Live Urgent Question - Adult Social Care House of Commons

is very unfair on back answers. And not taking points of order now, they

will come after the questions and statements, we will save the

honourable lady for later in the day. Urgent question, Barbara

Keeley. Does the minister share my deep concern about the state of

adult social care... For giving me. She needs to ask the minister for

the statement on the matter and then she follows with substantive when

the minister has given his substantive. Could the minister

respond on the CQC report on the state of adult social care and

issues on funding social care? Take two. There are few things more

important to any of us then the ways in which the oldest and most

vulnerable are cared for. Let me paid tribute to the 1.4 million

people in the social care sector who support vulnerable people in

difficult circumstances. I am proud we have done more than any

government to improve social care, introducing a tough system of

rating, new qualifications and standards to make sure everyone

receives high quality support. I am heartened that today's report shows

even in times of fiscal pressure, 79% of adult social care services

are good or outstanding that it is impossible to ignore the pressure of

our ageing population and advances in medicine. We have seen the

numbers of over 65 is increased by 1.2 million and today's report shows

in some areas it is unacceptable that standards are below those

expected by care users. This Government view social care as a

priority, which is why the spring budget announced an additional ?2

billion to councils to spend on adult social care. This means

councils will have access to ?9.25 billion, funding enough to increase

social care spending in real terms. Later this year we will consult

widely on the future of social care to put it on a stable footing. The

minister updated the House on Monday, last year there were 2.25

million delayed discharges, up from the previous year. No one should

stay in a hospital bed longer than necessary, it removes people's

dignity, leads to poor health and outcomes and is more expensive.

Since Burberry there have been improvements in the health system

with a record decrease in delayed discharges, but we must make faster

and more significant progress in advance of next winter to free up

beds for sickest patients and reduce pressures, which is why we have

introduced measures to support the NHS, this guidance includes

guidance, a performance dashboard, dance for the Government and NHS to

deliver to free up hospital beds and CQC reports. We will consider a

review in November of 2018 allocations of funding provided at

the spring budget for areas that are poorly performing. The budget

funding will remain with local government to be used for adult

social care. I thank the Minister for that

response, but I really must ask him if he shares my deep concern about

the state of adult social care highlighted by the report of the

Care Quality Commission today. Some 3200 care services were rated as

requires improvement, the other 340 rated as inadequate. What means some

92,000 vulnerable people are receiving poor care, and some 10,000

people are receiving inadequate care. The picture is even worse in

nursing homes, with one in three receiving the poorest ratings. Does

he share my concern about safety, with one in four care locations

failing on protecting people from abuse or avoidable harm? That means

thousands of vulnerable people not getting the scribe medicines, being

ignored when they ask for help or having enough time for their home

care visits. On this side we have repeatedly raised the damaging

impact of Ajit cuts with over ?5 billion cut from social care since

2010. Does he now see that this has caused the crisis in care staffing

which is at the heart of the poor care being reported? Or staffing

levels and start trading are key factors in those providers with the

poorest ratings. In his written ministerial statement earlier this

week, the Secretary of State suggested that the ?2 billion

allocated to local councils to which the Minister has just referred will

now be dependent on performance against delayed transfer of care,

and some councils could lose funding that they have already planned to

spend. As the Minister accept that threatening local councils with the

loss of planned funding could actually lead to the worsening of

the quality and safety issues highlighted today? With social care

in crisis, this is not the time to be threatening joint working with

local councils, so willingly reversed that threat, and will he

match the Labour pledge of an extra ?8 billion for social care,

including an extra ?1 billion this year? I thank her for that response.

I fear this is a subject that was obviously much discussed during the

general election, and will be greatly discussed during this

Parliament. Nobody is making any threats. The Government is very

supportive of the best performing systems where local government at

the NHS are working together to tackle the challenge of delayed

transfers of care. In November, depending on performance, we have

said we will consider a review of the allocations of social care

funding provided this year for areas that are poorly performing. This

funding will all remain with local government, as I said, to be used

for social care. Obviously we recognise that there are real

pressures in the system. That is why we responded as we did, and I think

her party were pleased with that at the time for the additional ?2

billion for social care in the budget this year. And of course we

have also given councillors the chance to raise the council tax

precept, and my authority has done that, and I think that has been well

received. Just turning to the actual report, I think it would be easy to

just dock all of this, which, dare I say, I hope we can conduct this in a

spirit of sensible debate, because people out there working in this

system, people who want to pass the mum test as it was said this

morning, want us to do that and are watching this closely. Of course it

would be easy to bury our heads in the sand, but should we just

remember that without this vigorous inspection ray -- regime, a lot of

the problems that happened when her party was in Government wouldn't

have been heard about, so we only know about this because of the

inspection regime that has been put in place. The CTC found a number of

things in its report -- the CQC found a number of things in its

report, and we will die just that in the years ahead. It found that adult

social care sector performed best in her caring services were. 92% were

rated good and 3% rated outstanding, so we can kick this around all that

we like, but that is why this report today shows exactly why we

introduced the inspection regime that we did, and it is that that is

uncovering the care that is good, and that is also uncovering the care

that is not, which is where we want to help and support local

authorities to make sure it improves the people that we represent. Mr

Speaker, it is concerning to note from the CQC's state of adult care

report that staff turnover rates have risen from 22.7% to 27.3% in

the three years to 15/ 16. Will the Minister meet with me to discuss the

important role that supporting skills and opportunities for career

progression can play in reducing turnover, improving morale and most

importantly improving the quality of care that people receive? And will

he visit my constituency to see the excellent joint working that is

being done by the trust and South Devon college to do just this? I

think my honourable friend knows that I will be in the vicinity of

her constituency at some point over the next few months, and I would

like to take her up on her offer. I wish her well and had current

campaign. Workforce is obviously critical to this. Adult social care

is a rapidly growing sector. 165,000 more social care jobs than there

were in 2010. It is imperative that we get the right people into the

right jobs resulting in an improved quality of care and the services we

all want to see. We are working closely with our delivery partners

to improve the level of skills for adult social care workforce, and we

are making the profession more attractive with the introduction of

the National living wage, up to 1.5 million people in the social care

sector are expected to benefit, a policy which I might point out has

only come in as a result of this Prime Minister and this Government.

If I could just point out that the same report gives 92% good and 3%

outstanding on caring, and that comes down to the commitment of

staff, who sadly have not been given a breaking of the 1% cap. What has

been raised is the safety issue, with one in for failing to provide

safe care, and that comes down to workforce and funding. Brexit

threatens workforce because as the honourable member says, there is a

one in four turnover. Funding has reduced to 9%, and that is something

that has to be tackled. So does the Minister recognise that one in five

emergency admissions could avoided if alternatives were provided, and

while the measures are different in Scotland, delayed discharges are

falling while they are rising steeply in England?

So will he get rid of fragmentation, and in the SDP reorganisation, look

at real integration of health and so? I thank the honourable lady for

that, and yes, I said at the very start of my response that the 1.4

million people who work in this country's social care sector are the

people that we should be saluted today, and the families who support

them, as well, because they are in and out of this setting all the

time. I'm grateful that she responded, I did also say that the

caring side of this sector does not surprise me that that came out as

one of the good bits in this. On the point that she makes about keeping

people out of the setting, absolutely, and that is what the SDP

process is about. We are one NHS, and it is one public sector, so this

is about the NHS, and getting it delayed transfers of care right, but

it is also about the whole STP process which works across the NHS,

in my area Hampshire it works closely with Hampshire County

Council, and it is about one system response, and she is right to point

it out, as usual. Mr Speaker, it is vital that we improve those adult

services that are failing and falling behind, but letters not lose

sight of the fact that most adult social services were of high

quality, and many were improving, and four out of five of adult

services were good or outstanding. We all know that there is a looming

crisis in social care, and that is why the Chancellor announced a ?2

billion further investment in that area. Could the Minister say, is

that starting to show some results? The CQC have completed their

ratings, and the prop portion of providers announced as good or

outstanding has increased, it was 72% previously. It also worth noting

that the CQC say that there are improvements. There is a challenging

element to this report to say, which we don't hide from and we don't

shirk, which is why we set up the inspection regime, but it wouldn't

be right or fair to people in the sector or to people relying on the

sector to say that everything is going to hell in a handcart, because

I don't believe it is. I hope the Minister would agree that these

widespread failures of care are intolerable in a civilised society.

And does he share my view that we will have to confront the need to

increase taxes to ensure that we have an efficient and effective and

compassionate system, and would he embrace a cross-party approach to

come up with a long-term settlement? I thank the right honourable

gentleman for that, and as a respected former care Minister, of

course I want to work with any members in this House who have any

sensible suggestions. In terms of taxation, that is a matter for the

Chancellor, but the challenged areas of care, that is why we have picked

up as the Secretary of State said earlier this controlled areas ready

for review, and we have developed those from the dashboard criteria.

We will be giving them every possible support, as we do with the

inspection regime, and we will be doing the same for hospitals. I'm

very happy to meet with the right honourable gentleman, and if he

hadn't asked, I would have offered. If the plan of the Government is to

reduce the pressure is on adult social care, can my honourable

friend explain why the clinical commissioning group is proposing to

close down the centre Leonards Community Hospital which provides

really good services at the moment, and is approved by the community? I

can't go into the detail of that, and I suspect my right honourable

friend knows that, but there will be an STP process in his area, and that

will have to come up with proposals that meet the reconfiguration

criteria. There were four areas to be met, there are now five, the

fifth is around patient safety, and any reconfiguration or change of

service in release into that have to be considered in that round.

THE SPEAKER: The Minister has just elevated the honourable member for

Christchurch to the Privy Council, of which is not a member. Whether

that was inadvertent on the part of the member or a gentle hint to the

power that be remains to be seen. Would only be a modest elevation for

summary of his experience. Thelma Walker. Will the Minister agree with

me that it is time we looked at bringing the social care sector back

into public ownership to remove the profit-making aspect of looking

after the most vulnerable in our society? Yes, Mr Speaker, I have no

advance knowledge of the future career prospects of the honourable

member for Christchurch, but I'm sure it is a matter of time before

he is a Dorset knight! I don't think what the sector needs right now is

rationalisation, and if I may just say once again, the answer to every

challenge in our public services is not public ownership. Visiting a

stick constituent at home last week, I discovered that he had had dozens

of carers, many of whom delivered excellent care, but he was concerned

about the sheer numbers of different carers that he had had. What could

my honourable friend say about proposals or plans that we have to

ensure that people receive consistent care from as few carers

as possible? Because that benefits both carers and patients. When you

look at the primary care and the named GP policy which was a step

forward, that is something that we should aim for in this sector, and

maybe that is something that will come out in the consultation later

this year, and I feel certain that my honourable friend will be

responding to that. THE SPEAKER: what an array of

riches! Thank you, Mr Speaker. This Government has pushed a national

crisis onto a hard-pressed local council and hard up local residents,

forcing council tax rises that barely cover the minimum wage

salaries that are paid to carers. He says that the precept is welcome. I

asked, by who? The precept is welcomed by local authorities who

wants to get extra money into their social care system. I understand the

honourable lady wants to play politics with this, but as I said in

my response, I do honestly think that we can do better than that. I

have found the CQC inspections of struggling care homes to be a useful

way to make sure that improve the care people get, but is he now

confident that the CQC is sufficiently resourced and skill to

carry out inspections on a timely basis?

Yes, I think the CQC does a fantastic job and its students back,

who members will have heard this morning on the media, was right when

she talked about social care services leading to meet the mum or

dad test because I have ageing parents like members of this House

and the mum and dad test is what we want because we want, when they go

into adult social care, we want them to feel they are as well looked

after as we could do so ourselves. Loneliness can be extreme in

housebound adults and mental health issues like depression can be high

but unrecorded, so will the Government ensure a holistic

approach to social care including key indicators of mental health and

well-being? She makes a good point and these are the sort of issues we

discuss in the consultation this year which she is welcome to take

part in. What is the status of what was the announced government policy

that the deal not cap will be implemented in the financial year

2122? So... The Prime Minister has been clear about the importance of

tackling this issue, she said we look after 2 million more over 75 is

in the next ten years and have to find a sustainable way to care for

older people. We will consult on proposals like a limit on the amount

of people can be asked to pay, with the objective to get the widest

possible consensus. Whether he regards that is satisfactory or not

is for him to decide but it is the uncertainty is getting. Did the

Minister see the recent destruction -- dispatches programme featuring a

care home which had shocking levels of care? If large well-known

providers like BUPA are caught putting profit before patient carer,

what can the Minister do to make sure smaller providers are not doing

the same I did not see that programme but I shall look out for

it. We can put in place that toughest assessment and inspection

regime that we have and that has come from the Secretary of State, it

didn't come from the previous government so we can make sure there

is rigorous inspection to root out poorly performance services and that

is the same in his scan the truancy and in mine. With an increase and

ageing population, does the Minister agree it's cynical to pretend there

is a financial solution which doesn't involve difficult decisions

in and across generations? I do and there were many disappointing things

for me about the recent general election but one of the more

disappointing things, being serious, was stabbed the debate around the

future of adult social care was reduced to using the words dementia

tax, which I think that this sector, architecture once, public life and

this parliament and enormous disservice. I think we do need to

have a grown-up debate around this solution and that is quite we will

bring our proposals for consultation. This week marked the

sixth anniversary of the deal not commission report into social care

yet this Government is no closer to finding a solution. Can the Minister

say why his government have waited six years and failed to take any

action to solve the crisis? Honestly, I'm being tempted into

politics. The Labour Party had 13 years in government to sort out the

social care assistant, it never did. It was in the manifesto in 1997, a

Royal commission in 1999, a Green paper in 2005, they said it would be

sold in 2007 and then there was another green paper. I think

lecturers from that side of the House about wasting time on this

subject are for the birds. The Minister made an excellent point

about the years of field opportunities on the other side, and

during those years 40,000 people per year were forced to sell their homes

in their lifetimes to fund their care. He is one of the most

disappointing things about the discussion around this subject in

the last few months is that the current situation is hardly perfect,

if it was we wouldn't be debating it and if it was easy to solve we would

have solved it years ago and the last Labour government would have

sold it. There is extensive interest and I would like to accommodate it

all that we have another urgent question to follow and then business

questions, so can I ask colleagues to be good enough to pose single

sentence pithy questions and I appealed to the Minister to provide

comparably pithy replies? In my constituency we had an appalling

case of abuse in a small private care home which resulted into prison

sentences. What will the Minister do to raise standards in small private

care homes? I cannot comment on that case but if she writes to me about

it I am happy to look into it. I welcome the CQC inspection of care

homes because it is helping drive up standards and highlight problems but

many older residents say they want to stay in their own homes for

longer. What is the Minister doing to help make that happen? That is

why I said this is out one system solution and we need the NHS to work

under league transfers of care that we need local authorities to work

with us, which is what better carer fund is about. It is better for

people to be cared for in their home but that is not always possible, so

we need a long-term solution which is doesn't just deal with

residential but domiciliary care, which is why we try to introduce

that debate. Liverpool City Council spends more on adult social care

than it can raise in council tax, yet still has more of a cut to make

and pays a low level of fees as a consequence. Can he give assurances

to the House that councils like Liverpool will not be further

disadvantage 20 rolls out the extra funding to improve the situation?

Councils have access to at total of ?9.25 billion funding for social

care as a result of the measures introduced by this Government,

enough to increase spending by real terms, and the UK spends more on

long-term care as a share of GDP than other countries including

Germany, Canada and the United States. I would say gently to the

Minister the only reason the Labour Party was able to mention dementia

tax was because the Conservative Party have put something stupid in

their manifesto and really, this is far too important a matter for party

politics. With the Minister agree we need the social care system is

broken and we need a cross-party agreement of how to move forward? I

do think we need a cross-party, cross-country solution to the

long-term funding of adult social care, which is why we started a

debate during the election campaign and why we need a proper

consultation which will come online this year. He is right, this is far

too important for the of party politics. Thank you, Mr Speaker. Of

the care homes requiring improvement, on the inspection 13%

still required improvement and 5% had deteriorated, so what action is

the Minister taking beyond inspections to improve standards

that is a fair question, that is why I said through the dashboard we have

picked 12 most challenged local areas for review. The reviews will

cover providers and commission of services looking at the interface

between general and primary care and include an assessment of the

Government is in place for the management of resources. That is

quite those reviews are being put in place because we're not just

pointing the finger and saying you were bad, we want to support areas

to deliver the care we are getting in the majority of areas.

Improvements in medicine have enabled people to live longer but we

also want to live more healthily. We know reducing loneliness, improving

activity and investing will help to reduce the need for social care. I

thank her for that, although I am not the carer minister I am the

public Health Minister and that is why we have brought those subjects

together because we want to see a healthy population across-the-board

and I'm pleased she mentioned the loneliness commission, although it

started before she entered this House, it was started by Jo Cox and

did some good work that is being taken forward in this Parliament.

Bearing in mind that carers in Northern Ireland save the NHS some

4.6 billion rising to 32 billion across the UK, Terrace super ride

for the elderly and disabled, can the Minister outlined how he intends

to fund more respite places to enable families to have a break

which lets them keep on caring long-term? I will look into that, I

am sure members across this post take part in carers week each year

and it is there that you meet the staff who work in the system but the

people who day in day out do not have the life they would like to

have because they have caring responsibilities and often young

carers in our kids seas do that in credible work and we should all make

it clear thank you to those people for their work. The extra money in

the last budget for social care is helping Kent County Council provide

more people with access to care especially at home, but the cost of

social care will keep going up. Does the agreed we need an honest

conversation about how we fund that growing cost fairly across

generations? Yes, and this is no different to the conversation were

having around every other funding of social services and it is easy to

take to the streets and asked to spend more, I think the leader spent

the national debt ten times over in his response to the Queen's Speech

and that is why we need a proper debate around long-term funding

because it can come out of general taxation but we need a debate as to

how much we can afford to do well funding other public services and I

don't notice us being short of requests to increase money into

other services. Can I have that honest debate, then I think the

Minister has to accept the decisions of his government have fuelled the

social care crisis in this country. My council as the third most

deprived in the country, has had the 17th highest cuts to its budget

including ?14 million taken out of social care and the social care

precept was not raised the amount of money it would in wealthier areas,

so can he accept some responsibility for the mess we are in? Governments

of all colours have delivered us to this place but has this Government

put more money into the system? Yes, did we put more in the budget this

year? Yes. We spend more on long-term care than other countries

including Germany, Canada and the mass of the economy of the United

States. As the Minister knows there are around 2.8 million adults over

the age of 65 in receipt of informal or formal social carer, so can he

confirm that despite the pressures, the CQC report shows the proportion

of carer services rated good or outstanding is increasing indeed I

can. We introduced the new system of CQC inspections for the reasons I

said, we introduced the certificate for a healthier assistance from new

standard to clarify what Axel Pons Spike, we brought in new terminal

offences of neglect, these are all happen under this Secretary of State

that never happened before. The care sector is a significant

employer in my constituency and able are being lost to other sectors. I

listened carefully to his remarks but I would arch that he is more

ambitious in supporting the sector to recruit more people and build on

career pathways between health and social care to encourage people who

want to do these jobs to try to do them. I thank her for that. That is

a sensible question. As I said earlier to one of my honourable

friends, this is a rapidly growing sector. They were all not sensible.

It is imperative we get the right people. Yours was marginally more

sensible. It is imperative we get the right people into the right

jobs. It is important working with organisations to improve the level

of skills and it is important, as I mentioned the National living wage,

which people in this sector are expected to benefit from. We have

the highest proportion of over 85-year-olds in the country and they

tend to be not well off and their major asset is their property. Can

the Minister make sure that in welcoming a grown-up debate that any

sustainable solution recognises that people who work hard, paid their

dues, looked after their families should be appreciated and not

penalised having done so. Yes, I thank him for that. I said we would

consult on detailed proposals later that year and that would include a

capital floor and an absolute limit on the amount people can be asked to

pay. They are the critical to pillars that must go together. More

care homes are faced with closure if they cannot get access to migrant

workforce is. What steps is the Government going to take to ensure

that migrant workers who are happy to work in our care homes and

provide excellent standards of care are still going to be able to come

to the UK after Brexit. The Secretary of State has been clear,

including at oral questions earlier this week, that we see the migrant

workforce is as critical to the NHS. By which we mean, in patient care as

well as the social care system and we went to see those protected. This

is a constituency issue raised to me across is late and delayed discharge

has also been prioritised. The Lib Dems on the council chose back in

February not to support ?27 million more to go to the county's social

care budget. With the Minister highlight that some parties...

Action but simply failed to make the difference when they can do locally.

My neighbour and honourable friend is a champion of our constituency

and I represent part of the borough as she knows. It surprises me what

she says but I am sure she will be pointing that out as part of the

national debate in the months leading up to next May, when I think

there are borough council elections. In March the select committee agreed

a report on adult social care. We called for significant extra funds

in the short and medium-term. In the long term we said a lasting solution

would only be found the cross-party working. The Minister agrees that in

principle. With the confirm that the consultation is going to embark on,

you'll engage with the opposition front bench and other parties. -- he

will engage. You will inform them of the consultation and approach with

an open mind and involve the select committee in the consultation as

well. I will confirm that there will be the widest possible engagement

across this house, across the sector and the select committee, which she

may or may not be in charge of the next few weeks. I have visited many

nursing and care homes and my constituency and met committed and

caring care staff. Does the Minister agree with me that the inspection

system introduced by this Government, which is finally shining

a light on poor care and driving up standards? Yes, I do. As I said at

the very start, as we are coming to the end, I think the fact we have

this inspection regime is a good thing. Of course for families and

people in the system themselves, that is important. I think actually

fully staff in the system as well. They want to know we are giving the

best possible care and they are benchmarked giving the best possible

care. It is as important for the staff as for the punters, for want

of a better word. Finally spotted me, Mr Speaker. Worryingly, age UK

recently described care homes... Does the Minister believe it is

acceptable to force people to take these risks? I did not catch a

question but I do not think the honourable member is easily

overlooked in any forum. Maybe she would like to write and speak to me

afterwards and we will pick up that point. There is somebody after the

honourable lady. So she need not develop a complex about the matter.

Somebody has to be asked and on this occasion, nevertheless with the very

cheerleaders position, it is... Some local authority areas are

undoubtably better than others when it comes to joining up social care

departments with the NHS. Does my honourable friend agree with me that

we need to see a greater focus on sharing best practice where it

exists? Yes, I do agree with my cheery honourable friend. There is

so much... This is the great praise to finish. There is so much great

practice going on in the sector and the report highlights that today. We

should celebrate that, as we do, as we learn from it, as the well. While

picking out those areas that need support in order to improve the care

they are giving. Thank you. Order, urgent question. Margaret Greenwood.

Secretary of State for Work and Pensions for his plans to close job

offices and the