Sixty Second Interview with Paul Burstow
By Maria Ahmed
Paul Burstow MP is one of the most prominent social care campaigners in parliament. He is co-chair of the all-party group on ageing and older people and former shadow health secretary and spokesperson for older people for the Liberal Democrats. He was named as last year’s Older People’s Champion at the annual Charity Champion awards. This month, he introduced a private member’s bill on the care of older people.
A report by the Commission for Social Care Inspection has found that care homes are failing to manage medication effectively. It found faults including dispensing the wrong medicine to residents, poor record-keeping, and medication being handled by unqualified staff. The CSCI described progress in managing medication “disappointingly slow.” Why do you think these problems are persisting in care homes, and what needs to be done?
The report follows one published just two years ago by the CSCI’s predecessor the National Care Standards Commission. Little has changed. Lessons have not been learned. For almost half of care homes to fail to meet medicine management standards is unacceptable. Lives are put at risk and quality of life is being diminished through incompetence and poor practice. At worst residents in care homes are being managed through sedation.
I want to see the government take the issue seriously. The CSCI makes a set of recommendations which requires action from providers, PCTs, local commissioners. I also want to see the Commission undertake more unannounced visits and prosecutions where care homes continue to fail on the medication standards. I also want to see the fulfilment of the National Service Framework standard on medication review which requires those over 75 on less than four medicines to have their medication reviewed at least once a year and those on four or more medicines to have a review every six months. This is still not happening everywhere despite the National Service Framework milestone being 2002.
The government has announced it will require 750,000 care workers be vetted and registered. How do you think this should work, and what benefits will this bring to older people?
I think that it is important that vetting and registration are used to lever up training requirements and drive a culture change that places a greater value on the work care workers do. Registration and vetting should help to exclude those who overtly abuse vulnerable adults in their care, but it will not tackle abuse that stems from poor practice that normalises neglect and mistreatment.
You introduced a private member’s bill on the care of older people. What is this calling for?
My Bill does three things. First, it closes a legal loophole which means that the Human Rights Act does not currently apply to privately run care homes. This was not what parliament intended but a court ruling opened the loophole and the Government has for three years failed to take action to ensure that vulnerable people in private care homes can enforce their human rights.
Second, the Bill would provide for new national standards for nutrition in care homes and other care settings. Research suggests that as many as 1 in 5 care homes residents are at risk of malnutrition. The current national minimum standards say next to nothing about nutrition and have no requirements in respect of training in the special dietary needs of elderly people. Over 2,000 care homes in England fail to meet event the most basic NMSs for meals and mealtimes.
Third, my Bill would enact the 10 year old recommendations of the Law Commission in respect of protection for vulnerable adults. It would place a statutory duty on local authorities to investigate allegations of abuse or neglect of vulnerable adults. The Bill also provides for application to be made to the courts for orders to protect vulnerable adults from abuse. This provision would give statutory force and teeth to the requirements of the No Secrets guidance issued by the Department of Health and Home Office.
What impact do you think the health and social care white paper will have on the care of older people, and what more does the government need to do?
The White Paper says little about social care. Rather than seeing social care as an equal partner with the NHS with its own distinct contribution to make towards the welfare and wellbeing of people in need it treats social care as little more than adjunct to the NHS, facilitating early discharge and preventing admission to hospital.
What is needs is a more ambitious vision of social care that recognises its distinct contribution to promoting independence and realising people’s potential. This requires engagement from more than just the NHS, it requires engagement from right across government.
There are fears that social care is not high enough on the government’s agenda. How do you think this can be changed?
Is the Department of Health the right sponsoring department for social care? I think it is now a question that deserves debate. In the DH social care is the poor relation of the NHS in policy, in resources, in ministerial and in civil servants seniority. The agendas of both the Office of the Deputy Prime Minister, with Supporting People, and the Department of Work and Pensions, with the Pensions Service and the focus on supporting return to work require effective social care policy and practice if they are to deliver on the ground.
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