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It is a great pleasure to serve under your chairmanship, Mr. Olner, and to have secured this debate on a subject of increasing importance throughout the country. I should say that I speak with a degree of personal interest because I have relatives in sheltered housing who have experienced the benefit of that form of care for a number of years.
It is an amazing fact, when one first reads it, that just over 7 per cent. of the retired population are in some form of sheltered or extra-care housing, and about 500,000 people are affected by the issues that we are to debate.
Let me say right at the outset what I am not here to do-perhaps I can address the Minister directly. I am not here to say that any particular local authority is uniquely bad or uniquely good. I am not here to argue that the growing orthodoxy of floating support is always wrong. I am not here to argue that floating support does not have significant benefits or that it ought not to be developed throughout the country. I am here to argue that something is going wrong with the process being followed in Supporting People administering authorities throughout the country, with the manner in which changes are being implemented and with the view that they are always right in all circumstances. Most particularly, there has plainly been a failure to make the elderly and the residents of sheltered housing feel that they have truly been consulted.
The Minister will have read the excellent report called "Nobody's Listening-The impact of floating support on older people living in sheltered housing" from Help the Aged and the Housing and Support Partnership, and I make no bones about saying that I am particularly indebted to those organisations. The report reflects many of the concerns that I intend to air this morning, but they are also reflected in the worried letters that Members throughout the country are receiving-my constituency is no exception-about the changes to the delivery of sheltered housing.
It is important to reflect on what sheltered housing with resident wardens provides for those who experience it. First, most residents speak of the sense of security, companionship and collective community in which they reside. At Glebe Court in Northam in my constituency, the proposed changes will have distressing consequences and are causing residents enormous anxiety. Like other residents of sheltered housing, they speak of the warden as the life and soul of their little community.
Invariably, wardens go well beyond the call of duty. They organise social activities. They often preside over fish and chip suppers or sausage and mash. They arrange bingo and outings. They call on residents in the mornings. They are always around to convey a sense of warmth and to provide a listening ear when one or other of the residents experiences trouble or ill health.
The hon. and learned Gentleman has brought an important matter to the House and he has started in a very sound manner. He was right to make avoiding generalisations a premise of his remarks, but he is equally right to generalise about one thing-that wardens are real heroes. They go the extra mile and they are extremely valuable. Will he therefore join me in deploring the fact that some councils have told wardens that they could be sacked or disciplined if they speak to anyone at all about changes to the warden system? Gagging wardens is not the way to run a reasonable democracy or local government.
I would agree with the hon. Gentleman on the general principle, although it is difficult to know about the individual circumstances.
Although this is sometimes difficult in the House, I want to avoid the tit-for-tat mudslinging that the debate could descend into. I want to invite hon. Members to embark on a real review and analysis of the changes taking place throughout the country. The Government seem not to have evaluated those changes or even always to have a coherent picture of what is happening, and we need to consider whether they should be getting a grip on the process and offering some clear leadership. As I said, I do not suggest that any particular local authority is uniquely bad or uniquely good, but the Government have a role in the process. They should offer leadership and set out clear guidelines and good practice. If changes are to be implemented, the Government should take the initiative in setting out how they should be implemented in general terms, leaving it to the Supporting People administering authorities to devise the specifics and take the decisions that best suit them.
The Help the Aged report predicts that although about 5 per cent. of provision is floating support, the figure will rise to nearer 40 per cent. in just two or three years. A fundamental, albeit silent and invisible, change is taking place across the country in the provision offered to tens of thousands of elderly people.
I was speaking of the value of wardens. In many cases, wardens are the life support for very frail, vulnerable and elderly people. Often, such people are newly widowed. Sometimes, they have no experience of carrying out small housing maintenance tasks or looking after the plumbing, the kitchen or the bathroom. A supportive environment with a single point of contact-the warden-on hand to help therefore provides intensely valuable care and support.
I am grateful to my Select Committee colleague for giving way. Like him, I regret the passing of resident wardens, although I do not believe that could have been the intention of the Supporting People changes. In my authority, there are 14 schemes and 333 places, 20 per cent. of which are vacant. Does the hon. and learned Gentleman agree that the problem is that some schemes can reach a tipping point, with vacant property accentuating and accelerating the feeling of vulnerability, such that the rest of the residents eventually leave? They will be decanted by the local authority, which will then flog the property off for other purposes, and that would be a tragedy. Like the hon. and learned Gentleman, I believe that floating wardens have a role to play, but they should not de facto be the only means of providing support. Does he agree?
Yes. I agree also that vacancies have driven change; the hon. Gentleman might suggest-I would not necessarily demur if he did-that they are often manipulated and engineered to produce a situation in which the home or the development is essentially changed in nature.
Today, however, I wish to place the spotlight firmly on the changes going forward under the aegis of the Supporting People programme. Having looked into the subject, it seems to me that it is happening at a much accelerated rate, and that it is happening as a result of a growing orthodoxy about how such care and support ought to be delivered.
I thank the hon. and learned Gentleman for laying out the argument as he has. I am sure that we all have had people raising concerns with us about the changes, such as those recently raised with me about the Rosemont flats in Bramhope in my constituency. We have touched upon the question of costs. Does the hon. and learned Gentleman agree that there is a glaring gap in the debate? Getting rid of wardens is used as an argument for lowering costs, yet we are not dealing with the cost of not having wardens to look after the vulnerable people that he so eloquently describes.
I agree with the hon. Gentleman. There is no doubt that the kind of environment that a warden can create will prevent the decline among elderly people that can often lead to knock-on and consequential costs of a much higher order.
However, I can see the other side of the argument, which has been expressed to me by the county council in my area. It is that floating support allows the release of resources to cover a wider range of people in a wider range of settings. I realise that floating support has such a benefit. One can reach people with the current accommodation-based support and tailor it to individual need. However, the argument runs that accommodation-based support does not do that, often delivering support to people who do not need it and sometimes do not even want it-although people can opt out. The release of resources enables people's needs to be met in their own homes and in other types of housing.
I fully accept the virtues of taking that approach. I fully understand that with floating support, the use of scarce resources is vital-even more so at present. I fully agree that the practice being developed in many Supporting People administering authorities-SPAAs-can often deliver considerable benefits. However, I am concerned that one increasingly meets a kind of intransigence over the idea that floating support is always considered better. The consultation resulting from that sense of righteousness over the delivery of floating support-if it is held-does not attract the confidence of those who are consulted, and it is frequently not held at the appropriate time.
I shall tell the Minister of a startling statistic given in the Help the Aged report. It found that something like 67 per cent.-it was certainly two thirds-of SPAAs whose consultation processes were considered had consulted residents only after the critical decisions had been made. That simply cannot be right. If one cry is coming from coastal regions such as the one that I represent and from the urban centres represented by other Members in the Chamber today, it is that elderly people feel utterly disempowered by the process. They feel helpless, believing that their voice is not heard. They feel that they are not consulted, and that if they are it is nothing more than a sham.
If it is true, as the report tells us, that 66 or 67 per cent. of authorities have already taken their decisions and only then condescended to consult those most deeply affected, it is a disgrace. The Government have a responsibility; I urge the Minister to take hold of the matter and to say to local authorities, "This is the way you should consult. You should not take decisions before you talk to the residents that are affected, just because they are elderly and frail and preoccupied with the complexities of life." Such actions are disgraceful. They are exactly replicated in the experience of those at Glebe Court, at Northam in my constituency. There, I was confronted with residents who were distressed and anxious, some tearful, and who were in a state of uncertainty and suspense.
When implementing change of so fundamental a character to the welfare of elderly people, it cannot be right to catapult them into such a state of mind in the twilight of their years, when they are entitled to peace and security. The change is being implemented in a way that does no credit to our Government. I do not mean to make a party political point; I mean that it does no credit to the systems that we have put in place. We need clear leadership from the Government. At the very least, we need clear principles of good practice that local authorities and SPAAs are required, or at least encouraged by the Government, to follow.
Those principles of good practice should make it clear that the wishes and desires of elderly residents, and their expressions of preference, are important factors when considering a move to floating support. It is a clear symptom of the failure of consultation that elderly people do not feel that they are participating in the change for which their assent is being sought. They should be persuaded by the arguments for floating support.
Such symptoms suggest that we face yet another judicial review. I understand that yet more local authorities are being taken to the High Court to challenge the changes that they are bringing forward. It is a great pity that we should have to rely upon the judges, although I declare an interest in that the law is my profession. I suppose that I should rejoice in the opportunity for lawyers to make more money, but I do not.
I do not, because if it is done at the expense of the insecurity of mind of a single elderly person-the House will recall that even as I speak I am reflecting upon the faces of loved ones-if it is done at the expense of a single trace of anxiety in them, I deplore it. If they and others like them have to go to the High Court of England and Wales to seek consultation and democratic participation over things that affect their circumstances and their lives, I would deplore it. I hope that the House would deplore it. I hope the House will send the Minister the clearest expression of its wish that the Government should offer leadership.
Help the Aged, in "Nobody's Listening", says of the Government's current approach:
"There has been a serious-and surprising-lack of leadership from the Department of Communities and local Government (CLG) and the Housing Corporation (HC), which are allowing retirement housing to wither away without proper debate or discussion. This is disgraceful, and a continued lack of engagement and leadership is likely to have further negative impact on existing and future residents."
Those are striking words. They are stark in their warning of the abdication of responsibility that the Government are choosing to adopt. I fully understand that the decisions are for the SPAAs and the local authorities, but that does not mean that the Government should not take a role in leading the right approach in implementing the changes. For when a warden is removed, it affects an elderly person in the most acute way. It removes the single most important thing to them-the symbol and substance of their peace of mind and security.
What I find particularly distressing and troubling is that there are cases in which the situation is even graver. I am talking about real cases. Elderly people may have taken big decisions in their lives based on the understanding that a warden would be present in the development into which they move. They have sold their houses and made family decisions. They have chosen not to live with their daughter who was going to create an annexe for them. They have chosen to sell their house and have made financial allocations to their children, yet they find, having been in the sheltered housing development for a number of years, that the warden upon whom they have placed their reliance is removed.
Some 67 per cent. of SPAAs acknowledged that elderly people in a warden-resident housing development regarded the warden as integral to their welfare but, perhaps significantly, a far lower proportion of those SPAAs agreed that wardens were in fact integral to their welfare. I ask the House to reflect for a moment on what that means. It is as if the SPAAs who filled in the questionnaires for Help the Aged said, "We accept that the overwhelming majority of elderly people regard wardens as integral to their welfare, but we don't accept it. We, the SPAAs, think we know better. We, the SPAAs, say that they are not really very integral and residents would not be lost without them." That permutation of answers to the Help the Aged researchers shows that an orthodoxy, or ideology, is developing about the way in which care should be delivered. My request to the Minister is that the Government should not only take hold of the process of change by delivering and setting down clear guidelines of good practice, but they should reject the idea-as I hope the Minister will say that he does-that the orthodoxy of floating support is, in all cases and circumstances, the only way in which extra-care housing should be delivered.
The Minister is a decent man of integrity and I guess we shall hear him say that the floating warden scheme, together with the emergency call system and other means, will provide-and does provide-an equivalent level of security for the people who live in sheltered schemes. But does the hon. and learned Gentleman agree that there must be recognition that a good proportion of the half million people who live in sheltered accommodation need the sense of community and security that can only be provided by someone on site? I know that it is accepted that 24/7 cover has always been an illusory ideal.
I accept that. It is the burden of my submission to the Chamber this morning. There are cases when nothing but a resident warden will do. If we are to make residents feel that they have been consulted, there are times when, if the majority of residents in a particular housing development vote or express the clear wish that they do not want their resident warden to go, it would be wrong to remove him or her. I do not accept the point-although the hon. Gentleman was well intentioned-that 24-hour care is an illusion.
I still do not accept the point. In the sheltered housing schemes that I have seen, the wardens may not be around all day, but they are known to be somewhere they can easily be reached. That sense of permanent presence conveys confidence and security to the frail and vulnerable.
I was speaking about a situation where individuals have made important decisions to their detriment, based on the understanding that 24-hour wardens would be present, and then they find that those wardens are removed. That cannot be right. In particular, it cannot be right when written or oral representations have been made to residents saying that the 24-hour warden will be there and that there is no risk of them being removed from that particular housing development. How can it be right then to break those representations? It cannot be right, and I apprehend that the legitimate expectations to which such situations have given rise are the basis of some of the cases before the High Court now.
We as a House of Commons should not leave it to the judges to sort out the problem. There is a developing picture of incoherence in the way in which such changes are being implemented throughout the country, and it is up to the Government, as the Help the Aged report says so plainly and eloquently, to take hold of the situation and to offer leadership. There should be no prescription for floating support. There should be no presumption that floating support always yields the better benefits. The system adopted must take account of residents' views, and when elderly people have made decisions based on the understanding that a resident warden will be present, it is not right for an authority to withdraw that warden contrary to the wishes of the majority of the residents in that development, and no authority ought to do so. Only if we offer that safeguard-only if we offer not just consultation but the knowledge that their wishes will be a critical factor in any decision that is taken-will we restore to tens of thousands of elderly people throughout the country the confidence that the Government and the House are listening, and that individual Members are willing to stand up and fight for them, as we are here to do this morning. They must have confidence that the system does not have to be a juggernaut that rides roughshod and tramples over the interests of individual elderly people. The Government must understand that elderly people are a critical and precious responsibility of this House. I urge them to get a grip on the situation as soon as possible and to offer moral and political leadership as a Government should.
I am delighted to take part in this debate. I congratulate Mr. Cox on choosing this topic. I know his part of the world rather well, but I will not talk about specific areas. However, I should like to put it on record that I was in one of my sheltered units in Sherborne under the tutelage of a scheme manager. I have to say at this point that it has taken me nearly 10 years to use that title rather than "warden". If I get it wrong, I apologise because I am always being told that wardens are now called scheme managers. The unit to which I refer is under the scheme managership of Marilyn Wood. It is an excellent unit that has become a very sheltered scheme. I want to say a few things about that, given the way in which the arrangements have moved on from the days of the traditional sheltered unit.
Stroud is very good in this field, as we have 29 units, which are enormously varied. In many respects, however, my message to my hon. Friend the Minister about the current system is that if it ain't broke, why are we trying to fix it? However, we must also recognise that sheltered accommodation has to move on, and one of the ways in which it should do so is in building more units, which are needed. Recently, the only units that have been provided are either in what I call the not-for-profit sector or, more particularly, in the private sector, whereas to me sheltered accommodation is a function of local authorities and one that they fulfil very well.
I pay due regard to Pauline Simpson, who chairs the United Sheltered Accommodation Panel in Stroud. Somewhat contrary to what the hon. and learned Member for Torridge and West Devon said, it is interesting that in Stroud, people have organised terribly effectively, to the extent that they are pushing the boundaries of participation and consultation. It is certainly not uncommon for 28, even on occasion 29, of the units in Stroud to be represented at that panel. It is a fairly fierce body for anybody going before it, because the people on it do not hold back in saying what they think and they are very clear in their thinking.
The starting point, or backdrop, to this discussion is that Stroud, perhaps like the rest of the country, has been reviewing the role of sheltered accommodation for some considerable time. The current review started in March 2007, which is more than two years ago, and that review was itself conducted on the back of earlier reviews. I think that we need to reach a conclusion about what we want to do. Much of the review process is about establishing where Supporting People fits in the context of sheltered accommodation. I must say absolutely clearly that Supporting People was a good concept. I say so, because Gloucestershire did peculiarly well out of the early budgetary arrangements for Supporting People. The difficulty was that it was not at all clear how the money would be divvied out, and as the money has been reduced, the allocations have definitely become much more tense and controversial, to the extent that Gloucestershire has had to pay back money, relatively speaking, and it has certainly been capped, which is very unhelpful. This debate is highly pertinent, because in April 2009, we lost the ring fence, which has brought this issue to a head and led a lot of tenants to question how sheltered accommodation will continue to function in future.
I take it as read that sheltered accommodation is appropriate for those who choose it. I deliberately use those words, because sheltered accommodation is not suitable for everyone. However, I become very annoyed when people see it as a historic form of institutional provision, because that is not what it is. It is very good at what it does, and the key to that success is not the buildings but the people involved. The most important person involved is the warden or scheme manager, and if a unit gets a good one, it functions very well.
One of the things that was drawn to my attention by Pauline Simpson of USAP was a report on this subject. The hon. and learned Member for Torridge and West Devon talked about a report by Help the Aged, but the report to which Pauline Simpson referred me was by Pascalle van Bilsen and others. It looks at sheltered housing, and compares it with independent housing, and the discussion section begins:
"The most prominent finding of this study is that two comparable groups of frail elderly people in two different housing conditions differed in perceived quality of life, autonomy and feelings of insecurity; respondents living in sheltered housing evaluated their quality of life more favourably and experienced greater autonomy and fewer feelings of insecurity than respondents living independently in the community."
That sums up the situation. Why do people want to go into sheltered housing? It is not to lose their independence but to protect it, because they get the best of both worlds; they have someone just keeping an eye on them, but they can keep their own room and their own way of living, despite the fact that they are living communally, which I think has an enormous amount to be said for it in older life.
The problem is that much of the accommodation has aged and we must recognise that it is necessary to invest in sheltered units, just as it is necessary to invest in every other unit of accommodation. If Stroud is taken as an exemplar, which I think it can be, many sheltered units are bedsits, which in this day and age are not popular, because of the lack of space. Moreover, there are always issues related to pets and the way in which people think that their home is really a home, rather than something else.
There is also the issue of the age at which people can go into sheltered accommodation-I am always wrestling with that issue. Notionally, people can go in from the age of 60 onwards and I think that that is quite important. For some people, their situation is such that they need to enter into this type of sheltered living at a relatively young age, normally because they have a disability or because they are vulnerable in some way or other. However, that causes some tensions, because there may be a huge age range of people in sheltered accommodation.
We must also consider the suitability of some of the accommodation for people as they become frailer. We need to talk about wet floors and how people can be bathed. All of the facilities, for bathing and for other activities, need to be made fit for purpose, if someone's quality of life is to be kept at such a standard that they want to live in sheltered accommodation rather than seeing it as a trap. There are also issues related to things such as mobility scooters, which in many respects are a pain, but they are absolutely vital for the people who use them. In the area where I live-Sherborne is in Stonehouse, where I reside-mobility scooters are very attractive, as it is a flat part of Stroud. However, if people are not careful, there are mobility scooter motorway wars, with scooters buzzing around. That is great, but each scooter needs to be powered up and kept in an appropriate place, which is not always easy in some of our older buildings.
Turning to the subject of resident scheme managers, there is always tension about availability. It is important to lay down standards that are fair to the scheme managers, but of course back-up is required. My father, who recently passed away, relied on an alarm system in the community, and that system is crucial. What happens when someone falls over? Who picks them up? There are some real tension points in that situation. Is it the ambulance service that picks them up? Is it a requirement that the scheme manager should do so, or is there some other way to deal with that situation? It is a perennial debate.
I am aware that other Members want to speak in the debate, so I will bring my remarks to a fairly speedy conclusion. We have spent long enough reviewing sheltered accommodation, which has a part to play. I certainly welcome some of the material from ERoSH-a consortium on the essential role of sheltered housing-which examines the role of sheltered accommodation in the round. ERoSH is not against floating support per se. There is a gentleman in my constituency called Ron Birch who provides floating support and he himself is quite critical about some of the ways in which we are going, because he believes that floating support is seen as a cheaper option and as a way in which people can try to pretend that they are providing quality support when in reality nobody is providing such support.
Does the hon. Gentleman think that it would help to inform and improve decisions about sheltered accommodation if there was some more reliable research into the overall total cost of this decision to remove wardens? Establishing that overall total cost would take into account contingent expenses in the national health service and in social services when wardens are withdrawn and floating support is provided, because there is a cost differential in the longer term.
Yes, I agree with the hon. Gentleman. As much as I do not want to see death by review, there is a lack of good qualitative research that looks at costs and some of the reasons why people go into sheltered accommodation. The point that I was going on to make was about how we manage the way in which people exit-I do not mean "exit" in the worst possible way, but literally the way in which people need to move into residential care because they are no longer capable of being nursed. That is why I liked the concept of very sheltered accommodation, as it was a stepping-stone. However, the issues are not easy, and they must be coped with at an individual level.
We need to get out there and proclaim the value of sheltered accommodation. It must change and be updated, and it certainly needs investment, but the benefits are there for all to see. I congratulate the hon. and learned Member for Torridge and West Devon, who spelled out those benefits much more fluently than I have done, but consultation with those in sheltered accommodation must be a real exercise. It must involve participation, and it certainly must give people-
I will bring my remarks to a close, Mr. Olner. We need definitive support from Government and local authorities, and we certainly need the support of those whom we would like to live in sheltered accommodation. That is where we should be going. Let us make sure that we put it on the record, along with the support that exists for it, because it is very appropriate for many of our older people.
I congratulate Mr. Cox on how thoroughly and exhaustively he introduced this topic. I will explain briefly, widening the debate a little, why I am here.
I picked up a lot of additional casework recently relating to tenancy and leasehold issues, many of which centred on service charges and quite a few of which concerned the role of scheme managers. There were complaints and discussions about their availability, the change in service and the cost-in many cases, the increased cost-of the service. It seemed to affect a wide variety of accommodation in my constituency, with a wide variety of clients and providers, ranging from the more traditional model of low-cost sheltered housing to high-cost bespoke luxury developments.
Generally, the picture was fairly simple. It was generally agreed that less was being provided for more. That is annoying, as the hon. and learned Gentleman explained in his initial remarks, to anybody on a fixed budget trying to manage their finances who does not anticipate those finances growing to any extent. If one talks to residents, they often put the cause down to something relatively simple: they blame either the parsimony or the profiteering of the organisation in putting up the charge.
However, when one talks to the organisations themselves-the various housing associations and companies that provide sheltered housing-it gets a little more complex. They talk about tax changes and the changing treatment by Her Majesty's Revenue and Customs of benefits in kind. Some-I must be careful with Bob Spink here-talk about the effect of the EU working time directive on the number of hours that wardens in sheltered housing can work. Many, of course, talk about the change in the Supporting People budget, the separation of housing and care costs and the end of local authority ring-fencing.
All those issues are, frankly, out of the range of ordinary tenants and leaseholders. They are simply confronted with the effects. A particularly acute case in my constituency occurred in a housing development run by Anchor housing, a reputable sheltered housing provider, and involved a tenant who was locked out. She happened to be locked out after the on-site warden had finished her hours. Other tenants visited the on-site warden on the tenant's behalf, trying to get her to open up the house, but the warden refused, saying that it was beyond her role at the moment. The tenants went one step further and asked for a key, which was not provided either. In the end, a locksmith had to come all the way from Bolton-that was how the Anchor scheme was supposed to run-to let in the old lady who had waited two hours in the cold to get into her accommodation.
That is not the nature of sheltered housing, which is why the incident attracted a degree of media attention in the national press. I suppose that the case could be seen as the extreme tip of quite a large iceberg. Generally speaking, the pattern is fairly clear. The warden service is changing, sometimes in good ways-wardens now are probably better trained now than they have been hitherto-but generally, there is a switch away from the beck and call model, which had its limitations and sometimes imposed on wardens in ways that were inappropriate, to the less popular remote model. That raises three key issues.
The first is a straightforward consumer protection issue. People choose and budget for a particular care package when they go into care housing, as the hon. and learned Gentleman explained clearly in his initial remarks. They pay for a warden service that is then reduced, or they pay for an on-site service that is then removed, seemingly with limited redress. The possibilities for redress must be explored. Warden service is not the only area in which that can happen. I do not want to make Anchor housing the villain of the piece, but the organisation also goes to residents and says, "You've got a bath now. We are replacing it with a shower whether you like it or not, unless you have a doctor's note." That does not strike me as being in the spirit of sheltered housing.
That brings me to the second issue. Sheltered housing providers need to think hard about their mission. They are identified with a particular product and a particular kind of client relationship. I know that some of the larger ones want to change the nature of that relationship, and are more attracted to the provision of peripatetic care packages than to the traditional role of providing sheltered housing in the understood sense. However, such providers risk becoming more business-like and losing some of their original sense of mission or soul. One thing weighing heavily on people who complain about what sheltered housing provides is the very high salaries paid by some of the bigger housing associations to their chief executives.
The third issue is public accountability. If providers have access to the public purse, how can they account for that better? Ironically, it is the bigger providers that sometimes find it easier to fill in all the forms and assessments for which they are asked. I have Abbeyfield homes in my constituency, as well as a number of smaller providers. They genuinely struggle to deal with the documentation loaded on them by the local authority, which goes as far as to ask individual clients, including 90-year-old ladies with dementia, what they think of procurement strategies. I have seen the documents; they are wholly inappropriate and make it difficult for smaller providers to prove they are doing a really good job, as is the case.
More bureaucracy is not the solution to any of those problems. The solution, which has been well mapped out in this debate, is to empower the vulnerable citizens who end up in sheltered housing. That might require considering arrangements for advocacy on their behalf, as some of them are not particularly capable of doing so themselves. As was also illustrated by the hon. and learned Gentleman in his opening remarks, we as policy makers must decide what should be provided, or we will simply end up with what we get, not having planned for it. That throws the ball back into the Minister's court, because the call for clear leadership is well supported.
I, too, congratulate Mr. Cox, as well as Mr. Drew and my hon. Friend Dr. Pugh, on not only the content of this debate but the tone in which it has been carried out. It is absolutely right that we seek a consensus on this issue, which affects our constituents, rather than indulging in party political debate. It is not a party political issue.
I am particularly indebted to the hon. and learned Gentleman for securing this debate. Had he not done so, I would have had to, in order to meet my commitments on the matter to the residents of Elizabeth court in Martock, whom I met only last week. I said, "Of course I will try to secure a debate early in the next parliamentary Session." The hon. and learned Gentleman has done me a great service.
The residents of Elizabeth court have a particular concern. They are losing their part-time warden, having lost their full-time warden some time ago. That is not a local government housing scheme, but a housing association scheme that did not derive from council housing. That widens the context of the debate slightly from the traditional question of what a council provides, because the issue concerns all providers.
While talking about my constituency, I ought to mention a case that was well publicised in the national newspapers over the summer. A gentleman in his 80s fell in his home in Holcombe and broke his hip. He was left for some time before being discovered by a neighbour. There was no easy recourse to deal with his problems. That illustrates the exposure of many elderly people. They are anxious, correctly, that if there is an emergency they will no longer have the support they used to have. Four years ago there was an on-site warden who would have dealt with that gentleman's issues.
In 2003, there was a court case in which 20 wardens from Harrow borough council claimed that their conditions fell foul of the European working time directive because they were contracted to work 37 hours per week, whereas they were working for more than 100 hours per week. The court found in their favour and awarded substantial compensation. As a result, concern spread quickly among housing managers that they could no longer have on-site sheltered accommodation wardens. That is still used as the reason for many of the changes we are discussing.
The changes have now gone well beyond that, because it is often not on-site wardens but part-time non-residential wardens who are being withdrawn in favour of the model described in this debate. Far from the amount of sheltered accommodation being increased, as the hon. Member for Stroud urged, 50,000 sheltered housing units have been lost over the last five years. It is estimated that there are 470,000 units in the country, compared with 520,000 units five years ago. When I say those units have been lost, I do not mean they have been bulldozed, but that the support for residents that provided them with sheltered accommodation is no longer provided. As the hon. and learned Member for Torridge and West Devon said, it is estimated that within three years, 40 per cent. of schemes will have floating support.
Like other hon. Members, I am not critical of local authorities or housing associations that are putting the greatest possible effort into providing support for their residents. There are some for whom floating support is the right answer; I simply argue that it is not right for all residents. For many residents, it creates a high level of anxiety. Like the rest of the population, residents of sheltered housing schemes as a demographic are becoming older and frailer. They are now more likely to lack comparatively young, good neighbours who can come to their aid and support them in difficult times. That is why wardens are valuable. As is so often the case with people who work in social support systems, wardens have sometimes been exploited because they provide added value. They often go beyond the strict terms of their remit. However, that provides not only support, but vital reassurance for residents.
Moving wardens away appears to provide a cost saving for the housing association. However, as Bob Spink said, the costs are often simply transferred elsewhere in the system, making the cost saving only an illusion. We have adduced similar arguments in debates on the value of community beat officers. Such officers were never cost-effective in terms of fighting crime, but they are desirable because they provide intangibles such as reassurance for the community. In the same way, rural post offices have high unit costs and cannot be justified by looking just at the bottom line on the balance sheet. However, they provide enormous value to a community that goes well beyond the strict terms of the business.
I have mentioned that we are discussing not just local authority housing but housing associations. The current judicial review is against the withdrawal of warden facilities in non-municipal housing associations. As my hon. Friend the Member for Southport suggested, it is reasonable for residents to expect warden support after they decide to enter such housing. It is a contractual issue because when the housing is bought, the advertisements say that it is sheltered housing with warden support. I have seen such advertisements. The contract they sign is therefore for sheltered housing with warden support. Residents are now being told that the support is being withdrawn unilaterally, without a consequent amendment of contract. We must wait and see what the judicial review says, but I think there is a reasonable expectation.
We have very few minutes at our disposal, so I will close to allow others to speak. I say simply that there must be alternative ways of delivering a better service for those who wish to see a physical presence. I will not prescribe the alternatives, but one that comes readily to mind was instituted many years ago when I was the leader of Somerset county council. Then, there was a movement from institutional care to so-called care in the community. We developed core and cluster systems that provided a resource to a group of people living in houses. That is not quite the same as sheltered housing, but perhaps such a system could be provided by long-term care establishments under contract, to give at least part-time warden support for sheltered housing schemes that goes beyond the simple emergency response and call-up systems being proposed.
We need to look at the consultation process and the kind of executive decisions that are too often being taken for the good of the residents, but without their agreement.
Thank you, Mr. Olner. It is a pleasure to serve under your chairmanship for the first time.
I congratulate Mr. Cox on securing the debate. This issue is of extreme interest to many people up and down the country. I congratulate him on the tone with which he opened the debate. He was careful to ensure that we understood that he was saying not that floating support is always wrong, nor that wardens are always right, but that the key point is consultation. We must ensure that residents in sheltered accommodation get what they need and that their views are listened to and taken into account.
Mr. Drew spoke of the complexities of the support that is needed in sheltered housing schemes and the dangers of appearing to follow cheaper models. Bob Spink, who is no longer in the Chamber, pointed out that the cheaper option might not always be cheaper in the long term. My hon. Friend Dr. Pugh spoke about changes in the models for warden schemes, even where they continue.
My hon. Friend Mr. Heath spoke about what happens when wardens are not in place; for example, people might fall and be unable to access support. That reminded me of what happened to my grandmother 20 years ago. She was living in sheltered accommodation that had wardens when she fainted and broke her shoulder. Unfortunately, she lay on the floor for the best part of eight hours, so it is not always the case that, where wardens are in place, people are prevented from being left in a vulnerable position for an extended period.
As I listened to the opening remarks of the hon. and learned Member for Torridge and West Devon, I was reminded of a consultation meeting with Age Concern that I attended just last week. Age Concern has been running a series of focus groups with elderly people to look at the Government's Green Paper, "Shaping the Future of Care Together." It wants to make sure that local politicians understand what older people think about the questions posed in the Green Paper and that we understand what older people feel most strongly about.
What struck me most particularly about the comments of the people on the group in Brent was what was said about their complex needs and how meeting those needs allows them to remain independent. The issue is not always about practical elements of support, for example, meals on wheels or adaptations to homes; it is often about emotional support. People on the group in Brent spoke about the extent to which depression is under-reported and under-diagnosed in older people and how daily emotional contact is essential if they are to remain independent. Once depression sets in, it often has a knock-on effect on many other aspects of physical well-being and someone's ability to remain in their own home.
My hon. Friend is making an excellent point about the specific nature of consultation and how it can be tailored to individual circumstances. One consultation pattern is for large housing associations to consult at national level and ignore the variants in establishments across the country. In such a situation, consultation has taken place, but it is not the right kind of consultation-with the residents on site.
I agree. My hon. Friend makes an excellent point-I was actually going to make it myself-about the nature of consultation and the importance of good practice. I am always a little cynical when central Government lecture either local councils or housing associations on what qualifies as good-quality consultation because they are often just as poor at producing decent consultation, and they almost inevitably fall into the trap that national consultations bear no relationship to local needs, as my hon. Friend has just mentioned.
By highlighting the issues that the Brent Age Concern group raised with me last week I was making the point that consultation needs to be sensitive, because to get at the issues relating to personal contact, and the kind of personal contact people need, requires sensitively framed questions. The questions in consultations are often framed in such a way that people feel unable to give the answers that they want to give, and they feel unable to express their needs. In terms of the support that they would like, even in relation to one-on-one support from a particular support worker, local residents have said to me that day centres and group activities can often be as important as practical issues. All those matters are part of the mix that needs to go into any kind of funding to support people in sheltered accommodation.
I accept the point made by the hon. and learned Member for Torridge and West Devon, which other hon. Members also mentioned, that elderly people have often made decisions about their life on the basis that support and a live-in warden is provided-for example, they may have decided not to live with their family. That is why the type of consultation I have mentioned is absolutely vital. The Help the Aged report that the hon. and learned Gentleman cited in his opening remarks suggested that before a decision is made to remove a warden, it should be put to a vote of local residents. That seems to be an example of good practice, which I hope housing associations and councils will consider following. It is perhaps most important that any changes introduced are given time and are not brought in overnight. All too often there is a three-month consultation and a month later, the warden is removed. Someone who is vulnerable needs longer to adapt, even if the proposed changes might be better in the long run.
I strongly encourage the Local Government Association, and perhaps also the Department for Communities and Local Government, to produce a piece of research on good practice in consultations. In addition, I strongly encourage all housing associations and councils to get involved with their local organisations, whether Help the Aged, Age Concern or older people's forums, to ensure that any questions asked in a consultation are properly framed around local need.
The Help the Aged report also suggested that the Tenant Services Authority should have a role to play. I think that it has a role in holding local providers to account if they fail to live up to good standards of consultation. I hope that it will set up a clear independent complaints procedure for tenants who are unhappy with their support services, rather than just for those who are unhappy with their housing management.
On consultation, it is undoubtedly the case that because housing management and social care are provided by different packages, it can be confusing for elderly residents to work out exactly what is on offer. The Help the Aged report recommended that the Government should consider providing retirement housing as a coherent package, and I hope that the Minister will respond to that point in his closing remarks as I would be interested to know whether the DCLG has any plans to provide housing in a more coherent way.
Ultimately, the question is whether it was the right decision for the Government to end the ring-fencing of funding for the Supporting People initiative. Unfortunately, when people are unhappy with what is happening on the ground, it is easy for the immediate knee-jerk reaction to be to bring back ring-fencing for a particular funding scheme. However, that is not the answer. I am no more confident that central Government will provide the right kind of care for people in a particular area than I am that local government will. In fact, local government is more likely to be held to account by local residents when it gets things wrong-it is far more difficult for people in a residential or sheltered care scheme to hold the Minister to account if he decides that a particular care package is appropriate for a residential home than it is for people to bang down the doors of their local council.
We know that we face great financial difficulty over the next five or possibly even 10 years in relation to public spending, but it is important that ending ring-fencing does not become an excuse for phasing out funding or squeezing budgets, and that local councils do not end up getting the blame for what is, in essence, the removal of money by central Government.
It is a pleasure to see you in the Chair, Mr. Olner. This has been an expert and calm debate that has been mercifully free of the party political rancour that sometimes disfigures these occasions. The reason for that lies in the contributions of all hon. Members to date, and in the fact that the tone was set from the start by my hon. and learned Friend Mr. Cox. I congratulate him on securing the debate, during which he reminded us that we all have sheltered housing schemes in our constituencies. I think that Dr. Pugh said that he had an Abbeyfield scheme; I have one in my constituency, too.
At the start of the debate, my hon. and learned Friend acutely and sensitively tried to focus the minds of hon. Members on the psychology of the older people who use sheltered housing. In some cases, the older people concerned will have perhaps recently lost a relative, be separated by a long distance from their children if they have any-their children may work elsewhere-and may not have easy access to their grandchildren. They may therefore suffer from the loneliness and depression to which Sarah Teather referred. Of course, the warden is important in such situations because, in many cases, they can take the place of a family member. Because wardens fulfil that function, they sometimes-perhaps often-work well above the literal demands made on the time for which they are paid, as Mr. Heath reminded us. It is quite right for hon. Members to highlight the role of wardens.
My hon. and learned Friend the Member for Torridge and West Devon said that he was not here to defend, per se, the application of any particular system. I have read both the Help the Aged report and the remarks of Imogen Parry of ERoSH-the Essential Role of Sheltered Housing, which is the national consortium of sheltered and retirement housing. It is worth noting an important point that she made in that organisation's assessment of what is taking place. She said:
"Many residents are pleased with changes that have been made to their support services, including a move away from resident warden services, particularly"- this is the key point-
"when they have been fully involved in the process."
If there is a single word that sums up this debate, it is "consultation". As the Liberal Democrat spokesperson, the hon. Member for Brent, East, has just reminded us, consultation should be carried out in the right way, sensitively and with face-to-face contact whenever possible. Imogen Parry has said that the Help the Aged report, "Nobody's Listening", which I have seen,
"noted a link between satisfied tenants and good communication and engagement by landlords or support providers...We promote better understanding of the reasons for the withdrawal of resident wardens, meaningful engagement with residents, better use of assistive technology...and a strategic approach to sheltered housing allocations."
Members have mentioned the legal challenge involving more than 40 authorities that is being carried out by the solicitor, Yvonne Hossack. My hon. and learned Friend indicated that a key issue relates to arrangements entered into by older people, perhaps including the older people to whom he directly referred, and the feeling that the arrangements were later altered arbitrarily and unfairly. As a distinguished lawyer, he knows that will be a matter for the courts, so I shall not go any further down that road. Instead, I shall ask the Minister a few questions.
As the Liberal Democrat spokesman indicated in her remarks on ring-fencing, with which we agree, it is important to strike the right balance between localism and what national Government should properly do. My hon. and learned Friend painted a picture of huge social change, with the move towards floating wardens, without the Government having any grip on the matter at the centre or providing adequate guidance. I have three quick questions for the Minister. First, are the Government making any central assessment of the great social change to which my hon. and learned Friend referred? Obviously, we do not want what Mr. Drew rightly called death by review, but we want to be sure that the Government have a grip on the issue, including a grip of costs.
Secondly-this question arises directly from the Help the Aged report-what could the Government do to tackle complaints? What guidance could they give local authorities? As the report has made clear, older people in sheltered accommodation, who have not necessarily been consulted about change, are vulnerable and there is a question about where they should go if they have a complaint. Should they go to the local government ombudsman or to the housing ombudsman? What is the Minister doing to ensure that the complaint process is more streamlined? What are the Government doing to ensure that the local government and housing ombudsmen in particular work together better on the issue, just as the local government and health ombudsmen are being encouraged to do by the Government?
Finally, I have a brief question about advocacy, which has been raised by the hon. Member for Southport and others. What plans do the Government have to make recommendations to local authorities regarding advocacy services, or to put such services in place themselves, to allow older people who may not have been properly consulted to make their case to the housing association or the local authority?
I congratulate my hon. and learned Friend again on having secured this important debate.
It is a pleasure to serve under your chairmanship, Mr. Olner. I know what a great interest you have taken in these matters, both as an MP since 1992, and prior to that as a local councillor.
I, too, congratulate Mr. Cox on securing the debate. He is well known for his expertise on this issue and for his commitment and dedication to campaigning for better services for older people, not only in his constituency but across the country.
I echo what several hon. Members have said about the tone of this debate. They have raised a series of important issues that I shall try to address. I hope that they understand how seriously the Government take the housing and support needs of all elderly and vulnerable people, whether they live in their own homes, with family or in supported housing such as sheltered or extra care schemes. I want to pay tribute to all those who provide care for older people, whether in sheltered schemes or in their own homes. I echo what hon. Members have said about wardens and the heroic work that they do, and I pay tribute to all those who provide floating support in the community, thereby enabling people to stay in their own homes, as many wish to do.
The Government's aim is to ensure that our vulnerable and older citizens get the best housing and support services that can be made available locally in the most effective way. In February 2008, my Department published "Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for Housing in an Ageing Society", in which we set out how sheltered housing is often a positive choice for older people who want to remain independent, but who value that little bit of support or shelter and the sense of security and community that such a scheme can provide. We said in that document that
"extra care and care homes at their best can be vibrant community hubs, tackling exclusion and promoting active ageing, even if the accommodation itself is dated."
As the hon. and learned Member for Torridge and West Devon has pointed out, it is for local authorities to decide how best to design and commission such services. We all agree that local authorities are best placed to identify the services that are required to meet the needs of their local areas and to balance local priorities. We are not in the business of dictating to local authorities or service providers the detail of what local services they should provide and how to do so, or in micro-managing the delivery of those services. However, we are equally clear that in developing and commissioning local services, local authorities should take into account the views and experiences of local service providers, local people and especially of service users.
Consultation and needs assessment are critical, both to ensure that any changes in services are effectively managed and reflect the wishes of service users, and to enable local authorities to meet the needs of all service users. That was emphasised in the Supporting People strategy paper, "Independence and Opportunity", which the Department published in 2007. One of the strategy's most important features is the emphasis that it places on keeping service users at the heart of the delivery of housing support.
The importance of needs assessment and consultation with service users is also enshrined in the quality assessment framework for the Supporting People programme, which was introduced in 2003 and sets out the standards expected in the delivery of Supporting People services. One of its five core principles is client involvement and empowerment, which demonstrates the importance the Government place on that issue. It also identified methods of evidencing achievement and has been a successful practical tool for ensuring continuous improvement in services delivering housing and related support over the past five years. It was reviewed last year to bring it up to date and further emphasise the need for high-quality, individually focused services that aim to improve outcomes for service users. The majority of administering authorities continue to use the QAF, and there is evidence that other services across authorities, such as adult social care, are adopting it as a standard tool to measure the quality of services provided.
Hon. Members have set out cases in which residents of sheltered housing schemes across the country are concerned about changes to resident warden schemes, especially how those changes are being implemented. I want to spend some time addressing that important and complex matter. It is fair to say that changes in support services for sheltered housing and the replacement of resident wardens by alternative service models are not a new phenomenon. Those changes have been taking place for two decades, as was acknowledged in the campaign report by Help the Aged entitled "Nobody's listening", to which the hon. and learned Gentleman referred.
There are several reasons for those changes. An independent review of floating support services conducted for the Department last year identified a range of factors. It found that there was less demand for sheltered housing, as people tend to move into sheltered housing later in life; that a large number of sheltered housing schemes are not up to modern standards, perhaps providing only bedsit accommodation; and that a significant number of sheltered housing residents do not require support services and are defined as the "active elderly". That is also reflected in the correspondence we have received from residents of sheltered housing, as they complain that they are sometimes required to pay for services that they do not want. As a result, some administering authorities are commissioning flexible, mobile support to sheltered housing tenants, based on an assessment of support needs, and they are extending that mobile support to older people in other types of accommodation. That is a key benefit of the Supporting People programme, which makes housing-related support services accessible to all vulnerable people, regardless of where they live or their type of tenure.
Other factors driving those changes include problems recruiting resident wardens, which have arisen in several areas, as sheltered housing is not immune to the wider demographic, technological and economic challenges and changes that society faces. We need to encourage innovative ways of caring for and supporting people to provide a more personalised service and make the most of emerging technology. For example, greater use of telecare can bring substantial benefits, including assisting people to remain in their own homes. It can reduce inappropriate admissions to hospitals, facilitate discharge from hospital more quickly and provide advance warning if someone's condition deteriorates.
The "Shaping the Future of Care Together" Green Paper, published earlier this year, sets out the Government ambition for a national care service in England. It recognises that Supporting People put in place structures that enabled partnerships of local authorities, health services and probation services to make decisions about improvements and local investment in housing for vulnerable people. It demonstrates the opportunities for increased innovation in the joint commissioning of those services. Supporting People contributes to the developing work on the national care service, as it shares the same aims of improving service user choice and control and keeping service users at the heart of the programme and its local implementation.
Hon. Members will be aware that my ministerial colleague, Lord McKenzie, is chairing a working group on sheltered housing, providing precisely the sort of leadership that has been called for in the debate, and I will take this opportunity to update hon. Members on that work. The group was established in April by Baroness Andrews, and brings together a range of interested organisations, including representatives of service commissioners, providers and residents, to consider how best to support good local decision making and practice. It is taking forward several projects on resident engagement and consultation and on service models, and that addresses the second and third questions asked by Mr. Goodman.
The National Housing Federation is leading work on good practice guidance in the implementation of any changes to current support services, including case studies on a variety of successful models for support services for older people, whether flexible community-based support, a scheme management service, the innovative use of technology or a hub-and-spoke model. That work will look at the costs and benefits of the various models-not just the financial costs, but the psychological costs to residents as well. By identifying value for money and overall benefits for older people, the case studies will present providers and commissioners with a sound evidence base for commissioning support services for older people.
Consultation is an absolutely vital part of any service, and that cannot be emphasised too strongly. I do not condone the examples of bad practice that the hon. and learned Member for Torridge and West Devon gave. As the report "Nobody's Listening" points out, if an organisation has really involved and consulted its service users, often change might not be such a contentious or frightening issue, and that is why consultation should happen before those decisions are made, rather than after.
Consultation should also be a proper two-way process, ensuring that the provider is able to portray the situation it faces and offering the opportunity to discuss why those changes are being considered and all the options available. It is for those reasons that consultation and engagement with residents is a critical issue for the ministerial working group, which is doing precisely the sort of work that Sarah Teather called for. The Centre for Housing Support is leading work on a good practice guide for providers and commissioners of services on how to engage and consult residents. The guide will improve providers' ability to consult meaningfully and engage people. It will help service users to understand what they can expect of consultation, and it will provide a benchmark so that they can make comparisons with what happens in their own organisations.
The ministerial working group is also looking at a key concern raised by Help the Aged: the lack of clarity over the complaints procedures for residents of sheltered housing. The Chartered Institute of Housing is leading work to produce a guide providing clear and concise information about the roles and responsibilities of the different regulatory agencies; when, how and by whom those services can be used; how the agencies relate to each other; and the type of information they require to act. The complaints guide will enable tenants and residents in sheltered housing and their families and carers to judge who to complain to and how to do so if they have exhausted the landlord's internal complaints processes. Those three guides will be published early in 2010.
This debate has raised several serious issues about the way in which residents in supported housing schemes are treated, as well as their concerns about the changes that they face. I thank the hon. and learned Member for Torridge and West Devon again for securing the debate, which has provided me with an opportunity to show how seriously the Government take those concerns and our determination to ensure that older people can live safely and independently in their own homes, wherever they may be. As I have explained, the key decisions on the provision of services such as warden support must be a matter for local authorities, but we have always made it clear that any changes to the way in which services are provided should be designed to meet the needs of residents and take account of their views through proper engagement and consultation.