Personal Care at Home Bill

My Lords, my understanding of the amendment is the same as that of the noble Lord, Lord Lipsey. It is confusing because the Bill is presented to us in a rather piecemeal form and one has to fit the jigsaw pieces together. The Government are saying to us, I think, "Those living in residential care will not get their personal care free, but by residential care, we don’t mean extra care". I think that that is how it fits together. Much has already been said very well by other noble Lords and I shall not take the time of the Committee in repeating it. However, I return to the theme of gaming, which was raised by the noble Lord, Lord Lipsey, the noble Baroness, Lady Murphy, and, in her own way—very ably—by the noble Baroness, Lady Barker. I share her view that precision in language and terminology is of the utmost importance in this Bill. I set aside whether the exclusion from the Bill of those living in residential care amounts to unfair discrimination—we shall come that question later when we discuss the European Convention. What troubles me is the word that the Government have chosen in subsection (2). I should like to hear the Minister explain what will stop a care home operator who currently provides residential care by way of a single contract dividing himself into two or more legal entities such that the contract from one legal entity, which relates to the residential accommodation, is separate from the contract from the other legal entity, which relates to the care services. In that situation, as the noble Baroness rightly indicated, there would in law be two providers operating side by side, one the equivalent of a hotel, the other the equivalent of a domiciliary care service. In those circumstances, what will prevent the recipient of those services claiming eligibility for free personal care? The Government’s answer, as I understand it, has been that the potential loophole will in practice be closed off by the Care Quality Commission and the registration system that will be put in place. I need the Minister to explain to me what that answer means, because I do not understand how the CQC will be in a position to influence the situation one way or the other. We may well end up with a market that is very distorted, with large numbers of care providers reconstituting their services in a different legal form that distinguishes accommodation from care. As the noble Baroness, Lady Murphy, said, that after all is what extra care amounts to. We have heard that someone living in extra-care accommodation will be treated as living in their own home for the purposes of this legislation. In practice, the effect is little or no different from care delivered in a residential setting. The legal dividing line which the Bill seeks to establish will in practice be unsustainable.