§ Mr. HinchliffeTo ask the Secretary of State for Health (1) if she will bring forward proposals to ensure that residents of care or nursing homes have security of tenure in law;
(2) if she will bring forward proposals to require the completion of a written contract for accommodation and services prior to admissions to care and nursing homes.
§ Mr. YeoI have no plans to do so. "Home Life" the established code of practice for residential care recommends that, before admission, residents should be given a full statement of the terms and conditions on which accommodation and care are offered, including details of the procedure for terminating the contract between the home and the resident. A copy of the code is available in the Library.
§ Mr. HinchliffeTo ask the Secretary of State for Health what evidence she has regarding the adequacy of the monitoring by inspection units of residential care and nursing homes during the 12 months ended 31 March.
§ Mr. YeoLocal authority inspection units are responsible only for the inspection of residential care homes. Health authorities inspect nursing homes.
In November 1991, the Department's social services inspectorate carried out a survey by postal questionnaire of the stage of development reached by inspection units to the end of September. The results were encouraging, showing widespread compliance with both the letter and the spirit of our directions and policy guidance. In 1992–93 the inspectorate will carry out a programme of more detailed and evaluative monitoring.
§ Mr. HinchliffeTo ask the Secretary of State for Health what proposals she has to change the current inspection arrangements for care or nursing homes.
302W
§ Mr. HinchliffeTo ask the Secretary of State for Health if she will introduce a requirement for the regular statutory review of the individual circumstances of all residents in residential care or nursing homes, where the resident concerned or their representative so desires.
§ Mr. YeoWe see no need to do so. "Home Life", the established code of practice for residential care, acknowledges the need for regular reviews and gives clear practice guidance on the subject. A copy of the code is available in the Library.
§ Mr. HinchliffeTo ask the Secretary of State for Health what assessment she has made of the impact of the April 1993 change in community care on the current number of residential or nursing places in private homes.
§ Mr. YeoThe Government are committed to a mixed economy of residential and nursing home care and it expects that the independent sector (private and voluntary) will continue to play a significant role in the provision of such care. New community care arrangements to be introduced in April 1993 will link the provision of care more closely to assessment of needs. Significant numbers of people will continue to need residential or nursing home care, particularly as the numbers of very elderly people continue to increase. However, it is generally expected that in some cases alternative, more appropriate forms of care will be able to be provided. The Government therefore share the widely held view that there is likely to be a decline in the rate of growth in residential care as a whole.
§ Mr. HinchliffeTo ask the Secretary of State for Health what advice she has given regarding the inspection by local authorities of the audited accounts of private residential care or nursing homes(a) as part of the annual inspection process and (b) prior to the placement of a contract under the National Health Service and Community Care Act 1990.
§ Mr. YeoThe Department does not give local or health authorities detailed guidance about how they should carry out their statutory inspections of private residential care and nursing homes. "Home Life"—a code of practice for residential care endorsed by my right hon. Friend the Secretary of State—recommends that financial implications should be among the matters discussed with those proposing to open a home.
The policy guidance "Community Care in the Next Decade and Beyond" advises local authorities to check the credentials of potential contractors, including their financial standing. It is for authorities to decide how best to do this.
Copies of the code and the guidance are available in the Library.
§ Mr. HinchliffeTo ask the Secretary of State for Health what steps she is taking to monitor the adequacy of the medical care available to residents of care homes.
§ Mr. YeoThose who run registered residential care homes are required by law to arrange for residents to receive necessary medical treatment and to keep records of such treatment. We would expect these arrangements to be monitored in the course of the regular inspections that local inspection units undertake.
303WThe Department is preparing revised and updated guidance about the health care of elderly people in residential care, for use in both local authority and independent sector homes.
§ Mr. HinchliffeTo ask the Secretary of State for Health if she will bring forward proposals to allow persons in residential or nursing care homes the same access to domiciliary, health and social services as persons living in their own homes.
§ Mr. YeoPeople in residential homes of all types have the same rights to receive social services and health services under the National Health Service as people living in their own homes.
Patients in independent nursing homes already have access to primary care services and acute hospital services.
The Registered Homes Act 1984 requires the person registered to provide adequate staff, equipment, facilities and services bearing in mind the age, sex and condition of the patients being cared for. Our guidance to health authorities is that support services such as physiotherapy and incontinence materials fall within the care that nursing homes could reasonably be expected to provide for their patients. Health authorities may provide support services to nursing home patients at their discretion.
§ Mr. HinchliffeTo ask the Secretary of State for Health what research has been undertaken as to the extent to which elderly persons positively choose to enter institutional care.
§ Mr. YeoThe Department has funded a recently-published study by the Policy Studies Institute, which examined issues of choice, participation and satisfaction among elderly people "at the margin" of community and residential care. The study explored, among other issues, the extent to which elderly people positively choose to enter institutional care.
§ Mr. HinchliffeTo ask the Secretary of State for Health what information she has on the relative levels of mental and physical functioning of residents in local authority part III accommodation compared with residents in private residential care.
§ Mr. YeoThe Department has in recent years funded a number of research studies on residential care, at the universities of Kent and York. One focus of these studies has been on the level of physical and mental functioning of residents in local authority part III accommodation and private residential care. The results were published in June 1991 by the personal social services research unit, university of Kent, in discussion paper No. 725, a copy of which will be placed in the Library.