Category: Social Care

  • Jonathan Gullis – 2022 Speech on Foster Carers

    Jonathan Gullis – 2022 Speech on Foster Carers

    The speech made by Jonathan Gullis, the Conservative MP for Stoke-on-Trent North, in the House of Commons on 21 April 2022.

    It is a pleasure to serve under your chairmanship in Westminster Hall once again, Mr Robertson. I warmly congratulate the hon. Member for Jarrow (Kate Osborne) on securing this important debate and sharing her personal experience. As Members from across the House have said, it is truly inspiring.

    My partner and I hope one day, when our children are slightly older, to offer a home and an opportunity to young people. For eight and a half years before entering this place, I worked as a head of year, dealing with behavioural and pastoral issues in the secondary education sector, and I had direct contact with some of the fantastic foster carers of the children I was proud to look after. It was an enlightening and warming story. Looking at how to spend money from the budget to invest in those young people and give them exciting opportunities outside the school gates, as well as pushing their learning and educational outcomes, was something that I thoroughly enjoyed.

    I want to focus on the great work that is being done in the constituency I am proud to serve, Stoke-on-Trent North, Kidsgrove and Talke, and across the wider city of Stoke-on-Trent. Since 2019, Stoke-on-Trent City Council has made it very clear that children and young people need to be its No. 1 priority. A complete overhaul is needed, as the challenge in 2019 was, quite frankly, immense. Children’s services in Stoke-on-Trent have never been rated good or outstanding. An Ofsted inspection in early 2019 showed that the situation was dire—that is the only word I can use to describe the quality of services available to more than 1,000 of the most vulnerable young children in our city, who required us to look after them. Children’s services received the worst possible rating of inadequate from Ofsted, and inspectors uncovered multiple failings, which left youngsters at risk of harm.

    Since May 2019, Councillor Dave Evans, who was appointed to the children and young people portfolio, has been working with Councillor Abi Brown, the leader of Stoke-on-Trent City Council, and has made big strides to improve fostering services across the Potteries. Ably assisted by team manager Kate Bailey and recruitment officer Marie Plant, Councillor Evans and his team have radically changed the council’s approach. The council has been pushing hard to get as many organisations signed up to the fostering friendly scheme, the Fostering Network’s programme to encourage employers to support fostering and, in particular, foster carers. Stoke City Football Club, Bet365, Staffordshire police, Stoke-on-Trent City Council and health groups are all now signed up to the scheme. That effort is part of the team’s new approach to running family services.

    To be recognised as a fostering friendly employer, the council has had to demonstrate support for employees, make the workplace friendlier for foster carers to benefit the children in their care, and also make it easier for people to consider fostering. In 2020, the council launched a new fostering friendly policy for all its employees, setting out benefits for any staff member who decides to come forward to become a foster carer. They include flexible working arrangements and paid time off for those going through the foster care approval process. Councillor Evans and his team are urging organisations and businesses across Stoke-on-Trent to become fostering friendly, as part of the push to become recognised as the first fostering friendly city in the United Kingdom.

    Part of the new approach that Stoke-on-Trent City Council is taking is making fostering more visible and spreading the word. Social workers now go to events across the city such as Stoke-on-Trent Pride and the Better World Festival, and they hold coffee shop drop-in sessions. I am pleased to say that the new approach that the council has taken is paying off. Recruitment of foster carers is up, with 33 recruited last year compared to 30 the year before, and the council is now the fifth biggest recruiter of social workers in the country.

    As well as getting more organisations signed up to the fostering friendly scheme and boosting recruitment, Councillor Evans and the team have worked to improve retention of foster carers, which is important as there are more than 1,000 cared-for children in the city of Stoke-on-Trent. Fosterers have been given a stronger voice, with increased representation on the corporate parenting panel to give them a say on key decisions across children’s services in the city. All of this progress has been reflected in Ofsted’s latest monitoring report

    Even the Stoke Sentinel has had to be positive about the turnaround. As Councillor Evans has said, the clearest sign of improvement is that Ofsted has found that children in Stoke-on-Trent are now safe—Ofsted had previously found that they were not. Of course, there is still a long way to go. As I said earlier, the council has never been ranked as good or outstanding for children’s services, but that is the goal, and I am 100% confident that thanks to the new approach adopted by Councillor Evans and his team, when Ofsted carries out its next full inspection this autumn, that goal will be achieved.

    Before I close I want to give the fostering team a shout-out for running the Potters ‘Arf marathon last year, and again this year. This is something I know my hon. Friend the Minister will be proud to hear. Having seen and walked the hills of Stoke-on-Trent, I will not be anywhere near that race, apart from standing on the sidelines and cheering with a cheesy oatcake in my hand. I warmly congratulate all those taking part to raise awareness and money for good causes, and I look forward to cheering the team on.

  • Kate Osborne – 2022 Speech on Foster Carers

    Kate Osborne – 2022 Speech on Foster Carers

    The speech made by Kate Osborne, the Labour MP for Jarrow, in the House of Commons on 21 April 2022.

    I beg to move,

    That this House has considered the recruitment and retention of foster carers.

    It is an honour to serve under your chairmanship, Mr Robertson. I thank the Backbench Business Committee and the supporting Members who made it possible to secure this debate. I also thank the Fostering Network, Home for Good and one of my local authorities, South Tyneside, for organising meetings and relevant briefings for me and my team, which were very useful for this debate. I put on record my thanks to those bodies for their work in championing the overlooked and neglected fostering sector. I am sure all Members present will want to join me in welcoming the Fostering Network and foster carers to the Public Gallery. It is great to see them here.

    One cannot overestimate the important role fostering plays across child protection and safeguarding. In a climate where, over the last 12 years, local authorities have been forced to adapt their operations through cuts to local expenditure, exacerbated by the coronavirus pandemic, the demand for foster carers has never been greater, with many children needing emergency support. That is why I will focus my opening remarks on why the fostering sector and carers need increased recognition and wraparound support from local authorities and independent fostering agencies.

    While the debate is centred on the recruitment and retention of foster carers, we also need to look at the challenges faced by the sector more broadly, and at where we can share experiences of local authorities and constituents to not only platform the sector, but raise its profile and actively encourage people to enter into fostering.

    Margaret Ferrier (Rutherglen and Hamilton West) (Ind)

    The Welsh Government’s initiative Foster Wales has created a network of local authority fostering services across Wales, showing a clear national commitment to the cause. Does the hon. Lady agree that England and Scotland would benefit from a similar national call to action?

    Kate Osborne

    Yes, I agree, and I will refer to a similar point in my speech.

    As I was preparing for this debate and looking at the statistics, two particular facts on recruitment stood out to me. First, the number of initial inquiries to foster is at an all-time high. There were 160,635 initial inquiries from prospective fostering households in the year ending 31 March 2021. In contrast, only 10,145 applications—a mere 6% of initial inquiries—were actually received. Secondly, according to the annual fostering statistics published by Ofsted, the number of foster carers in England has increased by only 4% since 2014, while the number of children in foster care has increased by 11%.

    Those statistics show a crisis in recruitment and retention. Members on both sides must ask why those significant shortfalls in the fostering sector are occurring and what we in this place can do to help to alleviate this recruitment and retention crisis. I believe that we need to champion foster carers, but central to that must be deeds, not just words: we need to make sure that foster carers are fairly paid and respected as workers.

    Set out in its 2021 “State of the Nation’s Foster Care” report, the Fostering Network’s findings on pay are damning:

    “Over a third of foster carers said that their allowances do not meet the full cost of looking after a child.”

    That is certainly something I can give personal testimony of, from my experience as a foster carer before entering this place; it has also been said to me today by some of the foster carers present.

    Secondly, the report notes:

    “Fourteen local authorities reported that their foster care allowances were below the NMA for at least one age group across England. Of these, two were in London, four were in the South East and ten were in the area of the rest of England.”

    While I thank the Children’s Minister for writing to 13 local authorities on the specific issue of the national minimum allowance, that has to be weighted against this Government’s political decision to put the burden of inflation and the cost of living crisis on the backs of ordinary people.

    Janet Daby (Lewisham East) (Lab)

    My hon. Friend is making a meaningful speech, including about her own experiences as a foster carer. She may or may not know that I used to be a manager in fostering, and for as long as I can remember there was an issue with the retention of foster carers and with those carers not being valued enough. Does my hon. Friend agree that the severe cuts to local government funding have had an indirect impact on the support that social workers can offer foster carers, which in turn has an impact on their ability to continue fostering and how they can look after, or manage the welfare of, a child?

    Kate Osborne

    My hon. Friend is absolutely right: we cannot keep taking money out of local authorities and expect them to still deliver the same level of services. The impact, unfortunately, is felt by the children and young people who are in the fostering system or child services.

    The financial pressures and stresses felt by carers, highlighted by the Fostering Network’s research, are only set to get worse. The Nationwide Association of Fostering Providers believes that the Government should urgently make a pay award to foster carers, both within local authorities and independent fostering agencies, to preserve and protect this precious resource for children and young people in need. This would be an important signal to foster carers that the Government really do value their contribution.

    Another critical issue that we have to be aware of is the responsibility local authorities and IFAs have in providing vital—often emergency—wraparound support for foster carers and their families. I put on record my thanks to South Tyneside Council, one of my local authorities, for its progressive outlook in prioritising this area. First and foremost, we have to recognise that each child currently being supported through fostering services has different and complex needs, which must be met from the first moment that child comes under the care of their carer. That is why South Tyneside’s model of training carers to degrees, whereby they can be matched with the child best suited to their level of training—a model that is in the best interests of all parties and, most importantly, those of the child or young person—is highly commendable. In this, it is vital that children are kept as close to the local authority as possible. This approach means that at crisis point there is no delay in support, and any crisis has a better chance of being mitigated, as tailored, traumatic and therapeutic support can be accessed quickly.

    Rachel Hopkins (Luton South) (Lab)

    My hon. Friend is making a powerful speech on this important issue. Regarding the role of local authorities and the point about funding, does she agree that the crisis with children’s social workers and the shortage that we have is exacerbating the problems, and will impact on the very commendable operating model she is talking about?

    Kate Osborne

    I absolutely agree with my hon. Friend. As has been said, the funding that is being taken out of the system means that, unfortunately, we are not continuing to provide the support that is needed, in terms of both social workers and the many other people who are involved in children’s care.

    The system South Tyneside Council has in place means that if a breakdown occurs between the child and foster family, the local authority is accountable, thus upholding the fostering standards to improve outcomes. With such support mechanisms in place, more people will be encouraged to become foster carers.

    However, we must recognise that South Tyneside’s model relies on factors for which the responsibility lies truly at the feet of Government Ministers. The cuts to local authorities over the past 12 years, along with the present day record levels of children needing emergency foster care mean that my local authority, like most others, must turn to independent fostering agencies to plug the gap. The money local authorities have to spend from Government grants, council tax and business rates has fallen by 16% since 2010. That means that local authorities have an increasingly limited capacity to respond to significant inflationary pressures.

    While I respect the work that members of IFAs do to alleviate the pressure felt by local authorities, those agencies have the ability to add another complex, unnecessary layer between the child and the local authority, meaning that when crisis hits, unnecessary delays, which are detrimental to all involved, are often hard to avoid. In South Tyneside Council, 50% of children are placed into IFAs.

    We also need to break down the popular perceptions of fostering, which undermine the diverse and varying shapes that it can take. Fostering should not be compared with adoption, although it often is. We need to break through the perception that fostering is a means, whereas adoption is the end, because one size does not fit all. We also need to recognise that circumstances in the lives of carers can change. The value of a carer fostering one child needs to be recognised as the same as a carer who may foster many children.

    Finally, we need to appreciate that, more often than not, foster carers can be thrust into a situation at extreme short notice. Their presence in the safeguarding process can often be to provide emergency care.

    Tulip Siddiq (Hampstead and Kilburn) (Lab)

    My hon. Friend is making a powerful speech. The House is always at its best when Members draw on their personal experience and my hon. Friend’s speech shows that she knows what she is talking about. I add my thanks to Fostering Network, who I have worked with a lot in the past and who I have found to be incredibly helpful.

    I want to pick up on black, Asian and minority ethnic foster carers and children from BAME communities. BBC analysis shows that two thirds of councils in England have a shortage of BAME foster carers, but 23% of children on the waiting list are from BAME backgrounds. Black boys are left longest on the waiting lists. I wondered whether my hon. Friend might comment, and I hope the Minister will also pick up on that point.

    Kate Osborne

    That point came up in my meeting with the head of children’s services in my local authority. As my hon. Friend says, we are desperately short of BAME foster carers.

    Often children arrive into foster care with nothing apart from the clothes they are wearing. The responsibility lies firmly with the fostering family to pick up from there, otherwise the child would have nothing.

    What do we need from the Government? I would like the Minister to look at and seriously consider the Mockingbird strategy as adopted by South Tyneside and many others, and to listen to best practice from my and other local authorities. I hope we will hear more on that today from other Members.

    The Mockingbird model is based on the idea of an extended family. The strategy focuses on a fostering hub, where satellite carers work in sync to provide specialist and centralised care to children along with real-time support for those satellite carers. Mockingbird means intervention can take place without the need to necessarily remove children completely from their support network, should an emergency occur. Depending on circumstances, the programme can be adjusted to include birth families and adoptive families, and to provide support for independent living, while giving assurance to foster carers and those in care that a secure and close support network is at hand.

    I also want the Minister to listen to the recommendations set out by the Fostering Network, which with others is calling for a fully funded national fostering strategy, a national fostering leadership board and a national register of foster carers. In addition, the Government need to carry out a comprehensive review of the minimum levels of fostering allowance, using up-to-date evidence to ensure foster carers are given sufficient payment to cover the full cost of looking after a child.

    There is no one quick fix to address the issues relating to the retention of foster carers. The themes of carers feeling unsupported, making a financial loss and not being treated as workers would lead to a high turnover rate and chronic difficulties in recruitment in any workforce. I hope that today’s debate acts as an opportunity to address Members’ concerns from their constituencies and encourages the Minister to put recommendations in place.

  • Rishi Sunak – 2022 Comments on the Health and Social Care Levy

    Rishi Sunak – 2022 Comments on the Health and Social Care Levy

    The comments made by Rishi Sunak, the Chancellor of the Exchequer, on 6 April 2022.

    This Government will not shy away from the difficult decisions we need to take to fix our social care system and slash NHS waiting times. The Health and Social Care Levy will fund a third more elective care, over 17 million extra diagnostic tests and a cap on the cost of care so people no longer live in fear of losing everything to pay for care.

    The British people deserve the best health care in the world and delivering that is our top priority.

  • Sajid Javid – 2022 Comments on the Health and Social Care Levy

    Sajid Javid – 2022 Comments on the Health and Social Care Levy

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 6 April 2022.

    The pandemic put unprecedented pressure on the NHS and is causing the Covid backlogs. This investment will go into tackling those backlogs and will help make sure everyone can get the care and treatment they need.

    We can’t have business as usual, which is why we are rolling out Surgical Hubs and Community Diagnostic Centres up and down the country to deliver millions more scans, checks and operations.

    This vital funding will ensure the NHS is equipped to not only reduce waiting times but also tackle the big challenges we face – from cancer to heart-disease and dementia. We will also reform the adult social care system, invest in the workforce and protect people from catastrophic care costs.

  • Boris Johnson – 2022 Comments on the Health and Social Care Levy

    Boris Johnson – 2022 Comments on the Health and Social Care Levy

    The comments made by Boris Johnson, the Prime Minister, on 6 April 2022.

    We must be there for our NHS in the same way that it is there for us. Covid led to the longest waiting lists we’ve ever seen, so we will deliver millions more scans, checks and operations in the biggest catch-up programme in the NHS’ history.

    We know this won’t be a quick fix, and we know that we can’t fix waiting lists without fixing social care. Our reforms will end the cruel lottery of spiralling and unpredictable care costs once and for all and bring the NHS and social care closer together. The Levy is the necessary, fair and responsible next step, providing our health and care system with the long term funding it needs as we recover from the pandemic.

  • Therese Coffey – 2022 Statement on the Household Support Fund Extension

    Therese Coffey – 2022 Statement on the Household Support Fund Extension

    The statement made by Therese Coffey, the Secretary of State for Work and Pensions, in the House of Commons on 31 March 2022.

    The economy is in recovery, with a record number of people on the payroll, but we recognise inflationary challenges and that people are concerned about pressures on household budgets. That is why we are extending the household support fund to provide cost of living support for households most in need. From April, the Government are providing an additional £500 million to help households with the cost of essentials. This brings the total funding for this support to £1 billion. In England, £421 million will be provided to extend the existing household support fund from 1 April to 30 September inclusive. The allocation for councils is the same as for the previous six months. The devolved Administrations will receive £79 million through the Barnett formula.

    The fund will be distributed via upper-tier local authorities. This support will continue to help those who are struggling to afford energy and water bills, food, and other essentials, to prevent the escalation of problems. We know energy bills may be of particular concern to low-income households and so local authorities are being encouraged to focus on supporting households with the cost of energy.

    At least a third of the extension funding (£140 million) will be spent on pensioners on low incomes and at least another third (£140 million) will be spent on families with children. This will ensure that the most vulnerable, including those unable to work to boost their income, will continue to receive vital support to help with the costs of household essentials throughout the next six months.

    This extension is just one way that we are helping families with the rising cost of living and other global inflationary pressures. The Government have recently announced a three-part plan of support to help households with rising energy bills, worth £9.1 billion in 2022-23. This includes a £200 discount on energy bills this autumn for all domestic electricity customers in Great Britain, to be paid back automatically over the next five years. This also includes a £150 non-repayable rebate in council tax bills for all households in bands A-D in England, as well as a £144 million discretionary fund for local authorities to support households who are in need, regardless of their council tax band.

    Likewise, the national living wage will increase to £9.50 an hour this April, providing an extra £1,000 pay for a full-time worker. This has risen every year since it was introduced in 2016. The cuts to the universal credit taper rate and the uplift to the work allowances will also put, on average, an extra £1,000 a year into the pockets of 1.7 million low-income families.

    These initiatives, alongside the household support fund extension, will work to help those most in need over the coming months.

  • Kemi Badenoch – 2022 Statement on Supporting Families Annual Report

    Kemi Badenoch – 2022 Statement on Supporting Families Annual Report

    The statement made by Kemi Badenoch, the Minister for Levelling Up Communities, in the House of Commons on 31 March 2022.

    As required by the Welfare Reform and Work Act 2016, section 3(1), today I have published the 2021-22 annual report of the Supporting Families programme. The report sets out how the programme has been helping our most disadvantaged families who face multiple and complex problems.

    Supporting Families (previously the Troubled Families programme) helps level up key services to give families the practical support they need to stop domestic abuse and combat problems such as unemployment, persistent school absence and poor mental and physical health, with funding allocated based on deprivation and population figures. It has been at the heart of our ambition to strengthen families and improve their futures for 10 years. At last year’s Budget, the Chancellor announced £200 million of additional investment to expand the programme. This is around a 40% real-terms uplift in funding by 2024-25, taking total planned investment across the next three years to £695 million.

    Through its 10 years of delivery, the programme has directly helped hundreds of thousands of vulnerable families make positive changes to their lives, with many thousands more benefiting from access to early, co-ordinated whole family support. Importantly, the programme has shown what is possible when we step in early to help families and prevent problems from escalating. The programme’s evaluation showed it reduced the proportion of children on the programme going into care by a third, the proportion of adults going to prison by a quarter and the proportion of young people going to prison by 38%.

    Reducing the pressure on high-cost statutory services such as children’s social care is a key focus for the expanded programme. Between 2022-23 and 2024-25 my Department will work closely with the Department for Education, local authorities, and their partners to deliver support to up to 300,000 more families.

    “Levelling up for families: annual report of the Supporting Families programme 2021-2022” marks the 10th year of Supporting Families delivery and includes an update on the programme’s performance and a summary of the latest research findings and policy developments for the programme.

    Between April 2021 and January 2022, the programme has funded local authorities to achieve successful outcomes with 55,421 families. This includes 1,838 adults who were helped into sustained employment, and builds on 414,955 successful family outcomes achieved by the Troubled Families programme between April 2015 and March 2021. These families faced multiple and complex problems including a combination of crime, truancy, neglect, anti-social behaviour, domestic abuse, poor mental health, worklessness and financial exclusion. Every successful family outcome represents a family’s life changed for the better—a considerable achievement for the families and the local services supporting them.

    The report sets out how we are improving the programme in this next phase. We have updated the programme’s funding formula to reflect current need by redistributing funding to more deprived areas in line with our ambition to level up across the country. We are setting refreshed expectations on the outcomes to be achieved with families through a new outcomes framework and setting expectations for an effective early help system through an updated early help system guide. Local authorities use the outcomes framework to assess whether families are eligible for the programme’s funding, measure if the family’s situation is improving, and define what a good outcome looks like for each problem. The refresh will make sure that the programme continues to reflect the needs of families. The early help system guide outlines a national vision and descriptors for an effective and mature “early help system” to enable local authorities and their partners to deliver seamless, responsive, and co-ordinated preventive support to families. Updating the guide will ensure that local authorities delivering the programme continue to improve their early help offer and have clarity on what a high-standard system looks like.

    The annual report summarises the latest research findings relating to the programme. Alongside the annual report, I have also published a new research report by the independent research organisation Kantar, which looks at effective practice and service delivery in local areas. This sets out what a sample of local areas report as the most effective approaches for delivering positive change in families’ lives. I will deposit copies of both reports in the House of Commons Library.

    I look forward to working alongside local authorities, their partners and other stakeholders as the programme celebrates its 10th anniversary, and seeing first-hand the continued impact it has on the lives of our most vulnerable families.

  • Chloe Smith – 2022 Statement on Support for Those Near End of Life

    Chloe Smith – 2022 Statement on Support for Those Near End of Life

    The statement made by Chloe Smith, the Minister of State at the Department for Work and Pensions, in the House of Commons on 10 March 2022.

    The Government are committed to improving the level of support provided to people who are nearing the end of their lives. The special rules process allows simple and fast access to financial support through the benefits system. Last July, the Government announced their intention to expand eligibility for the special rules, which is currently aimed at those with six months or less to live, with a new 12-month end of life approach. Today, the Department for Work and Pensions is introducing an amendment to the Universal Credit (UC) Regulations 2013, the Employment and Support Allowance (ESA) Regulations 2008 and 2013 and the Decisions and Appeals Regulations 2013.

    The regulations will apply in Great Britain and will come into force on 4 April 2022. They will mean that people who are thought to be in their final year of life will be able to receive vital support through the special rules six months earlier than they are able to at present, thereby increasing the number of people who are eligible and the length of time that they are able to receive this support for. This means that more people will be able to make a claim under the special rules, and as a result, they will not be subject to face-to-face assessments, waiting periods and, in the majority of cases, they will receive the highest rate of benefit. The 12-month approach supports clinicians by providing a realistic and straight-forward definition, consistent with the current end of life definition used across the NHS.

    The Government have amended UC and ESA, where the definition is in secondary legislation, and when parliamentary time allows they will also amend the special rules for personal independence payment, disability living allowance and attendance allowance, where the definition is contained in primary legislation.

    Having a life limiting illness can cause unimaginable suffering for the patient and for their loved ones and we are committed to ensuring the benefits system supports people nearing the end of their lives. To support the implementation of the changes to the special rules criteria we are making today, we will provide clear and helpful communications for claimants, clinicians, and organisations that support people nearing the end of their lives so that they are clear about what they should do in light of these changes.

  • Sajid Javid – 2022 Statement on Covid-19 and Adult Social Care

    Sajid Javid – 2022 Statement on Covid-19 and Adult Social Care

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 27 January 2022.

    Thanks to the success of the vaccination booster roll out, and the reducing level of both infection and hospitalisations across the country, the Government have been able to announce the end of plan B. This means we are now able to take steps towards getting care homes back to normal, easing some of the difficult restrictions that both staff and residents have had in place, which I know have been incredibly challenging for all, while still protecting residents from the continued risk of covid-19.

    From 31 January, there will no longer be nationally set direct restrictions on visiting in care homes and there will be no limit on the number of visitors a resident can receive. Residents should be supported to undertake visits out of the care home without the need to isolate on their return, but should continue to take reasonable precautions and undertake testing arrangements for high-risk visits.

    As well as removing those additional precautions we put in place in response to the omicron variant, we are now able to reduce isolation periods for residents in care homes so that they are the same as for the general public in most cases.

    Residents who need to isolate will now only need to do so for a maximum of 10 days. The 10-day maximum period will apply to those residents who test positive, are identified as a close contact or have had an unplanned stay in hospital. For some residents, the isolation period could be as short as five days subject to the testing regime that will be outlined in guidance.

    Today I am also announcing changes to regular testing for staff. For all adult social care staff, we are moving to lateral flow testing every day before work and removing weekly PCR testing. Recent clinical advice is that following the pre-shift testing regime provides better protection than the current regular testing regime of weekly PCR with three lateral flow tests a week in high-risk settings.

    As restrictions are relaxed for care home residents and for the general population, testing continues to be essential for providing the protections needed to support this relaxation of restrictions. The introduction of pre-shift rapid lateral flow tests should help identify and isolate positive cases quicker rather than waiting for PCR results to return from the lab.

    This change applies only to regular asymptomatic testing for staff meaning PCR tests will remain available for symptomatic staff and residents. Outbreak testing and monthly resident testing will also remain unchanged.

    By maintaining a robust regime of testing in adult social care, continuing to press ahead with our vaccination programme and maintaining high standards of infection prevention and control, we are able to support residents of care homes and recipients of care to gradually return to enjoying life as it was before the pandemic.

  • Charles Walker – 2021 Speech on Specialist Care for Young People

    Charles Walker – 2021 Speech on Specialist Care for Young People

    The speech made by Charles Walker, the Conservative MP for Broxbourne, in the House of Commons on 10 December 2021.

    Sadly, some children and young people are not able to live safely with their families. The significant majority of these children have experienced trauma at a point during their developmental years, resulting in a range of behaviours, many of which cause distress to them or others. Those behaviours include self-harm and an increased vulnerability to criminal exploitation.

    If a young person is unable to live safely at home, he or she may come into the care of the local authority or require hospital care. There is currently an insufficient supply of specialist care to meet the needs of such young people. As a result of the challenges posed by covid-19, health and social care professionals describe an unprecedented level of complexity and acuity of need, making an already difficult situation worse.

    When a young person comes into care they will require either a children’s home, with staff skilled and experienced in meeting complex needs, or in some instances a court-directed placement into a secure unit, to keep them safe. Over the past 18 months, Hertfordshire children’s service has made three applications to the national secure bed bank. Despite repeated referrals, a secure placement was achieved for only one child. The most recent referral was made approximately six weeks ago, and on that occasion the local authority was advised that there were 50 referrals for only four available beds. That means that a secure bed was not available for 46 young people who had been assessed as requiring such accommodation to keep them safe. In each of those cases, the relevant authorities, including Hertfordshire, were required to make their own arrangements while the secure referral remained active.

    Increasingly, local authorities turn to the courts for a deprivation of liberty order in the absence of more appropriate secure placements. Such orders are sought as a last resort, even though when granted they can place local authorities in the invidious position of having knowingly to place children in environments that are not best suited or equipped to meet their complex needs. Similarly, young people who require psychiatric hospital care find such care unavailable because of a shortage of appropriate hospital beds. In Hertfordshire, a number of young people have been assessed as detainable under the Mental Health Act 1983 and are waiting for appropriate hospital beds. The number waiting for a placement often rests at around 10 children, which means that in each of their cases their needs are not being met.

    Despite people’s best efforts, the whole system is creaking because it is unable to cope with the demand. Problems with recruitment and the increasing complexity of some children’s needs mean that Ofsted and the Care Quality Commission too often find themselves in the position of having to close providers down, or reduce their bed capacity. It is important to note that there is a difference between physical beds and usable beds. Many beds are not in service because, in meeting the increasingly complex needs of children in care, there is not the staff capacity safely to service all the available beds in a home.

    Not only is the current situation having a detrimental impact on young people, but its impact on the public purse is significant. Delivering bespoke care to a young person, often through a commissioned provider, is very expensive, particularly because these young people, due to the risks they present, will require high staffing levels. Placements are expensive: they can cost from £4,500 a week to upwards of £30,000 a week. Often, a child who has difficulty accessing support further down the needs scale quickly ends up requiring a far most costly set of interventions and specialist care.

    It is of course important to intervene early to work with young people in the community to prevent family breakdown and the escalation of needs, but the current placement situation must be addressed, so in this debate I wish to ask regulators to work with the care sector to reopen closed beds through the development of a specialist taskforce that supports providers—be they mental health providers, social care providers or specialist schools—that struggle to deliver good-quality care. Alongside such efforts, we should make a national intervention to reassure providers that their Ofsted rating will not be negatively impacted if they admit children with the most challenging of needs. Too often, specialist care providers will refuse these children because they are concerned that if a child absconds or creates a high level of service demand, that will negatively affect their Ofsted rating.

    We also need a national campaign both to challenge the stereotypes about children in care and to recruit residential childcare officers. Such schemes are already in place for fostering and adoption, and we have Teach First and Think Ahead. A similar programme now needs to be introduced to attract people into child social care and, in particular, the care of children with high levels of need.

    Backing up this recruitment drive, we need a programme of support to design children’s homes that can accommodate children with the most complex needs but, as I have already said, without extra specialist staff the Government programme to match fund local authorities to develop new children’s homes will face significant challenges. New homes require skilled staff if they are to be viable. Also, in wanting to build new specialist homes, we need to appeal to the better part of people’s human nature, as too many of these specialist homes, when they come up for planning approval, are opposed by local communities.

    When it comes to registering specialist residential care homes and facilities, we need to find a way of expediting the Ofsted registration process, which can take upwards of three months. In an emergency, a local authority will sometimes use one of its bedroomed properties as a care setting for a vulnerable child or adolescent, with a rota of specialist social care staff in attendance. Without Ofsted registration, such facilities will be operating outside the regulatory framework.

    Darren Henry (Broxtowe) (Con)

    I hear my hon. Friend’s point about care in the community, which is essential and something we need to focus on. Children and young people with complex needs too often end up in hospital, which is not the right place for them, as they end up being affected by people in hospital with other issues. Care in the community is essential. How can we give local authorities the onus and the investment to make this happen?

    Sir Charles Walker

    I thank my hon. Friend for his intervention, and I will come on to that. We need to have the right setting delivering the right care—the care that the child needs. The child needs to be at the centre of that care.

    How does a care emergency arise? That question is often put to me. Beyond the national shortage of beds, a provider can notify a local authority, with only a few hours’ notice, that it will be terminating a young person’s placement in its facility. They can say, “In just a few hours, you will have this child back. This child is now your problem again.” This practice needs to be eliminated, but eliminating it will only alleviate the need for the provision of emergency accommodation and care; it will not end it. That will be done only through the provision of more beds, in both the social care sector and the psychiatric care sector. In the psychiatric care sector, it is not just the overall quantum of beds that counts; it is also the type of bed. These will cover general adolescent units, eating disorders, low-secure units and psychiatric intensive care units.

    Almost all the concerns I have highlighted and will highlight this afternoon were identified in Sir Martin Narey’s independent review of residential care and in the Government’s response of 2016. We need to implement the findings of this report and tie them into a review of the Care Standards Act 2000 and the children’s homes regulations.

    If anyone watching or listening to this debate wants to learn more about what is happening in this sector, I refer them to an excellent report by the BBC correspondent Sanchia Berg that can be found on the BBC website, dated 12 November, “The court orders depriving vulnerable children of their ‘liberty’”. The report contains harrowing accounts of what is happening, and they are framed throughout by the concerns of the High Court judge Sir Alistair MacDonald, who is deeply concerned about what he is witnessing in the courts and family courts.

    Let me return to Sir Martin Narey’s independent review. Beyond its implementation, we need better joined-up care between the NHS and local authorities. The continuing healthcare framework has much to recommend it in relation to children and adolescents, but it is still heavily slanted towards their physical health. A robust commitment to parity of esteem would see the framework cover clinically diagnosed mental illness, as well as the challenges caused by trauma, attachment difficulties and, increasingly, autism. Let me say, as an aside, that all Department of Health legislation should make it perfectly clear that health means mental health and physical health; we cannot have one without the other.

    Why is mental health so important? There are still far too many lengthy debates between local authorities and the NHS as to whether a child is suffering from a mental illness or a behavioural difficulty. To many, this seems like dancing on the head of a pin, as the debate does not change the fact that at the heart of the discussion is a child in crisis, as referred to by my hon. Friend the Member for Broxtowe (Darren Henry). A good solution has to be more joint commissioning between health, education and care providers, thereby removing barriers to joint funding. An example of best practice can be found in my own county of Hertfordshire, where we are opening up a three-bed unit that will be jointly staffed by social care professionals and mental health professionals. Perhaps this initiative could pave the way for a national programme of hybrid mental health children’s homes, with a hybrid model of worker.

    I must conclude by returning to staffing and recruitment. There really is a need for an enhanced programme of training for residential workers that recognises the unique challenges of the role and the high level of skill required to deliver an effective service. Residential work currently requires a lesser qualification than social work, yet those working in residential settings have significantly more direct contact with the most vulnerable children with the most complex needs. Better training would lead to better pay and an enhanced profile, thereby making the role a career of choice and one which is attractive to graduates.

    I have made these recommendations and observations today on behalf of the excellent Hertfordshire County Council, which does a fabulous job across my county, and, of course, on behalf of the children for which it cares. Both Hertfordshire County Council and I want to support the Government’s programme to develop more beds in the secure estate, but we want an estate that is compassionate and able to provide the high levels of care and support that I know, the Minister knows and Madam Deputy Speaker knows, it wants to provide.