asked Her Majesty's Government:
When they plan to publish regulations on the standards to be observed in care homes.
My Lords, we will be consulting on regulations for care homes under the Care Standards Act 2000 shortly. Following earlier consultation, we also intend to publish soon the finalised standards for older people. The standards for care homes for adults will be published for consultation at the same time as the regulations.
My Lords, I thank the Minister for that reply. The Government have given ground relentlessly since the White Paper, Fit fin. the Future, was published in December 1999. They gave ground, first, on room dimensions and, secondly, on the phasing out of shared rooms, which is not now intended to take place until 2007. Is the reason for the delay in the publication of the draft regulations that the Government plan further concessions; namely, on training and staff?
No, my Lords. The preparation of draft guidelines and regulations must be undertaken very carefully. Thorough groundwork is being completed to ensure that we get them as right as we possibly can. The noble Lord spoke of "giving ground", yet during debates on the Bill as it passed through your Lordships' House many noble Lords urged the Government to be flexible in their response to the consultation we had with the care home industry to ensure that the regulations and standards were right. I believe that we have been flexible. We are giving time to care homes to enable them to come up to the standards we require. Ultimately, we will produce higher quality homes.
My Lords, bearing in mind the increasing proportion of older people in the population and their vulnerability. what consideration have the Government given to the need for a special commissioner with responsibility for the vulnerable elderly?
My Lords, perhaps I may make two comments. First, the commission itself will have a general obligation to report to and advise government on the matters for which they are responsible. As a body and through its regulation function, it will bring to itself a deep understanding of the issues relating to older people who are living in homes or are being helped by other services that are regulated. Through this, it will be able to give government careful and powerful advice. Secondly, important work is being undertaken through the national service framework for older people which is being prepared at the moment. This will ensure a high standard and consistency of service for older people across the whole of the NHS and, indeed, in personal social care.
My Lords, will the Minister give an assurance to the House that, when drawing up these standards, equal emphasis will be placed on the quality of life for and personal dignity of residents as well as to physical standards?
My Lords, yes, I very much agree with that observation. A criticism that could be made of the existing provisions as regards the registration of care homes is that they focus too closely on physical standards and not sufficiently on the quality of care outcome and dignity. We shall ensure that the new commission, once it is established, takes fully into account the points raised by the noble Lord.
My Lords, while paying attention to the standards for older people, which is extremely important, will the Government take care that the introduction of these standards does not result in more homes being closed? That is the experience locally and could result in bed blocking in hospitals, which would certainly not be to the advantage of elderly people.
My Lords, I take the point that, when looking at the wholesale provision of services for older people across the NHS, personal social services and the independent care sector, we must ensure that an integrated approach is adopted. I believe that the developments we are making in intermediate care will be extremely important to the aim of ensuring that, in the future, many more people will be able to stay in their own homes and live independently rather than needing to move into care homes. As regards the issues surrounding the number of places in homes, the fact is that at present occupancy of care home beds is running at 88 per cent. Throughout the country as a whole there is sufficient provision, but I accept that such provision can be patchy and that there may be some areas where shortages can occur.
My Lords, does the Minister agree that the establishment of a commission represents a major step forward in improving the standard of care for older people throughout the country? This matter is something about which many Members of this House have rightly complained over many years. Will the Government accept my congratulations on this development? Will the Minister also tell the House when the commission is to be fully operational?
My Lords, I am always happy to accept the congratulations of noble Lords and in particular from my noble friend. I agree with the criticism that the current regulatory activities of health and local authorities have been inconsistent. I believe that the appointment of a commission will lead to a higher consistency and standard of regulation. We hope that the new commission will operate in shadow form from April 2001. It will take over its legal duties in April 2002.
My Lords, in the further consultations on the regulations which the Minister mentioned in his Answer, will he seek the opinion of the Advisory Group on National Required Standards? Will he publish any recommendations that it makes?
My Lords, I imagine that it will be for that body itself to publish any recommendations it may make. I shall certainly draw the noble Lord's suggestion to the attention of the people concerned with the consultations.
My Lords, can the Minister say how care homes are expected to finance the higher physical standards that will be introduced, bearing in mind that many of them cannot make ends meet on the current fee rates paid by local authorities?
My Lords, there is a mixed picture throughout the country. Certainly, some homes feel that local authorities do not pay them sufficient fees; local authorities would argue that there is a market situation. We would encourage the closest possible partnership and relationship between care homes and local authorities. At a national level we are encouraging a concordat. Decisions in relation to funding will be taken by local authorities in the context of the overall increase in resources that is being given to them to fund social services generally. They will need to take that into account when agreeing fees with care homes. Generally, we must remember that while some homes will have to find extra resources, many homes are up to the standards that we expect the commission to recommend.