Personal Care at Home Bill

My Lords, at Second Reading a number of noble Lords talked about the position of carers, the position of carers in relation to assessment of need and the position of carers in relation to their capacity to implement care plans and the way in which those two factors are often confused by local authority staff carrying out assessments of people’s eligibility for services. This amendment addresses those two critical issues which determine whether or not many people are deemed eligible for free personal care. The first part of this amendment would ensure that somebody who is in need of personal care is fully and properly assessed and is given a choice over the type of service that they may be given. There have been frequent references to Scotland. This is one of the areas on which the noble Lord, Lord Lipsey, and I have more profound differences than we do on many others. The evidence from Scotland—from a Joseph Rowntree Foundation-funded study—is not that carers have abandoned the people they care for; they have not given up caring for their relatives. They have, in a number of cases, changed what they do in order to make sure that life is more bearable for them and for the older people, and I think that that is an entirely right thing to do. This part of the amendment, building on that experience, is absolutely clear that the presence of a carer should not be taken as part of an assumption about somebody’s eligibility. The second part is about qualifying services. At the heart of the Bill is something that we all know to be fundamentally out of step with the way in which many older people and their relatives now think. Their lives are very different from the lives of people when personal care at home was originally conceived. Many more people now work full-time or part-time. The purpose of this part of the amendment is to enable people to be more imaginative in finding services that meet their needs. I was struck by what the noble Baroness, Lady Murphy, said about one particular group of carers: spouses, usually the wives of older men, who do not have any choice about whether they care for their husbands. There is an assumption that they will, even though they might themselves be frail and have a number of health difficulties. Often, those carers can perform personal care tasks but need help with other things to enable them to care for somebody with whom they have spent their lives. Having somebody come and do the washing or the housework once a week enables them to carry on with the task of delivering personal care. Many older people who are cared for do not want personal care to be delivered by a stranger; but in order for that to happen, their carer must be supported. The amendment probes the extent to which, first, a carer's existence is not taken into account as part of the assessment of eligibility; and, secondly, how imaginative and free local authorities can be, working in partnership with service users and carers, in understanding the context in which personal care happens, and what the service needs may be, even though that service need may not be personal care itself but something that allows personal care to be delivered by somebody else. I beg to move.