Clause 27 - Review of care and support plan or of support plan

Part of Care Bill [Lords] – in a Public Bill Committee at 4:00 pm on 16 January 2014.

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Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health 4:00, 16 January 2014

On the hon. Lady’s final point, I agree that the whole objective should be to help a person improve their mobility and well-being; that is at the heart of the Bill. We all need to be focused on improving well-being.

One of the things that I feel strongly about is the need to improve how commissioning works by providing incentives to providers to improve well-being. We have amended the Bill through clause 5(4) to require local authorities to focus on well-being when they are commissioning services.

We know that if the right things are done, we can often reduce someone’s dependency. There is a role for the voluntary sector, friends and neighbours to help as well, tackling the awful consequences of loneliness. That can have a massive impact on reducing loneliness. Therefore I am very much with the hon. Lady, and I share the view that a follow-up assessment makes absolute sense if we can identify reduced need.

The points of the hon. Member for South Shields were, on the whole, well made. Right at the end, she introduced a sour note, which I thought was misplaced. The whole tone of our discussions has been about valuable reforms, which I think most people are behind. We are trying to achieve something that has been widely supported. The sense that the Bill sends a message about what this Government think of people introduces an unfortunate tone, which has been missing from the discussion until now. I gently chide her in that regard.

The local case described by the hon. Lady, about someone who has been waiting three years for a review, is absolutely shocking. I hope that she is taking her own local authority to task for that complete failure of care and support for that individual, who is clearly a vulnerable person. Failures can occur all over the system, and we should be indiscriminate in being unwilling to accept them where they occur.

Amendment 114 would require care plans to be reviewed regularly. Taken in conjunction with the related amendment 115, which would provide for regulations to specify a time frame for the regular review of care plans, the effect would be to establish a review period that local authorities must adhere to. Clause 27, which deals with the review of care plans, creates a general duty to keep plans under review and a specific duty to review a care plan whenever the adult concerned requests it. The clause introduces a right to a review if a reasonable request for one has been made, which should help in cases such as that of the hon. Lady’s constituent who has been requesting a review and not making any progress.

The clause also requires the local authority to revise the care plan and carry out fresh assessments whenever it believes that an individual’s needs or circumstances have changed. We believe that to be a more pragmatic way of fitting reviews around people’s lives. It supports our policy of personalised care, because it bases the decision to review on an individual’s needs, not on an arbitrary time scale. A regular review would imply only that the frequency of a review was consistent over time; it would not necessarily mean that the frequency was right or that the review took place at the most appropriate time for an individual. Our proposal to keep the plan “under review generally” would ensure that it was monitored constantly, and steps could be taken to change it as required.

Local authorities must act reasonably in the discharge of their duties, including those in relation to care and support planning and reviews. It would not be reasonable to delay or extend that process, as in the case of the hon. Lady’s constituent, beyond what is appropriate in an individual case. We will set out in guidance best practice  for conducting care and support plans and reviews, and we will work with social care partners to include indicative time scales for care plans. I hope that that might help the hon. Lady. For the reasons that I have given, we intend to refrain from specifying and prescribing time scales. I hope that on that basis, she will agree to withdraw the amendment.