My Lords, I strongly support the amendments which have been so expertly described by the noble Lord, Lord Best, and to which I have added my name, as well as Amendment 87ZC in the name of my noble friend Lord Hunt of Kings Heath.
This is an important group of amendments. In combination, they will help to ensure that housing is at the forefront of decision-makers’ minds when providing for an individual’s care and support needs. The person will be supported in a way which makes them the least dependent on health and social services only if housing solutions are properly taken into account. However, that element is all too often ignored, and dependency is ensured.
I well remember a dispirited social worker who described the effects of a two-year delay in providing an arthritic lady with lever taps. In the mean time, she had to have considerable support to wash and cook and objected strongly when that support was taken away because she was now able to turn on the taps. However, it helped to convince the council to clear their backlog of occupational therapy cases.
It is so often the case that the housing element ensures that a person can maintain their greatest independence and be enabled to live their life to the fullest extent they can. Housing solutions have to focus on the individual—ensuring that the person is at the centre of the services and not the system. There are numerous examples of how, when housing, health and social service professionals work well together, people are able to regain a control over their lives which can all too easily be lost when social or health care are seen as the only options.
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The National Housing Federation’s recent report Providing an Alternative Pathway gives many telling examples. One is of a man called Bruce which will resonate with anyone who has had experience of a spinal injury unit. He was left tetraplegic after a motorcycle accident which also killed his son. In an instant, his home had been made inaccessible to him and all he could do was move into residential care. He quickly went downhill and after three months attempted suicide. Fortunately for him, the residential care was part of Papworth Trust which was able to move him, as his health improved, to a semi-independent living scheme, still offering him lots of support. In the mean time, a two-bedroom flat was specially adapted to his needs and he now lives there independently, with a weekly care package, and is back in employment. In the National Housing Federation's estimate just this case represents an annual saving of more than £50,000 a year in social care costs.
Mencap's excellent report, Housing for People with a Learning Disability, was the focus of a recent meeting of the All-Party Parliamentary Group on Learning Disability. One mother described what happens when housing does not form part of the three-legged stool of the noble Lord, Lord Best. Her son, Sam, has severe learning disabilities and no speech. Following school, he spent three years away from home learning independent-living skills at college, with social services promising that they were planning appropriate provision for him when he returned home. He returned home to find nothing—no provision. Residential care was deemed inappropriate; the only supported housing was for people for more moderate needs and Sam needed 24-hour support. The housing department was not even aware of its responsibilities to youngsters with learning disabilities as a group with supported-housing needs. It was only by chance that Sam's mother heard of an empty, run-down house in the borough—empty because it had been left in a legacy to be used for people with learning disabilities and the council could not find tenants to fill it. It was about to be sold. The rest of her story was all too familiar with the hurdles and obstacles placed in her way, but her son and three other youngsters with severe learning disabilities moved in on 10 March last year. They are now flourishing in the community with their health and well-being markedly improved.
These solutions require teamwork and for people to work across disciplines in an integrated way. Why does it not happen? Is it that co-ordinated effort can all too easily be forgotten if it is not a legal duty and people are working under pressure? So it requires a clear duty on all the participants involved.
I do hope that the Minister will reconsider the recommendations made by the Joint Committee and that he will come back with his own amendments on Report or accept these to be included in the Bill. I urge noble Lords to support them.