Question asked by
To ask Her Majesty’s Government what action they are taking to
ensure the provision of domiciliary home care support, in the
light of the decision by Allied Healthcare to file for a company
voluntary arrangement.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care (Lord O'Shaughnessy) (Con)
My Lords, the law is clear that, if services may be disrupted due
to business failure, the Care Quality Commission will notify
local authorities so that they can put appropriate contingency
plans in place. In respect of Allied Healthcare, no such
notification has been made to date. The public should be
reassured that the Care Quality Commission has been monitoring
closely the situation at Allied Healthcare and will continue to
do so.
(Lab)
My Lords, Allied Healthcare is the latest hedge-fund-owned care
provider to have to take drastic action to keep up the huge
burden of paying off loans to its creditors. The precarious
finances of many domiciliary care companies has already led to
large-scale provider closures and to companies handing back
contracts in almost half of councils, and we know that
residential care is in a similar position. The CVA means that
Allied Healthcare has four weeks to come to an arrangement with
its creditors. Its closure would have serious consequences for
continuity of care and the safety of its 13,500 clients,
including many vulnerable older people and people with learning
difficulties, and for its 8,700 staff. With local authorities
unable to pay fees that cover the actual cost of care or meet the
implementation costs of the national minimum wage, let alone
address the potential £400 million of deserved back-pay costs for
staff sleep-in payments, what reassurances can the Minister give
that councils will be able to discharge their statutory duty to
deliver care if Allied Healthcare collapses? Does he really think
that this is the way to fund the care that people in need of
support in their homes deserve?
I thank the noble Baroness for the opportunity to provide that
reassurance for people using and benefiting from the care
provided by Allied Healthcare. I want to reassure them that the
Care Act 2014, passed by the coalition Government, gives local
authorities responsibility for continuity of care if a business
were to fail. Of course, we are not in that position with Allied
Healthcare, because it still has to go through the CVA process. I
can reassure people that the LGA has said that councils have
“robust”—its word—plans in place to ensure continuity of care if
that is required. I put that on record for those who may be
worried about it.
We know that extra funding is needed in the sector. Over three
years, through a number of means including extra money through
the precept and direct funding to local authorities, the
Government have increased by about £9 billion the funding
available for social care, which we know is required. I also
point out that, if you look at domiciliary care provider numbers,
you will see that there are 50% more than there were eight years
ago. We know that markets have entrants and that providers are
exiting, but we have more providers in the market and more
packages being delivered than ever before. Ultimately, the
backstop is that local authorities have that responsibility to
provide continuity of care.
(CB)
My Lords, does the Minister understand the importance of this
Question? Imagine being a very vulnerable person living in a
residential home with no alternative to go to or being dependent
on a home help for the basics of daily living. Now imagine living
under the shadow that the company that provides that service is
going to go out of business at any time. Nothing could be more
anxiety-provoking for these residents. The Care Quality
Commission telling the local authority that there is a problem
here is of no comfort. I hope that he will take this Question
rather more seriously.
I have huge respect for the noble Lord and his expertise in this
area. I take this issue very seriously, which is why I used the
opportunity in answering the noble Baroness to provide the
reassurance that is in law. Local authorities need to step in to
provide continuity of care with notice from the CQC, which now
has a new responsibility to monitor the financial sustainability
of providers and to make sure that that care is provided, whether
it is delivered in-house or through contracts with other
providers. That reassurance did not exist before it was
introduced in the 2014 Act. It ought to provide a degree of
reassurance among vulnerable people, who I accept will be
anxious. That responsibility is in law.
(Con)
The Minister has said that this is a matter of law. There has
been a court judgment that fees should be paid to carers for time
spent going between clients, which can be nearly half of their
day. They may have one hour to spend with many clients. Is he
aware that providers of domiciliary care—run as agencies and used
by most local authorities—are not honouring that legal decision
that this should be paid as part of their employment?
My noble friend is right to bring up that issue. They should of
course be paid. If she has any specific examples to share with
me, I shall be glad to investigate.
(LD)
My Lords, everyone knows that the social care sector,
particularly in domiciliary and care homes, is under great stress
at the moment—I declare my interests as in the register—and we
look forward to the Green Paper coming up some time in the
summer. I hope it takes into consideration that such homes need
to pay not only wages and pensions but, for larger ones, an
apprenticeship levy. Normally there would be a market for mergers
but at the moment the sector is anxious about inheriting sleep-in
liabilities. Can the Minister give any guidance about when these
issues within the department and the Treasury will be remedied?
We know that the issue of back-dated pay for sleep-ins has had an
impact on this and other sectors. Two aspects of this are, first,
that the Government have waived penalties for non-payment prior
to July 2017; and, secondly, that there now exists an HMRC scheme
that allows providers to work with HMRC and the business
department to understand their liabilities and gives them a
further year to pay them. That is the support we offer to any
organisation affected by the changes to the taxation arrangements
of sleep-ins.
