Covid-19: Effect on Retirement Communities — [Clive Efford in the Chair]

Backbench Business – in Westminster Hall at 2:55 pm on 1st July 2021.

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[Clive Efford in the Chair]

Photo of Clive Efford Clive Efford Labour, Eltham 3:15 pm, 1st July 2021

I am sure that Members are acquainted with the new arrangements, and as we are a small group, I will not read out the whole script that I have here to make you aware of the new arrangements. I will just say this. Those participating virtually must keep their camera on throughout the debate and be present; unfortunately, you are unable to intervene virtually. If Members participating virtually have any technical problems, they should please email westminsterhallclerks@ parliament.uk. Could Members participating physically please clean their spaces at the end of the debate? Mr Speaker has also indicated that people should wear masks at all times during the debate.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

I beg to move,

That this House
has considered the effect of the covid-19 outbreak on the retirement community housing sector.

It is an absolute pleasure to lead the debate. I asked for it some time ago, and it came through my constituents. Indeed, everything that I say in this House comes through my constituents. That is how we formulate our thoughts when pursuing legislative change and articulating, in Westminster Hall or in the main Chamber, what the issues are. Over the last year, the covid-19 pandemic has been incredibly difficult, particularly for those in retirement communities and residential homes.

I am very pleased to see the Minister in her place—I look forward to her response—and to see a former Secretary of State for Northern Ireland, Karen Bradley, too. We were just talking about languages and accents beforehand, so I hope that I do not talk too fast when expressing myself here in Westminster Hall. I am really pleased to see the shadow Minister, Liz Kendall. She and I have many things in common. One of those is Leicester City football club; we both support Leicester City. When I saw her coming through the door, I said to myself, “I must make a comment about that,” so I will just put it on the record that we have had a good season and we certainly hope that the next one will be equally good.

The reason why we are here today is to talk about the effect of the covid-19 outbreak on retirement communities. I was reading the background information that the House of Commons Library very kindly always puts together. It refers to it as an “Overview of Retirement Communities”. I want to make these comments early on, because the Minister is not responsible for the issues covered by these comments; she is not responsible for housing, for instance. But according to the Associated Retirement Community Operators, there are currently some 70,000 housing-with-care units in the UK. The sector is an emerging one and currently much smaller than the traditional retirement housing sector, which has 440,000 units. The briefing says:

“There is an uneven distribution across market segments, with 66% of UK Retirement Community properties available for affordable…rent.”

The point that I want to make on that is that there are many people in the retirement community who do great work, but there is a lot more that we need to be doing in partnership with those outside the sector as well.

As I said, the last year has been incredibly difficult. It is nobody’s fault. Government responded as circumstances unfolded, and Ministers found themselves having to respond to things that they had never had to deal with in their lives before. The same applied to residential homes and retirement communities. Quite simply, we were not ever in a place to be able to do very much. There was not an experience and there were not other things—examples—that people could refer to.

In a constituency context, there were issues for staff working in residential homes and retirement communities. There were issues to do with families visiting and access to—I will refer to these things later—personal protective equipment material. Early on, I had dealings with staff who worked through the process without PPE material and protection. And sometimes, early on, people were not quite sure what it all really meant. I pay tribute to the people who worked in residential homes and retirement communities, because they put their commitment to the safety of the residents in the homes above their own health.

The covid-19 pandemic has had enormous effects on the everyday lives of almost all individuals since the early days of 2020. Widespread lockdowns and what can only be described as unnatural and oppressive restrictions meant that people became isolated, and even now some remain in that category. The measures affected the world’s economy and limited our access to our families and friends, and especially our access to physical and mental health treatment from our doctors. Life was just completely different from what we were used to. Although the measures may have been necessary to minimise the spread of covid-19, the negative physical, psychological and social effects were evident right through that 15-month period and even today.

As a society, we had to learn to work, socialise and study in a new way by using technology that many of us—and I use myself as the supreme example—were not familiar with. I love meeting people in person, as we all do. There is nothing that elected representatives like more than meeting people, shaking hands and saying hello to them over a cup of coffee, but we could not do that. Meeting people in person suddenly became meeting people on a screen—on a Zoom call, a virtual call, at a distance. There is something—I say this very respectfully—impersonal about that. We did not have the close contact that we had every other day.

That way of carrying out day-to-day activities in the workplace is still in operation. It has become an important way of life, but it is not really what we want. I certainly do not want to do it all the time, and I hope we can come out of it, perhaps in September—we will see how things go. I respect that some welcome that and prefer it, but personally I long for a return to the old-fashioned way of meeting people in person and shaking their hand, or giving people I have not seen in a long time a hug. Those are the things that mean much more to me.

Our elderly population, however, which has been the worst affected by both the virus and the lockdown measures, has seen the fewest benefits from the shift towards these new digital solutions that, in a short time, have become the new way of doing things. Zoom and Skype do not and never will replace that all-important hug from a wife, husband, son, daughter or friend. How much we miss those things. We have all read of elderly couples—indeed, there is not one of us here who could not give an example of this—who have been married for decades, and were separated physically because one was kept, and I say this gently, locked inside a care home for endless months, and the other could do little other than wave at them through a window, unable to touch them and provide that vital human touch and physical affection that we as humans simply need to thrive. Is it any wonder that some of those people suffered emotionally, psychologically and ultimately physically? Some of those people probably died of a broken heart—that is a fact. I believe that nothing beats being able to speak and be up close.

From early in the pandemic, studies warned us about an increase in anxiety and depression and how that would affect general society, our youth and our children—especially the clinically vulnerable who were facing extended lockdowns. Every time we thought we were getting rid of it, we suddenly found we were back in it again. I give credit to the Government and the Ministers for all they have done in responding. The vaccine roll-out has been incredibly reassuring and has given us some confidence, but we do not really know what the winter will bring. Even now, we face a slightly uncertain future.

The effects, however, are increased significantly in the elderly population because of the stricter lockdowns, the higher threat of illness to them and their loss of social support. Social support is very important to elderly people, and one thing this pandemic has done is raise awareness of those who are isolated in normal circumstances. I am very fortunate to live on a farm, so I was able to go for a walk every night when I was at home and we were not coming here, but what about people stuck in a small flat or a small home, perhaps without a dog or a cat, who just saw through the window the person who left the stuff at the front door, knocked once, told them it was there and got off site?

I have seen wonderful work by many people in my own constituency who organised food parcels and delivered them to the elderly and vulnerable who could not leave their homes. I was greatly encouraged. It might be my nature, but I always see the positives of things. I see the positives of the good things that people did; I do not dwell on the negatives, which sometimes can distort what has happened.

My office issued several hundred food bank vouchers between April and December 2020. I and my staff on occasion collected bags of groceries from the food bank and delivered them to constituents who were self-isolating because of covid-19 or living alone and without transport. We phoned them up before we arrived, we got out of the car and left the stuff at the front door, got into the car, made sure they collected it, and then we went. Life was very different.

A group of motorcyclists in Northern Ireland formed the Volunteer Bikers Group and organised collection and deliveries of prescription medicines, which was very important for those people who could not leave their homes. That organisation was active in my constituency and across the whole of Northern Ireland. I met the guys at the shop one day—I was in the shop and one of the boys came over and spoke to me and told me what he was doing. I said, “You don’t mind if we contact you about this?” He said, “Please do, and make it known widely.” We did that. These were volunteers. More often than not they were ex-police or ex-Army, or individuals who had a deep interest in helping—“We’ve got a bike; we can do those deliveries.” They did that and they did it well.

It was not only prescription medicines, but necessities to the elderly and vulnerable. How active church groups were, too—every one of them. People who cooked, baked scones and pastries, and delivered them. Our local council, Ards and North Down Borough Council, was incredibly helpful and active in responding with food parcels. People swept into action during those difficult days and did what they saw as their civic duty. I pay tribute to them. The goodness of people always come to the fore—the positive actions of people shone through. I believe in a practical method of help and assistance, and that is what I was impressed by. There are a lot of good people out there and they want to help, and they do and they did.

The covid-19 pandemic had a huge negative impact on nursing homes and retirement communities with massive outbreaks being reported in care facilities all over the world, affecting not only residents but care workers and visitors. Many people living in retirement communities and independent living facilities were at risk from the virus because it was established that risk increases with age and underlying health conditions, such as heart disease, diabetes or lung disease.

Many of those in residential or retirement homes have complex health issues—it is the nature of life, when we get older. Most people do not have just one issue, but a number. Speaking personally, it is not just my type 2 diabetes—it is also my blood pressure. I am not quite sure what all the tablets are for, but they are probably all related to diabetes. People have complex health conditions.

There was also the higher risk of catching and spreading the virus because of the characteristics of retirement community living, such as daily social activities—which were curtailed—common dining facilities and other communal spaces, community activities and shared transportation. We have a saying back home—I am sure you and others will know it, Mr Efford—that they live cheek by jowl, which they do in residential homes and retirement homes. They live close together, and this virus made that no longer possible.

The more people a resident or worker interacts with and the longer that interaction is, the higher the risk of viral spread. Studies drawn from the United Kingdom of Great Britain and Northern Ireland and around the world in the past year have shown how the pandemic impacted on retirement communities and, even more significantly, how vulnerable they were to this kind of natural disaster. It is nobody’s fault, and we responded to it in the way that we thought was best, but we learned more and responded more. I ask the Minister whether it is possible to fund research on how we can make retirement villages and extra care homes more effectively pandemic-ready.

There is clearly a shortage of specialist housing for older people. Again, this is not the Minister’s responsibility but that of her colleague. However, the Library briefing outlined three things needed for specialist housing for older people: sector-specific legislation, which we need to see in place; clarity in the planning system, because it is not about building houses all over the place but about having the right kind of housing in the planning system; and funding options for affordable housing-with-care provision. We need to get those things right, and there is a reason for doing so. It is quite simple: the UK’s population is ageing, and people are living longer.

In March 2021, a broad coalition of older people’s representatives, policy makers, the private sector and civil society leaders wrote an open letter to the Prime Minister, calling for an increase in the supply of housing-with-care options in the UK. It has been fortunate that a number of people are doing that, and I believe that the Minister for Housing will respond. The questions asked by various Members from the Labour, Conservative and Scottish National parties indicate that there is clearly an issue for us to resolve.

The retirement community market has been steadily growing and is driven by the increase in life expectancy and an older age group who enjoy better health and financial security than previous generations did. As a result, people in that demographic remain active and able to engage in a social lifestyle for much longer. In approximately two weeks’ time, on 14 July, my mother will be 90 years old. I am very fortunate that she is able to tell me every day that I have to listen to her and cannot disobey her. No matter what your age may be, your mum is still your mum, and when she tells you what to do, you jump into line. I say that gently, because my mother is fresh in mind and body. She still drives her car and is very active. My mother is of that generation. My father died six years ago, but my mother is an example of someone who is very active and who does not let her age get in the way. She bakes for everybody in the wee group of houses that she lives in. She visits her friends and is very active socially as well.

Whereas the spread of covid-19 in institutional care home settings was more devastating, retirement communities tended to be safer environments during lockdown, because they offered the ability for residents to self-isolate in their own homes. That was the difference from a residential home, where people were sharing with everyone else. That is where the problems were. Although someone in a retirement community or retirement home was mostly on their own, they were able to self-isolate and had access to a network of support, supervision and social interaction, which was not possible in other domestic or care settings.

The challenges for those living in retirement communities during the pandemic were real, and they provide evidence for how we must prepare for similar events in the future in order to protect such communities. Age UK’s research among older people shows that depression, loss of hope, low mood, lack of support for meal preparation, deteriorating physical health and, in some cases, increased pain due to untreated health conditions—as we get older, our bodies break down—reflect an issue that we cannot ignore.

We are looking for a response from the Minister about the lessons learned and how we respond in the future. I put that forward in a constructive, positive fashion, because I believe that we all must work together and support the Government as we try to get a strategy and policy that will make the situation better next time around. If the pundits are right, we will have more pandemics in the future, and we have to be able to respond and learn from where we are.

Six months into the pandemic, Age UK conducted a poll among over-70s that found that one in three felt less motivated to do the things that they enjoyed. Two in three felt less confident taking public transport and two in five felt less confident going to the shops. For many, that wee trip to the shops is a daily outing to speak to someone and see a friendly face. One in four felt less confident spending time with their family. That is not because people did not want to spend time with their families but because they were not sure whether it was the right thing to do health-wise. Families felt the same.

The dreadful pandemic happened at a time when our ageing population is growing. Retirement communities became in many ways isolated communities, but in seeking ways to mitigate risks in future pandemic scenarios, retirement villages show that they can provide a safer and controlled environment for the elderly. That probably needs to be better worded: “provide a safer and controlled environment” almost sends the wrong message. I say this gently, but it almost sounds like, “Let’s move them into their own ghettos.” I am very conscious that words need to be picked carefully, and the word “control” niggles me a bit.

Food and necessities can be delivered to residents, thus minimising contact. The flow of people in and out of those facilities can be reasonably controlled and exposure to a dangerous contagion thereby greatly reduced. There are ways of doing it. That is why the opportunity to have retirement communities is so important.

However, the risks of having large groups of elderly and possibly unwell people living in close proximity are evident, and it is important to consider now how we can better mitigate them for the future. In Canada, research showed that retirement homes in Ontario impacted by the pandemic were those with more residents—the more residents in the homes, the greater the possibility of being struck down with covid-19—those connected to a nursing home, and those owned by large corporations or offering many on-site services. The study found that retirement homes with more than 100 residents had a more than fivefold increase in the risk of outbreak.

Retirement communities in the United Kingdom of Great Britain and Northern Ireland can include public housing for low to moderate-income older adults, assisted living homes that do not provide medical services and extra care retirement communities, which have a variety of housing options, including independent living. The residents in those communities depend on social engagement and community and personal activities for their continuing health and mental wellbeing. Those areas of their lives were impacted negatively by covid-19 because social activities were stopped, creating social isolation, communal areas were closed and visits were restricted or completely stopped. That restriction on interaction with other people has been difficult to comprehend.

In England alone, some 75,000 people live in retirement villages and extra care housing schemes, and it is important to understand how their lives were affected. In January 2021, a national survey, the RE-COV research project, was launched, led by the St Monica Trust. The aim of the project was to better understand the experiences of retirement communities and the extra care housing sector during the pandemic, including the effectiveness of measures taken to protect the health and wellbeing of residents and staff. I wonder whether the Department has had an opportunity to see that research. I do not think we should ignore stats—they give the data, which help us to forecast a strategy and a way to do better. Has that happened?

Those findings were delivered in April 2021 and this valuable project has, to a great extent, informed us how the retirement village and extra care housing sector responded to the task of managing the protection of the lives of many extremely vulnerable older residents during lockdown. We have learned that operators acted to lock down swiftly before 23 March, residents were asked to remain on site, and spaces and facilities were redesigned where services and communal areas had to be closed down because strict action was needed. Weekly food boxes were delivered to residents and residents were helped with gaining access to digital technology, which changed how social activities and social contact took place. That is critical. Many people in those homes do not have access to modern, digital technology or, like me, do not have an ability with that technology. I am fortunate that I have a number of staff who are all very good at that. Indeed, I have grandchildren who can do it, although their grandad struggles with it.

The pressures on the operators of retirement communities were enormous. The research tells us that lack of access to PPE for staff and the task of identifying those who needed to shield, had increased vulnerabilities and lacked an effective support network were issues that had to be addressed in a fast-moving situation. That is what the Government were doing as well. The Government and Ministers were reacting to an unfolding situation, and trying to learn and do their best. The job of the Opposition is to challenge the Government, so that the Government can learn, but the Government were also on a learning curve as to how to deal with the situation.

Maintaining morale among staff and residents was also a huge task, not to mention maintaining staff. Some staff were falling sick with covid-19 and finding themselves unable to attend work. The mental pressure was incredible. I pay tribute to the staff and operators of retirement communities. Some of them put their commitment to residents above their own personal health.

I am not sure if other hon. Members have noticed when they walk along the Embankment and over Westminster Bridge, towards the Park Plaza hotel, that there are a lot of red hearts on a wall that represent the people who have died due to covid-19 in the past 15 or 16 months. Some of those are staff, so I am ever mindful of their sacrifices. Fewer village and scheme residents died from confirmed covid-19 than expected, some 0.97% compared to 1.09% in the same age-profile people in the general population of England.

It was a massive undertaking and, what is more, the survey tells us that the residents benefited from their communities and from the special support and care provided by the villages and schemes. However, it is clear that their job could have been made easier. Guidelines changed from week to week and access to testing for staff was not quick enough, and perhaps could have been done better. This debate is meant to be positive and not meant to be critical, but the Government must do some self-reflection and consider how better our leadership through this pandemic could have been. We are all leaders in the community, we have a job to do and we have to set an example. We should be able to look back and learn from the covid-19 pandemic, to improve and do better. I hope that is something that we can all do.

There is no doubt that the covid-19 pandemic has changed our society. Looking at how retirement communities have come through the crisis, there is no doubt that the landscape for retirement communities has been redrawn. Covid-19 has done that. We must now look to the future because future pandemics are a matter of when, not if. What steps will the Minister take to fund later-living accommodation so that it will be secure and residents will be safe? I know that accommodation is not the Minister’s responsibility, but how can the Minister and my Government respond in a way that means they can help with those things?

The most important thing for administrators of retirement communities and independent living facilities to do now is plan and prepare. If there were a headline for this debate it would be “Plan and prepare for the future.” I know that the Minister will respond very positively to that. No matter the level of transmission in a community, every retirement community and independent living facility should have a plan in place to protect residents, workers, volunteers and visitors from a future pandemic. This should be done in collaboration with local public health departments, local regulatory agencies and other stakeholders. We must focus on the components of the plans that address infectious disease outbreaks.

I want to ask the Minister about the direction of the strategy and the response that came from Westminster to all of us in the regions we represent, in my case Northern Ireland, but Scotland and Wales were the same. What discussions has the Minister had with the devolved Administrations to ensure that the Scottish Parliament and the Welsh and Northern Ireland Assemblies have learnt the lessons regionally? We have all learnt lessons regionally that we can share with each other. That is the wonderful thing about debates here. If all the four regions of the United Kingdom of Great Britain and Northern Ireland come here, we all share our input in the debates and we all have a perspective on something that we have learnt. It is good to be able to learn things and take them back home. It is important that we can improve things across the United Kingdom of Great Britain and Northern Ireland.

I will close by suggesting that the impact of covid-19 on retirement communities will be that it will shape how we live later in life—not because I am getting closer to that later in life category, but because it is important in the role that we play here to prepare for the future. More of us are ageing, so more and better models of care will need to be put into place. I probably look back more than others, and I wonder where the past 30 years of my life went. They went so quickly. Now that we have all experienced and have a much better understanding of social isolation, important conversations will need to take place to find ways to support and promote the benefits of living in retirement community settings and how they can be made pandemic-ready for the future. We can then use those to improve care home settings, because that is where the scale of the pandemic was felt the most, and that is why this debate is so important.

Photo of Karen Bradley Karen Bradley Chair, Procedure Committee, Chair, Procedure Committee 3:46 pm, 1st July 2021

It is a pleasure to serve under your chairmanship, Mr Efford. I am trying to remember whether I have done so previously, but I am delighted to do so this afternoon. I congratulate Jim Shannon, whom I will call my hon. Friend from Strangford. I know he was concerned beforehand, but I want to reassure him. I do not know whether it was because of my 19 months in Northern Ireland as Secretary of State or something else, but I understood every single word that he said throughout the whole of his contribution, and I agreed with much that he said.

It is perhaps unusual that I am contributing to a debate introduced by the hon. Member for Strangford, rather than the other way round, but I wanted to contribute because I have a number of retirement villages in my constituency that offer a fantastic service, a real alternative to independent living in later life. I want to talk about how they tackled covid in a way that was as kind as it could be. Let us be clear: there is nothing about the pandemic that I like. I do not particularly like the fact that we are in the Boothroyd Room rather than the Grand Committee Room for a Westminster Hall debate, even though I fought very hard as Chair of the Procedure Committee to get this room opened up because it can host hybrid proceedings.

I do not like not being with my family and friends and not being able to see people freely, and I do not like what has happened to the more elderly in our communities. In my constituency, loneliness and social isolation have been prevalent among the elderly during the pandemic, and I want to talk about the role that retirement villages have played. Also, I want to talk about the role that I think they can play in the future provision of health and social care.

By retirement villages, I mean places with independent living: campus-based community living, but each individual or couple living independently. People have their own home and their own furniture. It is equipped for them to live the way they want to live, but in a communal setting. There are shared communal facilities with club rooms, restaurants, hairdressers, gyms and spas, and sometimes even swimming pools in what we might call the more desirable accommodation. They offer an alternative way of life for those who are post their careers, an alternative that perhaps means they can have a longer independent life than they might have had if they had stayed in their own homes.

As I say, I have a number of retirement villages in Staffordshire Moorlands. We have an older-than-average population, demographically, by which I mean that proportionally, there are more people aged over 55 in my constituency than there are in others. We therefore have an awful lot of traditional retirement homes, traditional care homes, traditional home care services and the housing with care alternative—independent living. One that I have visited on a number of occasions is Bagnall Heights. For people travelling into the moorlands through Light Oaks, Bagnall is the first village that they see after leaving Stoke-on-Trent. In fact, Bagnall Heights could be called the gateway to Staffordshire Moorlands. It is owned by the Vincent family, David and Phil, and run by the fantastic Sue Clarke.

I have had many visits to Bagnall Heights, and I have always been made incredibly welcome. I have also always been incredibly challenged by the residents, who very much enjoy getting a politician in and grilling them. They have had a difficult time during covid, as has everybody. Sue Clarke contacted me thanks to the work of Councillor Sybil Ralphs MBE, who is leader of Staffordshire Moorlands District Council and represents Bagnall at ward level. I will read out what Sue said, because she put it incredibly well and there is no point trying to paraphrase her. She said:

“Here at Bagnall Heights we have done amazingly well as we went in lockdown as soon as we had the information and as we were in a gated complex, we were able to monitor anyone coming in and out. We have always had plenty of PPE available and always done temperature checks on everyone and we have never let our care staff go home in uniforms since we opened.”

That is not just during covid; it is a full-stop thing for Bagnall Heights. She continued:

“We arranged for all residents and staff to have Covid Vaccinations”.

Sue said that residents had both by May and staff had both by April 2021, and she went on:

“We have done shopping for residents to cut the risk of families coming on site and we have managed to keep our residents all safe by working together as a community and with the help of excellent staff working all hours this has worked well.

We only let deliveries come to reception and leave everything with us so we were able to deliver to residents’ homes. The same with milk and papers. We have always had a good relationship with our 84 residents and were able to keep a close eye on everyone and know if they were feeling low and we were there to offer support with care needs or just as a friend. The families and friends of our residents know that they only need to call the manager if they needed to pass anything on or ask our advice on anything.

Here at Bagnall Heights we are set in beautiful gardens”—

I can absolutely vouch for that—

“and were able when restrictions were lifted to organise Sir Lee Pearson”,

who is one of our local celebrities, and a Paralympic gold medallist several times over,

“to come and give us a dressage with his gold medal Olympic winning horse Zion, and a local band playing in the gardens and all the residents were able to sit in the grounds at social distance and have a wonderful afternoon with ice cream van that they went up to one by one to stay safe. We also had meals delivered by local pubs/chip shops and we delivered them to the residents to keep everyone safe.

We also did Quizzes weekly and raffles and exchanged cheques for cash so they did not go short of anything they wanted.

We are registered with the county council to do weekly Lateral flow tests for our residents and twice weekly for staff and staff also have one PCR test a week. Before this we had them delivered and registered with the NHS.

We have now organised 6 residents per day to go in the lounge together for chats and to let us monitor track and trace if we did ever have anyone to test positive. This also lets us do a thorough clean each day. We have always done touch point cleaning 3 times a day on a rota throughout the pandemic. We make the Paramedics and Doctors smile when they come as they say we are the only ones that check their temperatures before letting them enter.

We all work as a team and to get through this we must appreciate that the government have had very hard decisions to make and need us all to help and work with each other. This has been so hard and now we all feel that we must try to get back to some normality.

It has been my pleasure working with such dedicated and loyal staff in such difficult circumstances, and for a company that cares. Bagnall Heights is more than just a retirement Village that offers care.”

That was Sue Clarke, the estate manager for Bagnall Heights. Once David Vincent found out that this debate was happening, he called to make sure that we heard from him. He made it clear that Bagnall Heights had taken a very proactive approach. He said that if a resident had to attend hospital, for whatever reason, the staff made sure that the resident went into their independent, private home and isolated for the requisite number of days before they went to hospital, and a designated carer moved into their home to isolate with them and look after them. He says they are a well-knit community within a community and felt that everyone was cautious on the whole. To me, that speaks of a real success story in dealing with covid. It has been difficult for everybody, but to hear what the management at Bagnall Heights have done—I can vouch that this is also happening at retirement villages around the country; it is not unique to Bagnall Heights—shows what can be done by a community working together in the way that they have.

That takes me on to my more general points about housing with care facilities—retirement villages. As Jim Shannon said, the statistical evidence is that they have dealt with covid in a safer way than other, comparable facilities. As he said, the St Monica Trust and the Housing Learning and Improvement Network published research in April showing that only 0.97% of housing with care residents died from covid-19 between March and December, compared with 1.09% of those of the same age living in the wider community. That might not sound like a very big number, but when we are only talking about relatively small numbers, percentage-wise, of people dying from covid who contract it anyway, the fact that the number was lower in that cohort indicates real success. The majority of housing with care operators also had no or very few confirmed or strongly suspected covid cases during each month in 2020, with fewer than 1% of residents with covid-19 in any of their properties through to November last year.

I think this is a real model for how care can be provided. I want to be clear: I am not criticising traditional models of care homes or retirement living. There has to be a full suite of facilities available, so that the right facility is available to the right person. It would be absolutely inappropriate for Government, Ministers or an MP to suggest what would be right for any individual, but this is a lifestyle approach for those in later life that I think should be considered more. It is worth noting that only 0.6% of over-65s in the United Kingdom, or one in 200, live in one of these kinds of facilities, whereas in the US, New Zealand and Australia the figure is closer to 5% to 6%, or one in 20. If 10 times as many people proportionately are living in them in other places, we might want to consider why that is.

The hon. Member for Strangford said—this has come from the Associated Retirement Community Operators—that it is partly down to the lack of sector-specific regulation and legislation, but I think it is also down to other things. In part, I think it is because this kind of facility needs to be looked at with a cross-Government approach. ARCO is calling for a cross-Government taskforce. I would urge the Minister to consider that, because this is not an issue that merely sits within the Department of Health and Social Care, the Ministry of Housing, Communities and Local Government or any other Department. It is a cross-Government issue that needs to be looked at in the round.

Indeed, there is a real opportunity to use this kind of facility to assist with the housing crisis and bring it into the debate about the housing crisis. One of the operators told me that every night there are 20 million spare bedrooms in homes of elderly people who are living in the old family home but have not yet downsized. Twenty million spare bedrooms a night goes a long way to tackling affordable housing needs in certain parts of the country. That has to be part of the agenda and discussion.

There is an opportunity for people to move into housing with care, and the attraction is that care can then be provided at home if needed. Care can, of course, be provided in family homes, but they often have to be adapted at great expense. Perhaps people feel they do not want that to happen in their home and they end up going into care homes unnecessarily, when they would not want to go into a traditional care home and it is not right for them, but it is the only option available at the time. Those in independent living—in housing with care facilities—have that care provided at home. Few of the people living in those facilities end up going into care homes. That has to be part of the answer to the care crisis. I am well aware that it is not the only answer, but it has to be part of it.

I am a big supporter of retirement villages, including those in my constituency, and a big supporter of making sure that they are part of the Government’s approach to dealing with the housing crisis for younger people and the care crisis for the elderly. I look forward to hearing from the Minister and shadow Ministers.

Photo of Anum Qaisar-Javed Anum Qaisar-Javed Scottish National Party, Airdrie and Shotts 4:00 pm, 1st July 2021

It is a real honour to make my first contribution to a debate in Westminster Hall, albeit virtually, under your chairmanship, Mr Efford. I congratulate Jim Shannon on securing this debate. As hon. Members will know, I am relatively new to this place. My friend, the hon. Member for Strangford, has displayed only kindness and compassion towards me and so it is fitting that I make my first appearance in an important debate that he has secured. I would also like to wish his mother a very happy birthday, when it comes.

I listened to the opening remarks from the hon. Gentleman, and we have agreement. While we may disagree on the constitution, we can agree that those in retired communities deserve as much importance as any other community across the four nations. I also agree that retired communities have given up as much as any other community.

I note the interesting comments made by Karen Bradley that retirement villages give older people the opportunity to live in the manner they wish—independently—but are also communal, so there is an opportunity for socialising.

When we discuss the effect of this pandemic on retired communities, it is important that we take a like-minded approach. As the right hon. Lady said, there must be cross-Government support when looking at policy development. I would say that there should also be cross-party support in this place and a joined-up approach between the UK Government and the devolved nations.

During the pandemic, much of the advice from the four nations was that older people should stay at home and limit social contact with others, which meant that those in retirement communities were at increased risk of loneliness and social isolation. Age UK is a key stakeholder in the Jo Cox Commission on Loneliness. I have joined this place many years after Jo Cox, but I have witnessed at first hand the impact that she had in this House and her legacy in tackling loneliness. A report from the commission was clear: tackling isolation and loneliness is not just the responsibility of the UK Government and their devolved counterparts. Mayors, council leaders, businesses and community groups can all play a vital role. We have seen that. We have seen communities from the Isle of Skye, to my constituency of Airdrie and Shotts, to Cornwall, mobilise in order to support and give companionship to people in retired communities.

As the hon. Member for Strangford said, many in retired communities began to use technology. They were, so to say, getting down with the kids. Rather than a family Sunday lunch, it was a family Zoom call, with games nights and catch-ups. However, using new technology has been a frightful experience for many. The pandemic has changed many of our interactions and Age UK has found that this rapid pace of change has left a significant number of older people behind. Some older people have been unable to access computer equipment and others are simply not interested in getting online. It is, of course, a personal choice.

Earlier this year, the updated digital strategy developed by the Scottish Government and the Convention of Scottish Local Authorities, in consultation with business and the third sector, highlighted a shared commitment to deliver digital public services that are accessible to all and simple to use. That ambition to achieve world-leading levels of digital inclusion is at the heart of plans to equip Scotland for the technological transformation of the post-covid world. I hope that opportunity is given to help those in retired communities to expand their digital literacy if they wish to do so.

As Members will be aware, the population of the UK is ageing, and we need action to fully support retired communities. Over this Parliament, the Scottish Government are increasing social care investment by 25%, which is equivalent to more than £840 million. An independent review has given the Scottish Government a clear road map, including the creation of a national care service and the scrapping of non-residential social care charges. That will build on existing services in Scotland.

The 2014 reform integrated health and social care bodies in Scotland to enable a more joined-up and efficient service. More than £700 million was invested between 2019 and 2020 to support free personal care for older people in Scotland, making Scotland the only country in the UK to provide free personal care. The UK Government should follow Scotland’s lead by committing to a national care service for England. A single line about social care from the Prime Minister in the Queen’s Speech is simply not enough. During the pandemic, our retired communities, many of whom live in social care settings, need to see real action. While the UK Government dither and delay, the Scottish National party is taking action to deliver in Scotland modern social care service that is fit for the 21st century.

May I also take this opportunity to note that we also owe an enormous debt of gratitude to our nation’s carers, many of whom are involved in retired communities? Their commitment and compassion throughout the pandemic have been admirable. This financial year, the Scottish Government provided £8.8 million of additional funding to integration authorities to deliver the real living wage commitment to ensuring at least £9.30 per house for social care staff. That is higher than the national minimum wage that applies to social care workers in England and Wales.

For us to fully examine the effect and impact of covid-19 on any community, Governments must hold inquiries into their handling of the pandemic. In the 2021 Scottish Parliament elections, the Scottish National party ran on a manifesto commitment to hold an inquiry, but the UK Government have not yet made the same commitment. I say that not to play party politics, but on the basis of accountability and ensuring that lessons from the pandemic are learned not after the fact but now, while they still can help to save lives.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health and Social Care) 4:08 pm, 1st July 2021

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate Jim Shannon on securing the debate on this important subject, which has, so far, had too little attention during the pandemic. This is a prescient debate because retirement communities, which are sometimes called “housing with care” or “extra care housing”, should be an important part of the Government’s plans to reform social care—when they finally see the light of day.

Retirement communities enable older people to continue living independently in their own home with properly regulated home care services and other community facilities available on site. We have heard some wonderful examples from Members’ constituencies. Around 75,000 people live in such communities in the UK. Around 40% of residents are under 80 years old; almost half are between 80 and 90; and 15% are over 90.

As hon. Members have said, the pandemic has clearly posed real challenges to retirement communities, the people who provide them and the people who live in them. Residents faced increased loneliness and isolation due to the measures being put in place to control the virus’ spread, and communal areas and non-essential services have been closed and postponed. Many providers, although not all, struggled to get PPE at the beginning. They faced considerable staff shortages, and staff and residents reported real anxiety and stress. One of the issues raised with me was the lack of specific guidance for housing with care providers. I was told that they had to come up with a lot of that themselves. That is an important point, as we all know that we will have to live with this virus for some time.

Overall, as we have heard from the hon. Member for Strangford and Karen Bradley, research has shown that people living in retirement communities have been remarkably protected, compared with people of a similar age in the rest of the country. A smaller proportion died, and most housing with care providers reported no or very few covid cases in each of the months between March and December last year. Interestingly, some of that is due to the design and layout of retirement communities, and the self-contained nature of individual homes. One of the things we will have to look at in the future is whether capital investment is needed in residential homes to change their layout to make people less susceptible to the virus.

Although it is clear from evidence and research that many retirement communities did very well in protecting residents from the immediate impact of the virus, there are real concerns about the long-term implications of covid-19 on residents. Providers of housing with care fear that some residents may avoid seeking support from the NHS in the future because they are still worried about catching the virus if they go into hospital. The providers are also worried about the longer-term impact on the cognitive functions of older residents if they are cut off from family and friends, despite all the efforts to use Zoom and other technology.

Providers are also worried about older residents’ physical abilities, because they have been less mobile during the pandemic. That is part of a much wider issue. We have rightly heard about the huge backlog in operations and treatment in cancer care or acute-based care in the NHS, but we also have to think about the backlog and need in the community. As Age Concern and others have reported, we need to think about the support we provide for older people whose mobility has been reduced. Lots of older people report that they are not able to walk as far or feel less steady on their feet. That can have an impact on falls.

There are also mental health needs. It is not just about not seeing and hugging people—the friends and family they love—but living with the stress of fearing that they will catch this virus and die. As we think about the NHS recovery plan, I urge the Minister—I am sure she has already done this—to think about not just acute services but services in the community.

The benefits for the health of people living in retirement communities have been known about for quite a while. We know that older people in housing with care have higher exercise levels and fewer falls, and are less likely overall to suffer from anxiety and depression. That benefits not just them as individuals but the rest of the health and care system. Research has shown that those living in retirement communities are less likely to go into hospital and have fewer GP and nurse visits than comparable age groups. Indeed, some evidence suggests that the overall use of the NHS is about 30% to 40% less. That is really important not just because the people living there have better health but because there is a better use of taxpayer money. The health benefits of retirement communities are just one of many reasons why Labour is calling for an expansion of housing with care options in the future as part of our wider proposals to transform social care.

We live in the century of ageing. We have all heard about how the number of people aged over 65 will increase by more than 40% by 2040 to over 16 million. Most people want to stay in their lifelong family home for as long as possible, but having more options between care at home and a care home must be part of our vision for social care and housing in future, so that someone can be in their own home, living independently, but draw down those services and support as and when they need them. As the right hon. Member for Staffordshire Moorlands rightly said, other countries are way more advanced than us. Only about 0.5% of over-65s live in housing with care developments in this country, compared with 5% or 6% in New Zealand, Australia and America.

If we are to expand the options, three things need to happen. First, we need a clearly defined category of housing with care in the planning system, as the Housing, Communities and Local Government Committee, and the sector itself, have recommended. It is currently much harder to build housing with care properties than care homes due to a lack of definition in the planning system. It was a real missed opportunity when the Government did not include that specific definition in their “Planning for the Future” White Paper and the legislation. They need to think again.

Secondly, we need—the sector itself is calling for this—sector-specific legislation and regulation for housing with care, to give consumers greater confidence, spelling out residents’ rights and the nature of the relationship with care providers. It is also crucial to give investors long-term confidence. The legislation that has been introduced in Australia and New Zealand has really underpinned the development in those countries, which is why we need something similar here.

Thirdly, the Government need to seriously look at how we ensure that housing with care is an option for all older people, regardless of their means or housing wealth—in other words, not just available to those who have a lot of equity in their existing lifelong family home. Currently, around two thirds of housing with care properties are available for affordable and social rent. We are doing well at the moment, but cuts to local authority social care budgets over the past 10 years, including funding for complex services through such things as Supporting People, have meant that the creation of new affordable extra care housing has slowed, and in some cases services have been withdrawn. It is not good for older people, or the taxpayer, if people end up having to use more advanced and expensive care, or end up relying on the NHS.

I hope the Minister will set out what plans the Government have to support this important sector as we continue to live with the virus, and crucially what plans they have to support its expansion, so that all people have the choice, as the right hon. Member for Staffordshire Moorlands said, to live the life that they choose in the home that they call home, which will include these options in future.

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care) 4:18 pm, 1st July 2021

It is a pleasure to serve under your chairmanship, Mr Efford. I thank Jim Shannon for securing the debate and for his fantastic speech setting out both some of the challenges and the wonderful things that the sector has done during the pandemic, while looking ahead and setting the tone for the conversation about wider housing supply challenges and opportunities. I also congratulate Anum Qaisar-Javed on her first Westminster Hall debate. She was extremely articulate speaking to us remotely.

The pandemic has clearly been a huge challenge across the whole of our society, but the sheltered retirement housing and housing with care sector has faced the challenges of the past 18 months and truly risen to them. Managers, support workers, carers and other staff have gone the extra mile for those they support, and I have heard personally how hard those providers and their staff have worked, supporting the wellbeing of residents during the pandemic. I thank all those organisations and their staff for their amazing work throughout the pandemic.

Sheltered retirement extra care housing provides a home to hundreds of thousands of—often vulnerable—older people across the country. Having the right housing options helps older people stay independent for longer, continuing to live as part of a wider community in their own home, with the care they need close at hand when needed, but still—as so many of us want for as long as we possibly can—living behind their own front door, as my right hon. Friend Karen Bradley said, with their own furniture, for instance. These things make a difference to someone’s quality of life.

During the pandemic, the Government’s focus has been on ensuring that those most vulnerable to covid have had help and support to get through these difficult times, including specific help for those living in the residential settings that we are talking about.

The retirement and housing with care sector itself put in place tons of measures to protect the more vulnerable residents and to look after frontline staff, such as closing down communal facilities; suspending activities; restricting access in and out of communities; issuing PPE; restricting in-person visits; and often, regular and increased cleaning.

My right hon. Friend talked about the retirement village in her constituency, Bagnall Heights, which has done a fantastic job of job of protecting its residents from covid by controlling who came in and out; arranging the PPE they had; extra cleaning; going shopping for residents so they did not have to take the risk of leaving the area; supporting the vaccination effort; lots of testing; and organising some fantastic socially distanced activities to keep up morale, which has been so hard during this time. She says that staff worked all hours to do that. It was clearly a great job by manager Sue Clarke and owner David Vincent, whom she mentioned. I congratulate them and the many others I have heard of who have gone to those lengths to protect residents and to support them through such a difficult time.

As hon. Members mentioned, we have engaged regularly with the retirement housing sector over the past year or so, and all the intelligence we have received, as was particularly mentioned by the hon. Member for Strangford, is that infection and death rates related to covid in that housing sector have thankfully been lower than we might have feared considering the relatively older and more vulnerable residents living in the sector. The measures we have put in place have clearly been effective in protecting those more vulnerable residents. However, as we have recognised today, there has also been a downside: the impact on the overall health and wellbeing of older people of, for instance, limits to socialising and communal activities; restrictions on visits; and not being able to get out and about as usual. In fact, a serious thing that happened, particularly earlier on, was residents sometimes not having access to healthcare or doctors as normal. As the hon. Gentleman said, life was completely different. As we have talked about, retirement housing providers worked really hard to get that balance between protecting their residents from infection, trying to maintain as much of the quality of life of their residents as possible and trying to maintain social contact.

The hon. Gentleman talked about technology being part of that, as did the hon. Member for Airdrie and Shotts, and about how Zoom calls have replaced visits for some; some people have actually found that they see more of their family via Zoom than when a long trip is required. We all agree that there is no way that a Zoom call actually replaces being physically together with people; it is not the same as coming together for a meal or a cup of tea and having a hug. However, it has been better than nothing. We all want things to get more back to normal, and we welcome the fact that that is happening.

The Government targeted our support at the sector; we have broadly worked hard for the last 18 months to support the social care sector. It is a hugely diverse sector, as hon. Members have talked about today, ranging from care homes and nursing homes to extra care housing, retirement housing, shared lives and shared accommodation. So there is huge diversity in the sector, which we have sought to support in different ways.

The shadow Minister talked about guidance. We have worked to provide guidance for the range of settings in the sector, but it has not always been easy, simply because of the diversity and the different circumstances that exist. Nevertheless, our support has included the provision of testing, which my right hon. Friend the Member for Staffordshire Moorlands said was clearly being used regularly by Bagnall Heights, and that was good to hear. There has also been access to PPE and all the particular support to settings that are more like care homes, where residents live in closer proximity and receive more care than in other settings.

Also, this year frontline health and social care workers, including those providing care in retirement communities and extra care housing, were prioritised for the vaccine by the Joint Committee on Vaccination and Immunisation in cohort 2. We are now in a great place, where the vast majority of people in those settings—both residents and the staff working there—have had not just one vaccination but two.

We continue to listen to and work with the sector, and to work with local authorities as well, on how we can support this part of society as we come through the pandemic. Although life is getting closer to being back to normal, as the shadow Minister rightly said, there have been long-term consequences from the relative isolation that people have lived in, and from their not being able to get out and about to participate in normal activities. We do not know all the consequences yet, but we know that getting back to normal brings its own challenges, too.

I will pick up on a particular question from the hon. Member for Strangford about future pandemic readiness. He made a really good point that we have seen that this kind of accommodation helps people to be protected from the risk of an infectious disease, for example because of separate housing units and that sort of set-up.

Looking ahead, however, we know that there will be opportunities to look back, to reflect upon and to learn the lessons of the whole experience of the pandemic. Of course we learn as we go, but actually taking the time to reflect is something that is still ahead of us. The Prime Minister has committed that there will be an independent inquiry established on a statutory basis, and that will begin its work next spring. I have no doubt that it will lead us to making sure that we are ready for future pandemics, looking across the wide range of settings where people are more vulnerable to infectious diseases.

This debate has also been a really rich conversation about housing provision more broadly for older people and the sort of provision that we want to have across the country. Housing will be part of our social care reform proposals, which, as hon. Members know, we have committed to bringing forward later this year. It is totally right that housing is so much a part of that work. The homes that we live in, and the environments and communities around us, have a huge impact on our health, wellbeing and quality of life. I want people to be able to live in the home of their choosing for as long as possible and as independently as their age and their health condition will allow.

We know that living in a home that is safe, so that it allows someone to keep living independently, not only improves someone’s quality of life but helps to prevent them from having an early admission to hospital and helps them to be transferred back out of hospital to go home. For many people, it can mean that they may never need to move into a residential care home setting, or at least delay it. However, we should all be clear that care homes and nursing homes are an important part of the mix of accommodation, and there is absolutely a time and a place when that setting is the right thing for people.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

Karen Bradley asked a question, Minister, which I will repeat. How can the health and social care reform work in partnership with the retirement communities, so that they can devise a strategy? I ask that because there are two Departments involved. The right hon. Lady made the point, and I just reiterate and reinforce it, because she and I both want to see that happening.

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care)

I thank the hon. Member for his point. I completely agree. I will come to that, if he will just bear with me. I will continue, but I will pick up on exactly that.

As a Government, we know that we need to review housing holistically, looking at existing stock, which is clearly the vast majority of the housing in the country, as well as new builds, and looking at the wide range of housing options that we want to be available to meet all the health and care needs of our population—the growing number of people who are living longer and what that means for us. Whether people are living with or without home care support, it is important that we remember that not everyone will want or be able to stay in their current, lifelong home. That means that we need to think very broadly about having the right specialist housing options, including those with extra levels of care and support.

In England, both my Department and the Ministry of Housing, Communities and Local Government provide capital grant subsidy to assist with delivery of specialist and supported housing for older and other more vulnerable people with care and support needs. Speaking for my own Department, we provide funding to build specialised housing, through the care and support specialised housing fund, for older people and adults with learning and physical disabilities and mental ill health, and £71 million has been provided for that fund in 2021-22. Furthermore, 10% of delivery under MHCLG’s £11.5 billion affordable homes programme will be used to increase the supply of much-needed specialist and supported housing for a range of people with care needs, including older people.

That is what we are doing now, but I think that we are in agreement in this debate that we need to do more and we need to increase the supply of retirement housing and extra care housing and have a broad range of the kind of housing that helps people to live with their own front door—in their own home—for longer. Therefore I am working with MHCLG Ministers, and my officials are working with those officials, on how we can best achieve that. We are working across Government and also working with stakeholders, with the sector, on how we can achieve it. We are indeed considering the proposal for a taskforce, which was referred to by my right hon. Friend the Member for Staffordshire Moorlands. Yes, the partnership approach is absolutely one on the table.

I will come to a conclusion, but I want to say that one highlight of this debate for me has been hearing about the mother of the hon. Member for Strangford. It is a highlight because it is a reminder to all of us that this is about people. It is about real people and about their homes, which matter so much. I have been to brilliant homes; I have been to wonderful specialist retirement communities. I have been to housing and care settings and everything in-between. We need a mix of provision, and we need that mix so that individuals like the hon. Member’s mother, family members of all of us, whether it is grans, grandads, mothers, fathers, brothers or sisters, and, in due course, we ourselves have the homes that we need where we can live the best possible life and live our life to the full for as long as we can.

Photo of Clive Efford Clive Efford Labour, Eltham

We have until a quarter to 5, but this will be a summing-up, not another speech—[Laughter.] I just point that out gently. I call Jim Shannon.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 4:33 pm, 1st July 2021

Mr Efford, I would not stamp on your toes and take advantage of that; I know I could not, but I would not do it anyway. May I first thank everyone for their contribution? I will go through them. The right hon. Member for Staffordshire Moorlands brought her wealth of knowledge to this debate, and I thank her for coming today and giving us all the opportunity to hear that. Her constituency obviously has a lot of retirement communities. She was right to say that that is a longer part of independent life. That is what we are looking at: people are living longer and they want to have a decent life as well, and that is what retirement communities provide. The right hon. Lady said that retirement communities are an example of what can be done in later life. I think that the Minister and, indeed, every one of us has referred to that. The right hon. Lady asked a question, and the Minister’s response was exactly the answer that we wanted. We thank the Minister for that, because we want there to be that close relationship. If anything can come out of this, that is what we would like to see.

I am very pleased to see Anum Qaisar-Javed. I know that she and I will disagree on the constitutional position, but I hope that her time in Westminster will be a long many years. She is a very talented lady, and I say that with great respect. We have had some conversations in the time that she has been here, and I know that she has a heart for this subject matter. I was very pleased that she was able to attend her first Westminster Hall debate. She told me last week that she would be coming, and I was pleased to hear her contribution. We can learn much from Scotland, as I have said many times. I am always keen to hear about what happens in Scotland’s health system, so that we can replicate that in our own constituencies and regions.

Liz Kendall made an excellent contribution. It was not just about the issues; it was about the strategy for social care reform going forward. I must say that I was greatly encouraged by that, and I was very pleased that we had the opportunity to hear those things. She spoke about the expansion of housing with care in the future, social care reform and how the strategy would work. There is the potential for both the Government and the Opposition to have collective responsibility for this issue.

I thank the Minister for her response. It is always good to have the Minister in her place. I look forward to her contributions, because they are always helpful and responsive to the issues that we bring to her attention. Today, she answered the questions that were asked of her. If every debate ended with the Minister giving us a commitment in response to our questions, it would be a better world.

I thank you, Mr Efford, for chairing the debate, and I also thank all the staff—we cannot manage without them.

Question put and agreed to.

Resolved,

That this House
has considered the effect of the covid-19 outbreak on the retirement community housing sector.

Sitting adjourned.