Asked by
To ask Her Majesty’s Government what assessment they have made of
the annual numbers of care home residents (1) evicted, (2)
threatened with eviction, or (3) facing a visiting ban, following
complaints against the care home.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
It is unacceptable for a care home to punish a resident for
raising concerns. This would be a breach of existing regulations,
and the CQC will investigate any such cases. Although the
Government do not collect figures on this, the CQC collects data
on care home evictions and seeks assurances that visits are
allowed by care homes on an ongoing basis. We are exploring ways
to improve the complaints system and the quality of care.
(Lab)
My Lords, may I urge the Minister to do even more than he
suggested today? We know that some care homes are still being
very highly restrictive on visits. The Alzheimer’s Society, the
Relatives and Residents Association and other organisations
report that many relatives are frightened to go through the homes
complaints system for fear of reprisals such as visit bans, or
even evictions in the most extreme cases. The CQC will not
investigate specific complaints. Will he change that policy and
give support to relatives who wish to make legitimate
complaints?
(Con)
I thank the noble Lord for raising this issue. I am sure he will
recognise, from when we have worked together on a problem, that
the first question I ask officials is: what is the problem and
what are we doing about it? When I asked this question, I found
that my colleague , Minister for Care and
Mental Health, has met relatives and residents’ associations to
hear directly about their experiences and focus on how we could
strengthen the CQC role. In addition, in the Living with Covid-19
strategy, we are reviewing a range of measures in place for
homes, including visitor restrictions. The updated position will
be set out in guidance by 1 April. We are encouraging
representatives, patients and patients’ groups to come forward
and feed into that.
(CB)
My Lords, I declare my role as chair of the National Mental
Capacity Forum. There are many people with impaired capacity in
care homes, whose mental state is deteriorating through lack of
stimulation, inability to be taken outside and lack of general
overall mental activities. Does the CQC have any idea of the
number of people with impaired capacity still subject to
restricted visiting by their relatives?
(Con)
The noble Baroness has identified a potential issue that we have
to address, which is drilling down into detail. One of the things
that the CQC does is to look at aggregate numbers of complaints
and concerns. Of course, there is a Local Government Ombudsman
who looks at this issue as well. We are looking at ways where
that works and where it does not work, and at how we could
improve the system. This is all part of the ongoing review to
build up a better, integrated health and care system.
(Lab)
My Lords, on the issue of carers hesitant to make complaints to
care providers, the confusion and muddle over the current
complaints system and the roles of the care home, the CQC and the
ombudsman compound the problem. Does this not underline the
urgent need for the review of the current arrangements to ensure
that people making complaints about their loved ones feel
reassured and protected through the process and comforted that
appropriate action will be taken?
(Con)
Having looked at the different procedures, I am sure that the
noble Baroness is absolutely right. One thing that we want to do
is to ensure that the guidance is quite clear. The CQC collects
certain data and the ombudsman can investigate certain cases, but
the CQC cannot investigate individual cases. It clearly is
confusing and one thing that we want to do to improve the system
is to make sure that we have a better complaints system and,
overall, a better quality of care for patients all round.
The Lord Speaker ()
My Lords, the noble Baroness, Lady Brinton, will make a virtual
contribution.
(LD) [V]
My Lords, the provision of high-quality, personalised care in
residential care settings is likely to reduce the chance of
complaints being raised in the first place. The Skills for Care
workforce review showed that only 44% of care staff have any
training on dementia. Will the Government commit to all social
care staff receiving tier 2 training in the dementia training
standards framework?
(Con)
The noble Baroness raises a very important point. When we look at
the current landscape in the social care sector, it is clear that
people do not really understand the overall sector. One thing
that we are looking at in regard to the voluntary register is
encouraging care staff to come forward to register. Registration
includes their standard of education and the qualifications they
have received. We will look at how we can improve and have a more
consistent qualification system, so that being a care worker is a
more rewarding vocation in the future.
(Lab)
My Lords, is the Minister aware that restrictive practices about
visiting in care homes extend not just to relatives and friends
visiting but to the outside people who come in to provide
stimulation to residents? These include people who bring in
animals, for example, and people who do physiotherapy or all
sorts of word games and so on. Those people are also restricted
now by some homes, though not all. That results in further
deterioration in the mental and emotional health of residents, as
referred to by the noble Baroness, Lady Finlay.
(Con)
One thing that has clearly upset a lot of people is that they are
unable to visit. This means not just relatives but, as the noble
Baroness rightly said, people who enter care homes to offer
healthcare, stimulation and other services to residents. These
issues were brought up, I understand, in a meeting with my
colleague, the Minister for Care and Mental Health, when she met
residents’ associations. It is very important that we recognise
all the problems and that we tackle this in a holistic way to
make sure that, as we improve the quality of our social care
system, and make it more joined-up and integrated with the health
system, we are aware of all these problems so that the patient
experience is far better all the way through.
(Con)
My Lords, I agree with my noble friend the Minister and noble
Lords opposite that it is very important that people can visit
their family and their friends in care homes. My husband has had
a copy of Wisdenfrom last year for a friend who has been in a
care home, and he has not been able to deliver it.
I want to make a wider point about the importance of focusing on
social care, despite other preoccupations of the Government. How
many care homes do we have now in this country? Is provision
going up, or do we have a serious problem?
(Con)
I am afraid I do not have the detailed answers to my noble
friend’s questions, but I will write to her. On the overall
sentiment behind that question, it is clear that people now
recognise—as we have an ageing population and people are living
longer—that we should not see social care as a sort of bolt-on or
a Cinderella service. It should be properly integrated, which is
why we published the paper on health and social care integration
and why we want to make sure that people and patients, all the
way through their lives, have access to good-quality care,
whether in the current health system or in the care system, at
whatever stage of their lives they need it.
