Registration of Domiciliary Care Agencies (Hansard, 24 March 1993)

§ Mr. David Hinchliffe (Wakefield)

I beg to move, That leave be given to bring in a Bill to make provisions for the registration of domiciliary care agencies; to make provisions consequential thereon; and for connected purposes. This Bill aims to clear up an anomaly in registration and inspection procedures relating to the provision of care services. The anomaly concerns the fact that, while a person in receipt of care in a residential or nursing home has the protection of the Registered Homes Act 1984, a person in receipt of the same form of care in his own home has no similar statutory protection. The Registered Homes Act requires the registration of all establishments providing care and a named person deemed to be suitably qualified who is responsible in law for the operation of the establishment. It enables homes to be inspected by local registration and inspection units. It makes provision for the cancellation of registration and for the protection and care of residents in residential or nursing homes.

My proposed Bill would apply the principles of the Registered Homes Act to domiciliary care, requiring all agencies in the private, voluntary and public sectors to be registered and inspected by the same local registration and inspection units. The same fit-person requirement would be applied, whoever was responsible for the operation of the agency.

When the National Health Service and Community Care Act 1990 was passing through the House, and consideration was being given to the development of domiciliary care, this inconsistency in the law was the subject of amendments supported by hon. Members on both sides. The amendments were resisted by the then Minister of State, now the Secretary of State for Health, on behalf of the Government, on the basis that the contracting and purchasing arrangements included in the legislation offered sufficient safeguards.

Many hon. Members will be aware that, after the House debated this issue, the need for legislation to protect vulnerable people who are cared for in their own homes became even more apparent when a 66-year-old woman in a wheelchair was viciously murdered in her home by her female carer. Subsequent police inquiries revealed that the woman convicted of the murder had supplied false written references to the agency that had arranged for her to care for the disabled woman. To the agency's great credit, it has been at the forefront of subsequent campaigning for the introduction of statutory registration and inspection requirements for domiciliary care.

It is quite apparent that the Government's reliance on contracting and purchasing arrangements does not in any way offer protection to vast numbers of elderly disabled and vulnerable people and will not avoid a repetition of such incidents. The Government's central assumption is of a local authority contracting with agencies for the provision of services. However, it is the case now, and will be the case after 1 April, that many people purchase these services privately without any form of local authority involvement. Such people therefore receive no protection whatsoever from the contracting arrangements, and the Government must be aware that the more stringent charging policies forced on local authorities are encouraging this process even further.

926 Many directors of social services have written to me supporting my proposed Bill, and several have pointed out that contractual arrangements are a very poor way of ensuring quality services at an individual level. One director said in his letter: Experience in the residential sector shows that placing authorities are often the very last to realise that abuses are going on involving their clients The extent of concern about the anomaly has led, in a number of areas, to the establishment of voluntary registration schemes. Many of those schemes are applying standards for registration for domiciliary care drawn up by the Joint Advisory Group of Domiciliary Care Associations. However, while such schemes are an important step forward, many of those organising them point to their weaknesses. Obviously, only the better agencies will volunteer to participate and those operating low standards are likely to be missed.

There is also no means of enforcement under such voluntary arrangements. As several directors of social services have said to me, voluntary schemes are a poor substitute for statutory regulations that would make the position of the service user, provider and local authority much clearer. In implementing the community care changes with effect from 1 April, the Government have included the requirement that 85 per cent. of the Department of Social Security funding that is passed to local authorities after next Thursday should be spent in what they call the independent sector. The Government anticipate that that will lead to more domiciliary provision by the voluntary and private agencies that are currently unregulated.

Many agencies have argued that the individual residing in his or her own home has the same right of protection under the law as those residing in a care or nursing home. In many ways, individuals are more at risk in the privacy of their own home. They are often housebound and frequently receive a declining number of visitors. Inevitably, the care staff helping them are supervised to a much lesser degree than they would be in a residential establishment.

On 30 November last year I asked the Department of Employment for its estimate of the number of independent sector domiciliary care agencies. The Parliamentary Under-Secretary of State for Employment replied that at that time there were 1,388 licensed employment agencies that had said that their field of activity might include domiciliary care. In addition to those agencies, an increasing number of private care and nursing homes also offer domiciliary services without specific registration and inspection. A sizeable number of agencies is already involved in such care and there is every reason to believe that the number will continue to increase.

My Bill is supported by the United Kingdom Home Care Association, which represents more than 300 voluntary and private agencies, the Joint Advisory Group of Domiciliary Care Associations, the British Association of Domiciliary Care Officers, the National Association of Inspection and Registration Officers, the British Association of Social Workers, and the Social Care Association. It is also supported by the Association of Directors of Social Services, Age Concern and many other interested organisations.

I understand that the social services inspectorate has drawn Ministers' attention to the need for such a measure. 927 I would not be at all offended if the Government took the Bill off my hands and implemented it themselves. I am happy to commend it to the House.

Division No. 200]	[3.43 pm
AYES
Abbott, Ms Diane	Dunwoody, Mrs Gwyneth
Adams, Mrs Irene	Eagle, Ms Angela
Ainger, Nick	Eastham, Ken
Allason, Rupert (Torbay)	Enright, Derek
Allen, Graham	Evans, John (St Helens N)
Anderson, Donald (Swansea E)	Ewing, Mrs Margaret
Anderson, Ms Janet (Ros'dale)	Fatchett, Derek
Armstrong, Hilary	Fisher, Mark
Ashton, Joe	Flynn, Paul
Banks, Tony (Newham NW)	Foster, Rt Hon Derek
Barnes, Harry	Foster, Don (Bath)
Barron, Kevin	Foulkes, George
Battle, John	Fraser, John
Beckett, Rt Hon Margaret	Fyfe, Maria
Benn, Rt Hon Tony	Garrett, John
Berry, Dr. Roger	Gerrard, Neil
Betts, Clive	Godman, Dr Norman A.
Boyce, Jimmy	Godsiff, Roger
Boyes, Roland	Golding, Mrs Llin
Bruce, Malcolm (Gordon)	Gordon, Mildred
Burden, Richard	Grant, Bernie (Tottenham)
Byers, Stephen	Griffiths, Nigel (Edinburgh S)
Callaghan, Jim	Griffiths, Win (Bridgend)
Campbell-Savours, D. N.	Grocott, Bruce
Canavan, Dennis	Gunnell, John
Cann, Jamie	Hain, Peter
Carlile, Alexander (Montgomry)	Hanson, David
Chisholm, Malcolm	Harris, David
Clapham, Michael	Heppell, John
Clark, Dr David (South Shields)	Hill, Keith (Streatham)
Clarke, Eric (Midlothian)	Hinchliffe, David
Clarke, Tom (Monklands W)	Home Robertson, John
Clelland, David	Hood, Jimmy
Clwyd, Mrs Ann	Hoon, Geoffrey
Cohen, Harry	Howarth, George (Knowsley N)
Cook, Frank (Stockton N)	Hughes, Robert (Aberdeen N)
Corbett, Robin	Hughes, Roy (Newport E)
Cousins, Jim	Illsley, Eric
Cryer, Bob	Jackson, Glenda (H'stead)
Cummings, John	Jackson, Helen (Shef'ld, H)
Cunliffe, Lawrence	Janner, Greville
Cunningham, Jim (Covy SE)	Johnston, Sir Russell
Dafis, Cynog	Jones, Barry (Alyn and D'side)
Darling, Alistair	Jones, Jon Owen (Cardiff C)
Davidson, Ian	Jones, Lynne (B'ham S O)
Davies, Rt Hon Denzil (Llanelli)	Jones, Martyn (Clwyd, SW)
Davies, Ron (Caerphilly)	Kaufman, Rt Hon Gerald
Davis, Terry (B'ham, H'dge H'l)	Kennedy, Jane (Lpool Brdgn)
Denham, John	Kilfoyle, Peter
Dixon, Don	Kinnock, Rt Hon Neil (Islwyn)
Dobson, Frank	Leighton, Ron
Donohoe, Brian H.	Loyden, Eddie
Dowd, Jim	Lynne, Ms Liz

McCartney, Ian	Raynsford, Nick
McCrea, Rev William	Reid, Dr John
Macdonald, Calum	Robertson, George (Hamilton)
McKelvey, William	Robinson, Peter (Belfast E)
McMaster, Gordon	Roche, Mrs. Barbara
McNamara, Kevin	Rooney, Terry
Mahon, Alice	Ross, Ernie (Dundee W)
Mandelson, Peter	Rowlands, Ted
Marek, Dr John	Salmond, Alex
Marshall, David (Shettleston)	Sheerman, Barry
Marshall, Jim (Leicester, S)	Sheldon, Rt Hon Robert
Martin, Michael J. (Springburn)	Short, Clare
Martlew, Eric	Simpson, Alan
Meacher, Michael	Skinner, Dennis
Meale, Alan	Smith, Andrew (Oxford E)
Michael, Alun	Smith, C. (Isl'ton S & F'sbury)
Michie, Bill (Sheffield Heeley)	Smith, Rt Hon John (M'kl'ds E)
Milburn, Alan	Snape, Peter
Miller, Andrew	Spearing, Nigel
Morgan, Rhodri	Spink, Dr Robert
Morley, Elliot	Steel, Rt Hon Sir David
Morris, Rt Hon A. (Wy'nshawe)	Steinberg, Gerry
Morris, Rt Hon J. (Aberavon)	Stott, Roger
Mudie, George	Strang, Dr. Gavin
Mullin, Chris	Straw, Jack
Murphy, Paul	Taylor, Mrs Ann (Dewsbury)
Oakes, Rt Hon Gordon	Trimble, David
O'Brien, Michael (N W'kshire)	Turner, Dennis
O'Brien, William (Normanton)	Vaz, Keith
O'Hara, Edward	Wardell, Gareth (Gower)
Olner, William	Wareing, Robert N
Orme, Rt Hon Stanley	Wicks, Malcolm
Pickthall, Colin	Wigley, Dafydd
Pike, Peter L.	Williams, Alan W (Carmarthen)
Pope, Greg	Winnick, David
Powell, Ray (Ogmore)	Wray, Jimmy
Prentice, Ms Bridget (Lew'm E)	Wright, Dr Tony
Prentice, Gordon (Pendle)
Prescott, John	Tellers for the Ayes:
Purchase, Ken	Mr. Keith Bradley and
Quin, Ms Joyce	Mr. Kevin Hughes.
NOES
Dover, Den	Tellers for the Noes:
	Mr. Andrew F. Bennett and
	Mr. Bill Etherington.