Norman Lamb gave this speech at the Laing and Buisson Social Care Forum on 16 April 2013. It may have been delivered slightly differently at the event.
Hello and thank you for inviting me to speak with you today.
I imagine that you will all know everything there is to know about the care and support reforms that have and will come in over this parliament.
But at the centre of all of that is location. When someone needs help or support, they need more than just a willing and able carer. They also need to be in a place that suits them, their needs and what they want.
More often than not, people want to stay in their own communities if it is at all possible. They are comfortable there. We should always try to enable people to stay in their communities wherever it is possible, if that is what they want.
Specialised housing fund
The care and support housing fund will help that happen. It will provide a shot in the arm to the specialised housing sector across the country. Increasing the range of housing options and making housing more innovative and suitable for older and disabled people. That will mean more people can stay in the communities where they feel most comfortable.
There they will be supported by the rest of our reform package:
Personal budgets; a more diverse, high quality and sustainable local market that meets the needs of local people; local authorities and providers putting in place the services that people want and need; and more choice and information than ever before.
Quality/failure
I have absolute faith in your ability to put these reforms into practice. The vast majority of care and support services are already excellent, and despite the clear financial pressures, there are opportunities to improve them further still. In fact you will soon get an opportunity to show the world exactly how good you are via the new NHS Choices website.
People will be able to go online and compare the different services that are on offer nearby, helping them to make more informed, confident and personal choices about what care to use for themselves or family members.
Over time, as more information is added, it will become a great tool for people and local authority commissioners.
Thousands of care providers have already requested access to add information to their profiles. That is an excellent start. I want to see even more providers doing that soon.
In the future, providers will be able to reply to comments individually, making it an even more highly developed and comprehensive system.
This is a unique chance to demystify the sector and include people in their care more than ever before.
I want to celebrate the brilliant care providers, many represented in this room, and applaud them and their staff for what they do. But, equally I will condemn failure, neglect, abuse. We must not tolerate poor standards.
We all know that that is more important now than it has ever been.
All I have to do is refer to two institutions: Winterbourne View and Mid-Staffordshire Hospital Trust. They have become a byword for our failings. And although they were both isolated incidents, our profession has been stained by the crimes and the failings that went on.
I know that both of those scandals were to do with providers of healthcare, not care and support. But I also know that we sometimes don't have to look too hard to find examples of unacceptable practice in our own sector too.
We need to stamp that out. Wherever it happens in the health and care system.
That is why we have announced a new role. A powerful new Chief Inspector of Social Care who will inspect, assess and rate care homes and other local care services including care at home. The Chief Inspector will play an important role in managing failure too, assuring the public that we reach high standards.
Very soon, we will set out our plans to make sure anyone running services is a fit and proper person to do so.
We will also respond to our consultation on market oversight in adult care and support, to make sure that care carries on even if a provider goes bust.
Homecare
Winterbourne View and Mid Staffordshire are the two big scandals recently. They have got a lot of the press. But it isn't only about these high profile failures.
I am equally concerned about the hidden failures of care and support that happen in people's own homes.
Homecare is by definition highly personal and delivered in isolated settings – making poor care difficult to spot. There have been several reports about rushed 15 minute visits for personal care and a lack of basic human kindness and support. We hear from service users all over the country who are frustrated by care service delivery. That can be a direct result of commissioning that doesn't focus on outcomes.
I have also spoken to homecare workers who have told me that they are themselves concerned about falling standards.
The coalition government has also found several cases in which the minimum wage has not been paid to homecare staff, as well as in residential care.
Yesterday, the government laid the Low Pay Commission report before Parliament – that too highlighted persistent problems with non-compliance in national minimum wage in social care.
I have written to the Minister responsible to ask for those providers to be named and shamed for their non-compliance. There is no excuse for breaking the law. And this practice can only devastate morale – and therefore the standards of care.
We will turn this around. But it is not easy or straightforward. It will take new ideas, new models and new partnerships to root out all incidents of illegally low pay.
And we need your help in identifying these care providers who give all the rest of you a bad name, destroying public confidence in the sector.
It may lead to the kind of situation highlighted recently by the Care Quality Commission of appallingly high staff turnover. Service users who need the most intimate and personal care reported regularly seeing new care workers, suffering the acute discomfort and embarrassment that this would inevitably cause. This must stop.
Homecare Innovation Challenge
If we make sure providers treat their staff well, the standards of care will go up. That is basic common sense. And it is in all our interests, indeed it is our duty, to find ways to make care and support services better. I want all providers – big and small, private and voluntary – to help with developing these new ideas.
Also, commissioners can work with local people to explore new service ideas and service models. They can promote personalisation and diversity. They can give clear guidance about services that are needed nearby. They can commission to actually support people, rather than just checking them off their list of 15 minute slots. Commissioners too can contribute new ideas.
And I want to hear the new ideas from people who are at the cutting edge of public service reform. People working at the front line or using services.
I will shortly invite a cross-section of people to talk to me about how we can transform home care services in the future.
We will try to stimulate more ideas and discussions and think creatively about what we need to do, and how we can do it. We will think about how we can make the most of the new reforms and raise standards across the board.
We can move on from the big failings that we have seen recently. We can make sure that service users, carers and staff are all proud of, and have confidence in, the care and support system in this country.
And above all, we can celebrate a system that takes your best care and fits around the people who need it most.
Thank you
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