National Care Standards (Hansard, 18 March 2002)

§ Mr. Andrew Turner
To ask the Secretary of State for Health what flexibility he has introduced into the national care standards to meet the needs of care homes with small rooms and their residents and those which support drug and alcohol dependency. [41271]

§ Jacqui Smith
[holding answer 7 March 2002]: Existing homes, including local authority homes, will have until 2007 to comply with some of the more challenging environmental space standards. We decided that the requirement for existing single rooms to have a minimum of 10 square metres of usable floor space should be postponed until April 2007. In addition, the standards include flexibility to allow some rooms down to 9.3 square metres to remain in use after 2007, provided additional compensatory facilities are made available.
We have listened to concerns from the drug and alcohol sector and have amended the standards for care homes for younger adults to meet those concerns.
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The draft standards said that new homes should accommodate up to 16 people in groups of up to eight. The final standards raise the limits to 20 and 10, and allow homes that accommodate people for less than six months further flexibility.
The draft standards said that there should be one WC for each two people and one bathroom for three people, in both cases adjacent to bedrooms. The ratio has been changed to 1:3 for both WCs and bathrooms, and existing homes have been given two more years (until 2004) to reach the standard. The standards say that facilities should be "near" bedrooms.
The draft standards said that all service users should be offered a single room. Existing shared accommodation is to be phased out by 2004, unless people choose to share. New provision would be built with single rooms. The standards now recognise the concept of a clinical need for sharing in the substance misuse sector. In existing homes, up to four people may continue to share a room where there is a clinical need, and in new premises, rooms can be shared by two. The standards also recognise that two people may choose to share a room.
We have also issued statutory guidance to the National Care Standards Commission, which says the commission should consider whether care homes can fulfil the needs to service users without making environmental changes to meet the standards. The guidance particularly covers issues of room size, lifts, baths and shared rooms.

§ Mr. Andrew Turner
To ask the Secretary of State for Health how the national care standards take account of the desire of married couples to share rooms. [41212]

§ Jacqui Smith
[holding answer 7 March 2000]: Standard 23 of the standards for care homes for older people allows residents who wish to share a room to do so. Standard 23.10 states that in new build, extensions and all first time registrations, service users wishing to share accommodation should be offered two single rooms for use, for example, as bedroom and sitting room.
In the standards for care homes for younger adults, standard 25.8 recognises that two people may choose to share a room.

§ Mr. Andrew Turner
To ask the Secretary of State for Health what representations he has received on the accuracy of the estimate by the regulatory impact assessment of the cost of implementing national care standards. [40886]

§ Jacqui Smith
[holding answer 7 March 2002]: Ministers at the Department have received only one representation as to the accuracy of the regulatory impact assessment for the implementation of the regulations and national minimum standards for care homes.

§ Mr. Andrew Turner
To ask the Secretary of State for Health what the basis is for the assessed capital cost of changes in the physical environment for younger adults contained in annexe A of the national care standards full regulatory impact assessment. [40889]

§ Jacqui Smith
[holding answer 7 March 2002]: The basis for the assessment of the capital cost for changes in the physical environment for younger adults final regulatory impact assessment for care homes was the same as that used for the estimated costs during 167W consultation. A survey undertaken by the Department in 1999 indicated that only 13 per cent. of care homes in this sector would have difficulty in meeting the 10 sq.m. room requirements. It also showed that 7 per cent. of homes had more than 20 per cent. of places as shared places. As a result of the flexibilities introduced in relation to overall room sizes and additional flexibilities for homes dealing with drug and alcohol rehabilitation we estimated that between no more than 10 to 15 per cent. of homes in this sector would be significantly affected.

§ Mr. Andrew Turner
To ask the Secretary of State for Health how many residential and nursing care provisions he estimates meet the national care standards; how many have programmes to upgrade their homes to meet the standards; and what proportion each represents of all care homes. [41241]

§ Jacqui Smith
[holding answer 7 March 2002]: Following analysis from responses to the original consultation on the national minimum standards for care homes, "Fit for The Future?" the Department estimated that 50 per cent. of local authority and 20 to 25 per cent. of independent care homes for older people would have difficulty meeting the standards as proposed at that time. Subsequently the standards were amended and flexibilities introduced in relation to space standards.
For care homes for younger adults a departmental survey estimated that 13 per cent. of homes would have difficulty meeting the room size standards. The additional flexibilities introduced following consultation on the standards for both sectors has, in the view of the Department, significantly reduced the number of providers likely to have difficulty meeting the standards.
The National Care Standards Commission will not have a comprehensive picture of how many care homes meet the standards, how many producers have established programmes to upgrade their homes and what proportion this represents of all care homes, until it completes the first round of inspections of all homes after 1 April 2002.

§ Mr. Andrew Turner
To ask the Secretary of State for Health to what extent the cost to local authorities of purchasing places at care homes complying with the national care standards is met by the local government financial settlement for 2002–03. [41209]

§ Jacqui Smith
[holding answer 7 March 2002]: The local government finance settlement for 2002–03 takes full account of the cost to local authorities of purchasing places at care homes complying with the National Care Standards Commission's requirements.

§ Mr. Andrew Turner
To ask the Secretary of State for Health which representative organisations constituted the reference group referred to in paragraph 12.1 of the national care standards full regulatory impact assessment. [41210]

§ Jacqui Smith
[holding answer 7 March 2002]: The following organisations were members of the reference group for the development of national minimum standards for care homes for younger adults.

Alcohol Concern

Association for Residential Care

British Council of Disabled People
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CHANGE

Drugscope

Independent Healthcare Association

Leonard Cheshire

Local Government Association

Mental After Care Association

National Association of Adult Placement Services

National Association of Inspection and Registration Officers

National Autistic Society

National Centre for Independent Living

National Institute for Social Work

National Heads of Registration and Inspection

NHS Confederation

Norwood Ravenswood

NSF Registered Homes

Oxfordshire county council

People First

Portland College

Richmond Fellowship

Royal Association for Disability and Rehabilitation

Royal College of Nursing

Royal College of Psychiatry

Royal National Institute for Deaf People

SENSE

Turning Point

Voluntary Organisations Disability Group.

§ Mr. Andrew Turner
To ask the Secretary of State for Health on what basis he concluded that the estimated cost of changes to the environment for a home providing places for 28 residents to comply with the national care standards would be significantly lower than that estimated by the full regulatory impact assessment. [41208]

§ Jacqui Smith
[holding answer 7 March 2002]: The information provided by the provider at paragraph 9 of annexe A of the full regulatory impact assessment was a general statement from that provider. That estimate was not disaggregated into its constituent parts and it was impossible to reach a conclusion as to its accuracy. On that basis the Department concluded that the estimate of overall compliance cost based on survey evidence was a more reasonable estimate.

§ Mr. Andrew Turner
To ask the Secretary of State for Health for what reason his regulatory impact assessment for national care standards does not cite as a benefit of option 1 the saving of money which under option 2 would have to be spent on alterations of homes to meet new standards. [41272]

§ Jacqui Smith
[holding answer 7 March 2002]: The regulatory impact assessment for regulations and national minimum standards for care homes does not cite option 1 as a money saving option for good reason. In the first instance keeping the status quo does not mean that there are no additional costs incurred. If the system of regulation is left as of now with local authorities and health authorities regulating providers locally this would lead to increased subsidies for the cost of regulation included in the funding to these authorities. Those who responded to the White Paper "Modernising Social Services" were unanimous that regulatory costs should be 169W borne by both providers and commissioners of services and that the new National Care Standards Commission should be funded through full cost recovery.
Finally, option 1 would do nothing to improve the standards of care and accommodation afforded to service users.

§ Mr. Andrew Turner
To ask the Secretary of State for Health what plans he has to monitor the responses to the national care standards and to amend the regulations. [41211]

§ Jacqui Smith
[holding answer 7 March 2002]: The national minimum standards will be continuously monitored. We propose to review them within the first three years of operation, and in the light of the review consider any changes needed.