eileen McNally, who is the director of Age Concern, Southwark, attended the meeting. She said that costs are higher than the local authority pay, but that those costs are necessary to provide decent care. Residents' family representatives are fighting an intensive battle to ensure that the home stays open because it is a good home where there is great satisfaction with the levels of service. They do not want their relatives to be moved away to other places, but they understand that decent care must be paid for.

Mr. Hammond has prompted me to ask a question that arises out of that case. We have started the new financial year and money has been allocated to local authorities, but in Southwark there are relatively high costs because of land values. Furthermore, there are few nursing and residential homes in the local authority, private or voluntary sectors, which has always been a problem. What guarantee is there that Southwark council--and others in a similar position--can find the money to guarantee the necessary staffing levels, pay and decent conditions to provide the care wanted by residents and their families?

Local authorities must battle with voluntary sector and private sector providers if they cannot afford to pay what is being asked for placements. They may threaten to place people elsewhere, but where is not apparent to me because I do not know where other beds are available. What can we do in such circumstances?

The second problem relates to what we can do to ensure that between now and implementation of the 2000 Act we can go above the minimum standards of the 1984 legislation. I accept the premise that the 1984 legislation is out of date and does not provide a sufficient base because the threshold is too low. However, that is the present threshold and a local authority or health authority, depending on whether the home is residential or nursing, inspects twice a year. If there is any reason for concern as a result of regular or on-the-spot inspections or in response to complaints, they will return. They then have a blunt choice. They may be able to close a home immediately, but only in the most draconian circumstances--I am aware of the necessary criteria for that--or they must serve notice, after which there is a long drawn-out appeal process.

During our debate a few weeks ago, it was clear that there was sometimes considerable dissatisfaction with the level of care, but if the health authority and local authority cannot find sufficient criteria to enable them to serve an immediate closure notice, they can only start on the long, expensive and ineffectual route for dealing with generally low standards of care.