Report (2nd Day)

Part of Care Bill [HL] – in the House of Lords at 3:17 pm on 14th October 2013.

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Photo of Lord Low of Dalston Lord Low of Dalston Crossbench 3:17 pm, 14th October 2013

My Lords, I very much welcome the Government’s Amendments 33, 39 and 40. So far as Amendments 39 and 40 are concerned, in Committee, as the Minister has remarked, I sought a strengthening of Clause 12(1)(f) to ensure that regulations would specify the circumstances in which a specially trained person must carry out an assessment or a reassessment of persons who need one. The Minister was kind enough to thank me for raising the point, and I thank him very much for bringing forward these amendments. I am delighted that the Government have come forward with amendments that effectively meet my wishes, recognising that the Bill, as initially presented to the House, did not precisely reflect the Government’s intention.

Talking of specialist provision, I kick myself that I forgot to refer to this in connection with Amendment 26 from the noble Baroness, Lady Meacher, about the need for local authorities to commission a full range of services to meet the diversity of their residents’ needs. I meant to illustrate this by reference to the situation of deafblind people who are all too often offered mainstream services or services designed for those with a single sensory loss instead of the specialist provision appropriate to their particular needs. Perhaps, in welcoming the Government’s amendment on specialist assessments, I can slip in the thought that if local authorities are required to ensure that sufficient services are available for meeting the needs for care and support of adults in their area, they would rightly be under some pressure to identify the full range of deafblind people’s needs, and those with other specialised needs as well, and plan accordingly.

On Amendment 33, I argued in Committee—I fear at too great a length for some, but I shall try not to repeat that mistake today—that the Bill would be much stronger if local authorities were also placed under a duty to take prevention into account in exercising any of their functions under Part 1, not just those relating to direct provision of care. Failure to do this meant that there was little in the Bill for those not deemed eligible for care and support, even though their needs might be quite considerable. It also did little to advance the Government’s own strategy of rebalancing the care system away from crisis intervention and in a more preventive direction.

The new government amendment, however, embraces a more strategic approach by obliging local authorities to consider whether measures short of full care and support, including anything which might be available in the community and not just directed at individual care, could assist the individual. This could ensure that those who did not reach the eligibility threshold were not bereft of support entirely and would in effect make the eligibility threshold go further. This is very much to be welcomed, and makes the Government’s setting of the eligibility threshold at the equivalent of “substantial” somewhat easier to accept.

However, I ask for an explicit reassurance on one or two points; perhaps the Minister might like to make a note of them in order to respond to them when he comes to wind up. I would like a reassurance that preventive services will remain universal and free of charge. We know that entitlement to many reablement services is assessed against the FACS criteria. We also know that councils have previously tried to charge for them even though it is illegal to do so. An explicit commitment has been made to minor aids and adaptations continuing to be provided free and without the need for a financial assessment. No similar statement has been made about intermediate care. I believe that the House would very much welcome the Minister giving the same explicit commitment to intermediate care services, including most reablement services, continuing to be free of charge. There is evidence to indicate that councils will look to restrict access to preventive support. I therefore welcome the Government’s underlining their commitment to universal and uncharged preventive services.

In Committee, the Minister assured us:

“Under this Bill, local authorities would be expected to consider how the provision of reablement and other types of care and support could contribute to the achievement of an individual’s desired outcomes as part of the assessment process. Clause 13(2)(b) makes it clear that, in determining eligibility, local authorities must consider if the person would benefit from preventive services—whether or not they have eligible needs. This would include reablement services”.—[Hansard, 9/7/13; col. 262.]

However, research undertaken by the British Red Cross last month found that 64% of councillors think that preventive services provided through the duty set out in Clause 2 will be focused on adults whose needs for care and support meet their council’s eligibility criteria. It would be helpful if the Minister could give an assurance that the commitments made in respect of Clause 13(2)(b) attach to its new placement in Clause 9, so that local authorities must consider during an assessment if the person would benefit from preventive services, including reablement services, whether or not they are likely to be determined as having eligible needs.

In Committee, the noble Earl gave me an assurance, as he has observed in speaking to the government amendment, that,

“we intend to maintain the existing entitlements to aids, minor adaptations and intermediate care in regulations”.—[ Official Report ; 16/7/13; col. 695.]

However, research undertaken by the British Red Cross last month found that 60% of councillors think that services offered through the duty set out in Clause 2 are more likely to be charged for than to be free at the point of need. Therefore, can the Minister give an assurance that, as per the Community Care (Delayed Discharges etc.) Act (Qualifying Services) (England)

Regulations 2003, intermediate care will continue to be required to be provided free of charge to any person to whom it is provided, for any period, up to and including six weeks, and without the need for a financial assessment?