Personal Care at Home Bill

My Lords, in replying to Amendments 3 and 39 in the names of the noble Baroness, Lady Masham, and the noble Earl, Lord Howe, I start by thanking the noble Baroness, Lady Barker, for her helpful explanation of the issues on which one might appeal. We recognise that clarity and transparency are important here. That is why we are putting a great deal of emphasis on developing what the department calls a national tool—I know that the noble Lord, Lord Tebbit, will cringe when I use that expression, but he knows what I mean—that all councils should use to assess people with the highest personal care needs to ensure a consistent approach. Therefore, people who are unhappy about their assessment, about the package of reablement or about the package of care should have the right to make a complaint to the council in the usual fashion. It is right that people should be able to pursue a challenge if they feel that the wrong decision has been taken. The noble Lord, Lord Tebbit, and the noble Baroness, Lady Gardner, highlighted why we will be asking the noble Baroness, Lady Masham, to withdraw her amendment. We do not wish to create a separate and potentially bureaucratic layer to deal with this on top of the existing complaints system. People already have an opportunity to pursue their case, if necessary as far as the Local Government Ombudsman. This House has discussed the work of the Local Government Ombudsman on previous occasions and noble Lords have remarked how effective and accessible the ombudsman has been and is. We are reluctant to create another mechanism over and above that, as that would add to the costs and the administrative burden placed on councils and it might create confusion for users. The noble Baronesses, Lady Masham and Lady Gardner, raised the issue of people being able to choose whether to stay at home or move into residential care. The purpose of the Bill is not to remove choice. We recognise that some people will choose to enter residential care—we will discuss the issue later in Committee. However, we are also encouraging local authorities to work with, for example, the voluntary sector to encourage the development of wider community services for older people who are lonely. Here the noble Baroness made an important point. She also asked whether it would be possible for the Care Standards Tribunal to deal with these appeals. I have already addressed that. The appropriate appeals system is already recognised in this area. The noble Baroness, Lady Gardner, and the noble Lord, Lord Lipsey, raised the issue of the incentive for people to stay at home because it is free when a residential setting may be more appropriate. The decision about the appropriate care setting for people should be made first based on the person’s needs and whether they have carers who can help with some of them. The Bill will give people a breathing space sometimes to stay at home for longer, rather than going into residential care. Amendments 3 and 39 would require the Secretary of State to make regulations to establish a specific appeals mechanism for those who believe that they are entitled to indefinite provision of a free qualifying service but have been denied it by their local authority. I have explained why that is not an appropriate route to go down. As the noble Lord, Lord Sutherland, said, it is important that decisions on free personal care are as fair and transparent as possible. People who believe that they have not been treated fairly and that the criteria have not been applied fairly should have the right to challenge the local authority’s decision. Refusals to provide free personal care that are felt to have been wrongly determined should be dealt with under the existing procedures. We intend that this area should be considered as part of the review policy within 12 to 18 months of implementation. Several noble Lords asked whether the system would be overburdened by appeals. As part of the review that will take place within 12 to 18 months of implementation, the issue of whether the appeals procedure is appropriate and working will be considered. I hope that the noble Baroness will accept that, while it is entirely right that people should be able to appeal and that the appeals system should be accessible, we should not create a new system on top of that which already exists.