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Sheltered Accommodation (Barnet)

Volume 492: debated on Friday 8 May 2009

Motion made, and Question proposed, That this House do now adjourn.—(Ms Diana R. Johnson.)

I hope that I have rather more success with this debate than I had with my private Member’s Bill.

At the start of the year, Conservative-run Barnet council announced that it intended to cut entirely warden and scheme manager services from tenants living in sheltered housing in the borough. The council makes no bones about it: this is a cut to save money. In its consultation document, one of the more outrageous ideas was to ask the elderly and vulnerable people who are affected to suggest what alternative cuts should be made if their services were to be left alone. How ludicrous is it to suggest that the elderly should be able to trawl through the council’s budget to identify alternatives?

Instead, the council proposes to provide a floating support service that would be linked not to any particular sheltered housing location, but to an individual and only for a few months, with the long-term aim of ending even that inadequate alternative. It even proposes to end the dedicated alarm service. In its document, the council suggests that

“many people already living in sheltered housing are unhappy about paying charges for a service they could manage without”.

That shows just how out of touch Conservative Barnet council is. Not one of the dozens of people to whom I spoke suggested that they were unhappy with the service. Every single one, though, was extremely concerned and frightened about the consequences of the council’s proposals. All believed the consultation to be a complete sham, based on bitter experience of Conservative Barnet council’s past consultations.

The council suggests that part of the problem is inadequate financial support from the Government, yet it has had above-inflation rises in aggregate external finance every year since we came to power bar one, the year reflecting the census. It was widely believed to have underestimated the population, but Barnet council chose not to challenge it.

If the council wants to look for savings, it should start with the 22 per cent. pay increase that Conservative councillors voted for and Labour and Liberal Democrat groups opposed. If it had not recklessly lost £27 million in speculative investments in Icelandic banks, the interest alone would have gone a long way to meeting the costs of that dangerous cut. It is not fair to expect vulnerable elderly people in sheltered accommodation to pick up the bill for the Conservatives’ mismanagement of the council.

Many tenants make the point that they would not be in sheltered accommodation if they had been able to remain in their own homes. They are there because they require that support; indeed, they would not have been offered sheltered housing without first being assessed as being in need of it. The council suggest that others who are not in sheltered housing are being “discriminated against” because they receive less support. That is a false comparison, which shows the need to level service up not down, and the council’s failure to provide adequate sheltered housing to those who need and want it. From my own observation, as well as tenants’ own comments, it is clear that the majority would be unsafe if left on their own. They have varying degrees of frailty, many are bewildered and forgetful and it is clear that some really ought to be moved into higher dependency support. However, they manage to cope with the help of the current warden service.

Many tenants told me that they gave up larger, family-sized council or housing association properties, which are in high demand, in return for the offer of sheltered accommodation with warden support. Without wardens, the tenants would not have moved. The proposal therefore will have a deterrent effect on other elderly people occupying larger properties, because they will be less willing to downsize to sheltered accommodation.

The tenants’ descriptions of the council’s proposals include, “very frightening”; “people will die”; “chaos”;

“it is a great injustice”; “it will cost more in the end”;

and

“it’s diabolical to pick on the elderly”.

I was also shown a number of tenancy agreements that demonstrate that a significant proportion of tenants have a contractual right to a residential warden service, and that it would be a breach of contract to remove the service.

Many health issues—perhaps the most important kind of issue—were raised with me. Individual examples include epilepsy. One resident has had three epileptic episodes; he was found promptly by the warden and an ambulance was called. The fits struck so quickly that there was no time for him to have called for help. A resident with a laryngectomy valve has just one hour to get to hospital if the valve comes out. If it does, she cannot—for obvious reasons—call or phone for help herself. She relies on the warden to do so. An oxygen-dependent tenant relies on the warden to check on his medication and the oxygen to ensure that they are being taken and used properly. Another resident said:

“I collapsed and knocked myself out. The warden came straight away.”

Another commented:

“I am asthmatic and the warden regularly checks on me.”

Still another asked:

“Who will let in the ambulance staff if there is an emergency?”

With no warden service, the number of calls to the emergency services will increase, because beforehand the tenants would have relied on the wardens.

However, the residents rely on wardens for help in more than just emergency situations. One said:

“The warden calls the GP if we are ill. The GP might not come if it was just us.”

Another commented:

“He sits with me, reassuring me until the paramedics arrive.”

Many residents told me about wardens organising GP and hospital appointments, collecting prescriptions and supporting ill tenants:

“She cooks a meal if someone is ill.”

It is clear that, to the sheltered accommodation tenants, wardens are a lifeline—a word that they frequently use.

Wardens play a big role in the safety and security of their tenants and their homes. They help deter and keep out intruders, and alert the police if necessary. They check on the security of the premises, especially in the evenings. Some tenants commented that, due to forgetfulness, doors are sometimes not secured at night. One asked:

“Who will deal with the fire brigade? Our common parts alarm is not switched through anywhere, and we rely on the warden to call them.”

Another said:

“The warden checks that our smoke alarms and emergency cords work.”

A third said:

“I overcooked something, and the smoke alarm went off—the warden was there immediately.”

The issue of fire was also raised:

“We’ve had two fires. We rely on the warden to deal with the fire brigade.”

In another example of forgetfulness, a tenant left her handbag on an open staircase. Luckily, the warden found it and returned it to her. The level of reassurance given by the wardens’ presence cannot be overestimated—

“Every day, he checks on us.”

I was also told that

“The warden holds spare keys for us, in case we lose them or urgent help is needed.”

In blocks with lifts and upper floors, wardens are a vital support for tenants who cannot use the stairs unaided in the event of an emergency or lift failure. For obvious health and safety reasons, such tenants will probably have to be rehoused at ground floor level, putting additional pressure on housing stock in acute shortage. Alternatively, they will have to be housed in accommodation with higher, more expensive support.

Following the winter’s heavy snow, it is not surprising that many commented that their warden cleared the paths of snow and ice. Furthermore,

“The warden made dinner for me, when the carer didn’t come due to the snow.”

Wardens know their own tenants well—by sight, name and behaviour pattern. They will be the first to know if someone is missing, unwell or otherwise suffering. No floating service could ever have such important, intimate knowledge of such vulnerable people.

The warden service really comes into its own when it comes to social needs. Its dedicated men and women support their tenants, in ways that go way beyond their contractual duties, out of their common humanity towards people who depend on them for help. Tenants spoke of their fear of isolation, without the social activities that wardens help to organise:

“She helps make life liveable.”

Examples given to me include:

“The homely touch—she puts flowers in the reception”;

“Who will put up the Christmas decorations and cook the Christmas lunch?”;

“The human factor—she remembers my name”;

“I can’t read or write, and she reads all my letters for me. I don’t want to ask others, as they’d know my private business”;

and

“The warden delivers meals from the on-site restaurant to me. I’m 94 and can’t walk far or prepare my own food.”

Extra help given by wardens includes: information and advice; form-filling for benefits; the social club—coffee mornings, visits and outings; cooking meals for the tenants together; help with minor home repairs; changing light bulbs; help with shopping; maintaining contacts and links with residents’ families; and ensuring that residents are up and about in the mornings. None of that support can realistically be given by a floating service.

As part of my research, I also contacted and surveyed sheltered accommodation tenants whose warden service had been withdrawn and replaced with a floating service. All complained of very brief visits and a lack of interaction between the visiting support worker and the tenants, either individually or collectively.

I have listened to my hon. Friend with great interest. What he describes is not only happening in Barnet and Hendon; he may not be comforted to know that many Conservative boroughs across London, including Hammersmith and Fulham, are doing exactly the same, and it goes alongside cuts to meals on wheels, domiciliary services and all services provided for social tenants. In every single case, and despite campaigns by the GMB and other unions, the cost goes up and the service quality goes down. We are talking about a concerted political campaign against social tenants, and it is continuing throughout London.

I am grateful for my hon. Friend’s intervention. He is absolutely right. I know a little about what has happened in his borough. If my local elderly people were look at what is happening in Hammersmith and Fulham, they would fear that Barnet might follow it with serious cuts to other services such as meals on wheels.

I am sure that my hon. Friend the Minister has seen the Help the Aged booklet published earlier this year on support for older people living in sheltered accommodation; there is a lot to recommend to him in that publication.

The root cause of Barnet’s cruel proposal can be found back in 2003, when the “supporting people” system was introduced, separating support services such as wardens from housing costs. I am sure that when these changes were introduced, it was not foreseen that councils such as Barnet would exploit them to cut services to vulnerable people. I urge my hon. Friend to carry out, as recommended by Help the Aged, a review of the policy on sheltered housing, including consideration of whether sheltered housing should be taken out of “supporting people” to end the artificial separation of housing management and support that will prove so detrimental to Barnet tenants if the council gets it way. We have to be absolutely clear who is responsible for what is going on in Barnet: the Conservative party, heartless, not compassionate, intends to withdraw this service.

It is clear that the council’s proposals have caused immense worry and fear for the tenants who stand to lose their warden service. As part of my survey of tenants, I asked them to rate their service: only a handful gave ratings below nine or 10 out of 10, and many went even higher. Not one agreed with the council’s proposals. The tenants referred to their wardens as “materfamilias”, “friend and confidante”, and “our guardian angel”. The human cost will be fear and isolation of elderly, frail and vulnerable people—those we should be doing everything we can to support. Some will die through lack of emergency response. Others will inevitably be forced to move to more expensive forms of support, which will no doubt prove to be a false economy. These proposals cannot be justified, either subjectively from the tenants’ individual viewpoints, or objectively from their impact on other council services or budgets. The proposals must be withdrawn without delay to give elderly tenants in Barnet the safety and security that they need and deserve.

I congratulate my hon. Friend the Member for Hendon (Mr. Dismore) on securing this important debate on warden services in sheltered accommodation in Barnet. I have read about his hard work on this matter in his constituency carefully and followed it closely. The whole House will acknowledge that such services are vital to many vulnerable people in the borough of Barnet. My hon. Friend is a great example of a connected, responsive and campaigning constituency Member of Parliament.

I should like to do two things in responding to the debate. First, I will set out the national policy context in respect of housing and related support needs for vulnerable and older people; then, I will turn to the specific concerns in my hon. Friend’s constituency. I am sure that he is well aware that this Government are mindful of the housing and support needs of all vulnerable and older people, wherever they live—whether in their own homes, with family, in supported housing such as sheltered or extra-care accommodation, or residential care establishments. The issue is becoming increasingly important as the population of this country ages. The Government’s vision in this policy area is to ensure that our vulnerable and older citizens get the best housing and support services that can be provided, locally and in the most effective way.

In order to achieve that vision, we have provided unprecedented sums of money for local authorities to invest in this area. The “supporting people” programme has provided funding to local authorities to deliver housing-related support since 2003. As my hon. Friend knows, “supporting people” is a cross-cutting, preventive programme providing housing-related support to help vulnerable people to live independently. It helps more than 800,000 older people each year, enabling them to maintain their independence through, for example, sheltered housing, home improvement agency and adaptations services, community alarms, and floating support. Such support covers a large number and range of services, generally at a low unit cost, and it can secure independence for a large number of older people. The Government have invested more than £8.7 billion since the programme began in 2003, and we have announced a further £4.9 billion of funding up to March 2011. That three-year settlement will provide stability for service planning and delivery over that period. It will hopefully bring about efficiencies and economies of scale by providing certainty and longer-term contract and procurement services.

Housing-related support services are provided in conjunction with social services for those with more intensive needs. For frail older people, they can be provided in supported accommodation or, increasingly, delivered to their own homes. Those services are for a smaller number of people—some 30,000 a year—and come at a relatively high unit cost, but they still avoid the need for expensive residential care.

That example illustrates an important principle of the “supporting people” programme, namely that it is an invest-to-save budget. Expenditure of £1.5 billion in housing-related support services, alongside other expenditure costs associated with supporting vulnerable people, such as social care costs, delivers estimated net savings to the Exchequer of £2.7 billion. That comes through costs saved to the NHS and savings on the provision of long-term, expensive residential care. The model underpinning that analysis shows the value of providing good-quality, strategically relevant services to meet local needs and priorities and to support the early intervention and preventive agenda. It reduces calls on other services, such as those on the NHS through emergency admission to hospital.

In this financial year, 2009-10, for the first time the “supporting people” budget has been paid to local authorities without being ring-fenced. That provides them with an opportunity to work more flexibly and to develop new and innovative ways to support vulnerable people in a range of situations, including by delivering more holistic and needs-based services for older people.

That brings me to an important part of my speech—the devolution of responsibilities and priorities to local government. We emphasise, and I am sure my hon. Friend agrees, that it is for local authorities to decide how best to design and commission services. Central Government believe that local authorities are best placed to identify services to meet the needs of their local areas, and to balance local priorities. Central Government are not in the business of dictating to local authorities or service providers the details of what local services to provide and how, or indeed of micromanaging 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 service users. I shall discuss that in relation to Barnet in a moment. Consultation and needs assessment are critical to ensuring that any changes in services are effectively managed and reflect the wishes of service users as well as enabling local authorities to meet the needs of all such users. That was emphasised in the “supporting people” strategy paper, “Independence and Opportunity”, published by my Department 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 sets out the standards expected in the delivery of “supporting people” services. It has become an essential part of the administering authorities’ means of ensuring that providers deliver services to an acceptable standard and in accordance with contractual expectations. The QAF identifies methods of evidencing achievement and has been a successful practical tool for ensuring continuous improvement in services for delivering housing-related support over the past five years. We have recently raised the bar of what is expected at all levels of the QAF. Its original purpose remains—to ensure that quality standards across the sector continue to be raised and that services evolve to meet the changing needs and aspirations of clients.

In February 2008, my Department published “Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for Housing in an Ageing Society.” In that strategy we set out how sheltered housing is often a positive choice for older people who want to remain independent, but who value the little bit of support or shelter and the sense of security and community that such a scheme can provide, as my hon. Friend articulated. We stated in that document:

“Sheltered housing, 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.”

I am also aware that a number of residents in sheltered housing across the country, not only in Barnet, are concerned about changes to resident warden schemes. This is an important and complex matter, and, in view of its seriousness, my ministerial colleague, Baroness Andrews, chaired the first meeting of the sheltered housing working group in April. The meeting brought together a wide range of interested parties, including representatives of service commissioners, providers and residents, and considered how best to support good local decision making and practice. The group agreed to take forward two discrete strands of work focusing on resident engagement and consultation, and service models. It also agreed to report to Baroness Andrews on progress in a short time.

I hope that I have made clear to my hon. Friend the Government’s commitment to the matter. We believe that local authorities are best placed to decide priorities and the local design of services, but that appropriate consultation with local people should be at the heart of such design.

In that context, let me consider Barnet council. My hon. Friend set out with great eloquence and passion his concern about Barnet’s priorities and consultation on the matter. As he said, Barnet proposes to reduce the amount of funding for sheltered housing by £950,000 as part of a borough-wide strategy to find £12 million of savings in the authority in 2009-10.

Of course, it is right for local authorities to examine their activities and the manner in which they provide services to ascertain whether they can provide better value for money for the taxpayer. We endorse that, and I am sure that my hon. Friend agrees. However, I have to say to my hon. Friend that the proposal and the related cuts amount to one twelfth of the financial savings required by the authority. That raises several questions, which I would like the local authority to answer. I question whether such a large proportion of cuts or efficiencies should focus on one specific part of the authority’s activities, especially one that provides a service for older and often vulnerable people.

I also question the timing. I am not one for conspiracy theories, but is it purely coincidental that the local authority wishes to make large cuts in money for supported people and warden services in sheltered accommodation in the first year that we state that moneys provided through “supporting people” are no longer ring-fenced? The intention behind removing the ring fencing was to allow local authorities to provide innovative solutions tailored to local needs and the wishes of the local population. We did not see the removal of the ring fence as a green light to cuts in services for the elderly and the vulnerable.

I question whether Barnet is taking into account the important principle that I mentioned earlier in respect of “invest to save”. I have read correspondence on the matter, especially from Unison, and it is clear that unions and others believe that the new scheme would cost more, following the cuts in service that Barnet advocates and the subsequent increase in involvement by other statutory agencies, such as social services and the primary care trust. Unison made the good point that residents who leave hospital would have to spend time in a nursing home because there would be no one on site to monitor them closely. That obviously puts major pressure on budgets and costs in the NHS and social services.

As I have said, it is not the Government’s policy or wish to intervene in the affairs and priorities of local government, which is best placed to decide what happens locally. However, I highlight to my hon. Friend my concern that, as part of the £12 million efficiencies programme, Barnet seems to focus on £950,000 of cuts in warden services and a £1.4 million direct cut in children’s services—to be fair , the local authority states that changes in services will mean a corresponding increase in resources of around £970,000 for children’s services. Nevertheless, there remains a cut of approximately £500,000 to children’s services. There seems to be a series of cuts focused on vulnerable people and younger people in the borough. In contrast, I have been told that the proposed cuts in central expenses in Barnet amount to £14,000. Council tax payers in Barnet need to consider whether those priorities are appropriate.

I have been told that Barnet has completed the consultation on the change to its sheltered housing and warden services, but has yet to take the final decision on the budget reductions and the changes to those services. I am also aware that there is considerable interest in the outcome of the consultation and in the future service delivery and funding arrangements that Barnet plans to put in place.

My hon. Friend has led the opposition to the proposals from the front, and I again pay tribute to him. I am told that the Barnet portfolio-holder with relevant responsibility will consider the findings of the consultation later this month. I will keep a close eye on the issue, as I am sure my hon. Friend will. I hope that the portfolio-holder in Barnet will answer some of questions that my hon. Friend and I have raised in the House today.

Question put and agreed to.

House adjourned.