Personal Care at Home Bill

I take this opportunity to recognise the key role played by carers in supporting family networks with health and social care needs. The National Carers Strategy includes a 10-year vision for carers, a commitment to move carers’ issues to the "centre of family policy", and to reflect this by promoting the concept of whole family care planning following separate assessment. Undertaking effective carers’ assessments is a key part of making this a reality. But while we will continue to rely on carers to contribute to the wider package of care, we do not want to place unreasonable caring burdens on them. The planned White Paper is addressing longer-term issues, and it may have future implications for the way that social care is delivered. However, given that any fundamental system reform is unlikely to take place for some time, we have recently consulted on revised FACS guidance which will be published shortly in recognition that more immediate action can be taken to improve the current system. Compared with the previous guidance, the new FACS guidance will address the key role that carers can play in meeting people’s care needs and how their needs can be addressed at the same time if they are to continue in their caring role. In determining an individual’s eligibility for care, account will be taken of the input that the carer is able and willing to make. In that sense, it will not be "carer blind", nor should it be, but this will help to establish whether someone is in the highest band for help with social care—FACS critical. For those with critical needs, the assessment for personal care will be based on activities of daily living and that will be carer blind, focusing only on what the individual themselves can or cannot do. That might be the opposite way around from how it was related by the noble Earl. I think I will check on that, but the Box tells me that that is what this says. A practice guide and online learning tools for FACS are being developed by the Social Care Institute for Excellence to help frontline staff and their managers apply the criteria in a more consistent way. These will be available in early April. In relation to Amendment 18, I wish to stress that it is important that we properly reflect the role of carers, as outlined by my noble friend Lady Pitkeathley. At this point, I wish to pay tribute to the work that unpaid carers are doing up and down the country day in and day out. It is also important, as the noble Baroness, Lady Barker, pointed out, that we make sure when undertaking assessments that the role of a carer is not taken into account inappropriately. So, for example, when undertaking assessments, professionals should seek to establish whether a person can carry out a particular task such as washing or bathing, and that they are assessed on their own ability to do that, not the ability of the carer to assist them. Taking into account a carer’s role to a greater extent could inadvertently affect the outcome of the assessment for eligibility for free personal care. However, while I recognise the sentiment expressed in this amendment, we are committed to addressing this issue in statutory guidance. I therefore do not consider it necessary to have this on the face of the Bill, although clearly we will need to discuss the issue further as the guidance unfolds. I turn to the point raised by the noble Baroness about "qualifying services". Section 15 defines qualifying services as a range of services provided under community care legislation. This amendment would seek to extend the range of services provided free to any services needed by a person in receipt of personal care, not just services to meet their personal care needs. This would be uncertain and beyond the policy, which is limited to personal care for those in the highest need. Amendment 22 aims to ensure that regulations may specify the extent to which a carer’s practical assistance can be taken into account when determining an individual’s eligibility for free personal care. We will be setting out the assessment process for deciding whether or not an individual is eligible for free personal care in statutory guidance and, as I have said, we will also be providing local authorities with a national assessment tool to help them make this judgment. The revised FACS guidance sets out how local authorities should take into account the practical support of a carer when they are carrying out a community care assessment and judging which FACS band an individual sits within, based on their level of risk. The additional assessment of personal care needs which will determine eligibility based on requiring significant help or prompting to carry out four or more of the activities of daily living will, as I have already said, be carer blind. Finally, I note that Amendment 41 is consequential on the other amendments tabled by the noble Earl, Lord Howe, and the noble Baroness, Lady Morris of Bolton, which use the term "carer", and is only necessary if these amendments are passed. In itself, the proposed definition of "carer"—that which is set out in the Carers and Disabled Children Act 2000—is unobjectionable. However, since those amendments to which Amendment 41 is consequential are being resisted, this amendment should also be resisted; I ask the noble Earl to withdraw it.