Report (2nd Day)

Part of Care Bill [HL] – in the House of Lords at 3:45 pm on 14th October 2013.

Alert me about debates like this

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health 3:45 pm, 14th October 2013

My Lords, I am grateful for the support that noble Lords have given to the government amendments. Perhaps I may start by covering the questions that were put to me. The noble Baroness, Lady Pitkeathley, and my noble and learned friend Lord Mackay of Clashfern asked for assurances that the guidance will make clear that local authorities cannot assume that support will be forthcoming from community services or carers as a get-out. I assure the noble Baroness and my noble and learned friend that the intention in Amendment 33 is not to place extra responsibilities on carers and families, nor to delay local authorities in providing statutory services. I will commit to making this absolutely clear in the statutory guidance that will be co-produced with stakeholders. I hope that that is a valuable reassurance.

The noble Lord, Lord Low, asked for reassurance about preventive services remaining universal and free of charge, as well as intermediate care. I can reassure him that certain services will be provided free of charge, and regulations will set out which types of prevention services must be provided free of charge. Regulations will also set out which types of prevention services local authorities can charge for. It will then be for local authorities to decide whether they charge for such services. This will maintain the current position, where charging for preventive services is determined locally, in accordance with local requirements. Additionally, we would expect intermediate care, including reablement and community equipment such as aids and minor adaptations, to remain free of charge. That is a minimum. The regulations will allow for flexibility, to keep the list up-to-date as services change over time.

The noble Lord, Lord Low, also asked whether the commitments in Clause 13(2)(b) will apply also to Clause 9. Will an assessment be deemed necessary where preventive services may be of benefit, even if someone is unlikely to be eligible? The duty to assess in Clause 9 is independent of the provisions on prevention. Amendments 33 and 45 make it clear that preventive services should be considered during the assessment rather than having to wait for the eligibility determination. This will mean that people can be advised during the assessment on their preventive needs, whether or not they have eligible needs. I hope that that is helpful.

Perhaps it will be helpful if I move on to the amendments tabled by the noble Baroness, Lady Meacher. Amendment 41 seeks to ensure that an appropriately qualified social worker will carry out complex assessments. I absolutely sympathise with the noble Baroness’s amendment and believe that my Amendments 39 and 40, to which she referred, will go some way towards addressing her concerns. I also reassure her that, through the powers in Clause 12, we will require local authorities to ensure that assessors have the appropriate training to carry out the assessment. We have listened to the concerns of adults who use care and support, and to their carers. They are right to say that assessors should receive appropriate training.

Amendment 39 will enable us to specify circumstances in which a specified person, such as a social worker, must or may carry out an assessment. We believe that an expert must carry out an assessment for a deafblind person. We will consult stakeholders during the development of these regulations to identify any other conditions where a specified person should carry out the assessment.

I am grateful to the noble Lord, Lord Dubs, for raising in his Amendment 60 the issue of fluctuating and emergency needs, and, in his Amendment 61, anticipated review dates in the care and support planning process. Clause 25 sets out the minimum framework for the planning process, and balances the need to set out standards for care and support planning while not constraining the ability of local authorities to fit the planning process around the person. I reassure the noble Lord that providing advice and information on what can be done to meet or reduce a person’s needs will include providing advice and information where an adult may be experiencing fluctuating or emergency needs.

In addition, where it is clear that an adult experiences fluctuating needs, the care plan should reflect this by specifying how the needs will be met. I undertake to the noble Lord to ensure that statutory guidance clarifies this, and that fluctuating and emergency needs are included in what advice is to be provided.

The issue of timescales of reviews is something we have considered carefully. The review is an important part of the process as it can identify where a person’s needs have changed and if their care and support plan should be revised to reflect this. Clause 27 on the review of care plans creates a general duty for the local authority to keep plans under review as well as a specific duty to review the plan when the authority believes the person’s needs or circumstances have changed. In addition, the clause contains a right to request a review. I reassure the noble Lord that nothing in the Bill prevents the local authority and the adult agreeing a time for the next review if they wish to do so. We believe this to be a more pragmatic way of fitting reviews around the lives of people, and one which supports our policy of personalised care. I reassure the House that we intend to detail these issues in statutory guidance on care planning.

I hope that I have reassured the noble Baroness and the noble Lord and that they will feel able not to move their amendments.

Amendment 32 agreed.

Amendment 33

Moved by Earl Howe

33: Clause 9, page 8, line 36, at end insert—

“( ) When carrying out a needs assessment, a local authority must also consider—

(a) whether, and if so to what extent, matters other than the provision of care and support could contribute to the achievement of the outcomes that the adult wishes to achieve in day-to-day life, and

(b) whether the adult would benefit from the provision of anything under section 2 or 4 or of anything which might be available in the community.”

Amendment 33 agreed.

Clause 10: Assessment of a carer's needs for support

Amendments 34 and 35 not moved.

Amendments 36 and 37

Moved by Earl Howe

36: Clause 10, page 9, line 21, leave out paragraph (f)

37: Clause 10, page 9, line 31, at end insert—

“( ) When carrying out a carer’s assessment, a local authority must also consider—

(a) whether, and if so to what extent, matters other than the provision of support could contribute to the achievement of the outcomes that the carer wishes to achieve in day-to-day life, and

(b) whether the carer would benefit from the provision of anything under section 2 or 4 or of anything which might be available in the community.”

Amendments 36 and 37 agreed.

Amendment 38 not moved.

Clause 12: Assessments under sections 9 and 10: further provision

Amendments 39 and 40

Moved by Earl Howe

39: Clause 12, page 10, line 39, leave out from “which” to “jointly” in line 40 and insert “the assessment may or must be carried out by a person (whether or not an officer of the authority) who has expertise in a specified matter or is of such other description as is specified,”

40: Clause 12, page 10, line 46, after “matter” insert “or is of such other description as is specified”

Amendments 39 and 40 agreed.

Amendment 41 not moved.

Amendments 42 to 44

Moved by Earl Howe

42: Clause 12, page 11, line 23, leave out subsection (5) and insert—

“(5) A local authority may combine a needs or carer’s assessment with an assessment it is carrying out (whether or not under this Part) in relation to another person only if the adult to whom the needs or carer’s assessment relates agrees and—

(a) where the combination would include an assessment relating to another adult, that other adult agrees;

(b) where the combination would include an assessment relating to a child (including a young carer), the consent condition is met in relation to the child.

(5A) The consent condition is met in relation to a child if—

(a) the child has capacity or is competent to agree to the assessments being combined and does so agree, or

(b) the child lacks capacity or is not competent so to agree but the local authority is satisfied that combining the assessments would be in the child’s best interests.”

43: Clause 12, page 11, line 26, leave out from “in” to “, the” in line 27 and insert “relation to the adult to whom the assessment relates or in relation to a relevant person”

44: Clause 12, page 11, line 37, at end insert—

“( ) A person is a “relevant person”, in relation to a needs or carer’s assessment, if it would be reasonable to combine an assessment relating to that person with the needs or carer’s assessment (as mentioned in subsection (5)).”

Amendments 42 to 44 agreed.

Clause 13: The eligibility criteria

Amendment 45

Moved by Earl Howe

45: Clause 13, page 12, line 1, leave out paragraph (b)

Amendment 45 agreed.

Clause 14: Power of local authority to charge

Amendments 46 to 48 not moved.

Amendment 49

Moved by Earl Howe

49: Clause 14, page 13, line 13, at end insert “; and the regulations may in particular (in reliance on section 112(6)) specify—

(a) different amounts for different descriptions of care and support;

(b) different amounts for different descriptions of support.”