I apologise for not having read the hon. Gentleman’s new clause. I have been focusing on my own new clauses and amendments, but I will look at his new clause at a later stage.
Amendments 31 to 33 would establish firm time scales for assessments and reviews of service users’ care needs. During the Bill’s passage so far, the Opposition have repeatedly tried to raise the issue of the funding gap in adult social care, which threatens some of the positive changes that the Bill would bring about. In my constituency, our local authority has been forced to make £24.3 million-worth of savings, with predictable consequences. One of the consequences for local authorities has been a decline in the regularity of assessments and reviews. I have spoken to people whose assessments have been grossly delayed; I have also visited care homes in which some residents have not been reviewed for up to three years, during which time their needs may have changed dramatically and their support may have become inadequate.
It is easy to understand how that happens. Under-resourced departments must set priorities, and routine steps such as the reviewing of someone’s care plan are often at the bottom of the list because there is no pressure for them to be taken in a timely way. However, those steps are very important, because they identify changes in a person’s condition which, if ignored, might lead them to a crisis point. The amendments would reverse a worrying trend which has seen delayed assessments rise significantly since 2010, when 18.7% of new clients waited four weeks or more for an assessment. By 2011-12, the latest year for which figures are available, the figure had risen to 22.7%. In some individual local authorities, the change is even more worrying. In one authority, the number of new clients waiting to be assessed jumped from 12.6% to 70.7% between 2010 and 2012. It is important to remember that those are not just percentages, but represent vulnerable people whose needs are not being met.
In Committee, the Minister said that he was concerned about assessments being rushed to meet the timetable, and that a simplistic time scale would not be tailored to meet individual needs. I agree that that is of concern, but it should not be necessary for the time scale drawn up by the Secretary of State to be a “one size fits all”. The timetable for more complex cases could take into account the more complex nature of the assessment and allow more time for completion. It would be much more dangerous to have no benchmark at all and for those people to have their assessments delayed and their needs not met. The amendments would improve the situation for people with more complex needs, for whom putting support in place quickly is most important.
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The Minister made two points on reviews: that a “regular” review would be too rigid and would impose an arbitrary time scale on clients whose needs might be very different from each other; and that clause 27’s introduction of a right to review on “reasonable request” would guard against the problem of clients going unreviewed for long periods. I do not believe that a timetable would need to be so rigid. As with assessments, the timetable would not need to be identical for all patients regardless of need. During the consultation, the severity of individual conditions could easily be addressed, as could other factors such as age, to ensure that local authorities use their time most effectively. A properly formulated time scale would not have the disadvantage of inflexibility that the Minister suggests. I hope he will agree that only through legislation can we really motivate local authorities to conduct a review in a timely manner.
On the Minister’s second point, I agree that a right of request is a step forward, but I worry that it does not address all, or even the majority of cases. Many of the people we are talking about live alone, or have issues with mobility or communication. They do not have a family member or other permanent carer to be an advocate on their behalf. Establishing a firm timetable would ensure that those people are not overlooked.
The Minister said in Committee that the Government would produce indicative time scales for support plans and reviews. Although that is helpful and shows that the Government recognise the problem, I do not think that indicators will provide enough motivation for local
authorities to get on top of the issue. As I have explained, a measure already exists to show how quickly initial assessments are conducted. A measure also exists for reviews to be proportionate, but neither has stopped the gradual slide in performance of recent years. Informal measures simply do not carry much weight.