News

The new inspection and regulation regime for care homes will mean a major shake-up of the sector. It will also cast light on the efficacy or otherwise of private public partnerships, says Yasmin Alibhai-Brown.

As readers of this occasional column will know, I approve of inspections, standards, and strong actions that can lift care and social services out of the pit. They have too long been undervalued, underfunded and underdeveloped.

A rich society such as ours must be judged by the way it treats those most in need. We fail this test utterly. To turn this round, we must think creatively and boldly about how an intelligent strategy using rewards and criticisms can revitalise and enthuse these services so that people who care enough to work in them feel a new sense of mission about who they are and what they are doing. Personal and national aspirations (plus proper resources obviously) could transform the sector.

The National Care Standards Commission (NCSC), which has been set up to inspect and raise standards in care homes, is an important step in that direction. Such forensic information may also help to make better judgements about whether ubiquitous public and private partnerships actually do produce better services or whether the government's ideology of no ideology (pragmatism is the new mantra) is zealous blind faith. I remain deeply sceptical of this miracle and the assumed and presumed excellence of anything run by the private sector.

Many other people out there, (not all of them "forces of conservatism" as Blair once described those who oppose New Labour policies) are unconvinced too. Roy Hattersley has come out strongly since the election with a barrage of intelligent questions. (It is interesting though that during the election campaign he and I argued on Radio 4 about the use of the private sector for public services and he was completely and passionately on side with New Labour. Such a good tribal chap, Roy.) The fact that a number of care homes privately run but contracted to local authorities are closing down or are threatening to do so because of the new standards makes me even more wary.

Yes, imposing impossible standards with little additional money is neither wise nor fair. But if, as Chris Hume of the Department of Health and a key supporter of the NCSC, claims: "The aim is not to cause chaos in the sector but to provide minimum standards below which people cannot operate."

Why should any care home owner find that so impossibly difficult? And what would that tell us about the levels of care in that home? I have long wondered about how it made any business sense to run care homes especially for older people. Yet, many East African Asians I know have made good doing just that. Some of them are very honourable people and I cast no doubt on the places they run. I have visited some and the residents were obviously happy and felt that they were respected - Asians are brought up to respect the old, a habit we are sadly losing.

But the money that a number of others have made in this business worries me. The residents are not rich; the local authorities demand Best Value. Your investment has got to deliver, otherwise it is not a business. During the 1980s the mosque was rife with talk of profitable sectors. Small hotels in London and care homes were always top of the list then and money was clearly made by enthusiastic entrepreneurs. I suspect these people will not be warmly welcoming inspections and a scrutiny of standards.

Inspections could demand to know: are there enough workers? Are they paid decent or even minimum wages? Is training and progression part of the contract? Falls, deaths, and other events need to be audited too. How free are workers and inmates to complain? The physical environment, activities and ambience matters hugely to older people. In some of the privately run homes, there is minimal attention paid to these.

I remember taking my mother to visit a friend in a privately run care home for older people in Southall, in west London. I was horrified. The residents were all sitting completely silently in a stark room with formica furniture and peeling floral wallpaper. The television was on and two Polish workers who spoke 10 words of English and none of the Asian languages were serving tea. The owner's Mercedes was parked in the driveway.

National care standards will hopefully close homes like this. They may provide evidence to counter the government's current obsessional commitment to private public partnerships.

Or they may show that such partnerships can deliver Best Value and best practice if standards are imposed. If so I will eat my words.

Yasmin Alibhai-Brown is a journalist and broadcaster.