UK Parliament / Open data

Personal Care at Home Bill

My Lords, I am replying to Amendments 2 and 4, tabled by the noble Lord, Lord Low, and the noble Earl, Lord Howe. It is appropriate that we should be discussing now, right at the beginning of the Bill, the importance of the involvement of users and carers in determining care needs. These are entirely appropriate amendments, each addressing slightly different aspects of this area. However, I think that we all agree how important it is that an individual should be involved in determining how their own care needs can best be met, by being involved in the assessment and decision-making processes. That is the whole ethos of the transformation agenda in Putting People First. The excellent work going on in councils such as Manchester, Trafford, Oldham, Essex and others demonstrates the value of life-changing projects which ensure that people who need care are involved in shaping it. I am not claiming that this happens everywhere, but we know that there is very good practice that needs to be spread throughout the country. Our aim is to put people in the driving seat to enable them to be in control of their own lives, as explained by my noble friend Lady Wilkins. It is important to say that there may be situations where a person has the onset of a degenerative or other neurological condition, as pointed out by the noble Baroness, Lady Gardner, and it is no longer possible for them to determine what is best for them. In these situations, others must be entrusted to make the right decisions. In doing so, they have to be mindful of the provisions of the Mental Capacity Act and seek to do this in a way that is not only in the person’s best interest but follows as much as is possible what the person would have wished for themselves. This House has discussed that Act on many occasions. We will continue to encourage councils and to champion those which do good work with their user organisations. We do not believe that we need to insert new provisions into the Bill to do so, because we already have directions made under the National Health Service and Community Care Act 1990 that support user involvement in care planning. These directions already place a statutory requirement on local authorities to ensure that people receiving care services have appropriate input into determining their care. The noble Lord, Lord Low, rightly said that his amendments refer to the users of services being involved in those decisions. The problem is that they conflate the functions with which the regulations will be concerned, which concern the eligibility for free personal care, and the functions relating to the delivery of free personal care themselves, which is not something with which the regulation power of Section 15 is concerned. However, it is right that people receiving care are involved in the development of their care plans, which is a key element of the principle of personalisation that we have already begun to develop over the past two years. We have been working to transform adult social care. I therefore say to the noble Earl that it is entirely consistent with the approach of personalisation. The Bill will be setting through the regulations, when they are made, an entitlement to free personal care. People will then receive a personal budget that can be spent flexibly with their carer to meet their needs, and guidance will make that clear. Several noble Lords have said that they agree with the principle of this—as do the Government. We think that the regulatory framework is there. However, we believe that what the noble Lord, Lord Low, is proposing would be covered in guidance. We would be very happy to re-emphasise this in guidance and to discuss it with the noble Lord and others as the guidance is developed. Finally, I understand from the noble Lord’s remarks that he was concerned that user involvement in this way might result in some people being pushed above the threshold of certain benefits if they receive a small payment for their involvement. I can assure him that that would not be the case. This is not a scheme that will involve payments for user involvement. I therefore ask the noble Lord, with those assurances, to withdraw the amendment.
Type
Proceeding contribution
Reference
717 c820-1 
Session
2009-10
Chamber / Committee
House of Lords chamber
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