Care Bill [HL]

Amendments
to be moved
ON REPORT

Clause 1

EARL HOWE

 

Page 1, line 8, at end insert—

“( )   personal dignity (including treatment of the individual with
respect);”

 

Page 1 , line 9, leave out “, emotional well-being and personal dignity” and insert
“and emotional well-being”

Clause 3

EARL HOWE

 

Page 4, line 10, at end insert—

“( )   For the purposes of this section, the provision of housing is health-related
provision.

( )   In section 13N of the National Health Service Act 2006 (duty of NHS
Commissioning Board to promote integration), at the end insert—

“(5)   For the purposes of this section, the provision of housing
accommodation is a health-related service.”

( )   In section 14Z1 of that Act (duty of clinical commissioning groups to
promote integration), at the end insert—

“(4)   For the purposes of this section, the provision of housing
accommodation is a health-related service.””

Clause 4

EARL HOWE

 

Page 4, line 22, leave out from “matters” to “, and” in line 24 and insert “relevant to
the meeting of needs for care and support”

 

Page 4, line 28, after “particular” insert “—

( )   have regard to the importance of identifying adults in the
authority’s area who would be likely to benefit from financial
advice on matters relevant to the meeting of needs for care and
support,

( )   ”

 

Page 4, line 32, after “arise” insert “, and

(iii)   to understand the different ways in which they may access
independent financial advice on matters relevant to the
meeting of needs for care and support.”

 

Page 4, line 34, at end insert—

“( )   “Independent financial advice” means financial advice provided by a
person who is independent of the local authority in question.”

BARONESS MEACHER

 

Page 4, line 41, at end insert—

“(6)   Regulations must make further provision in relation to information and
advice; in particular to ensure that information and advice meet the needs
of those for whom they are provided, a local authority must require social
work-qualified staff to provide information and advice in cases where
present or foreseeable needs are classified as complex.”

Clause 5

BARONESS MEACHER

 

Page 5, line 19, at end insert—

“( )   the need to adhere to specific minimum quality standards and
requirements in the commissioning and provision of services to
adults, as regulations may prescribe;”

EARL HOWE

 

Page 5, line 22, at end insert—

“( )   the importance of fostering a workforce whose members are able to
ensure the delivery of high quality services (because, for example,
they have relevant skills and appropriate working conditions).”

BARONESS MEACHER

 

Page 5, line 22, at end insert—

“( )   Regulations made under this section may not normally specify that visits
to deliver personal care in an adult’s home last less than thirty minutes,
excluding travel time.”

EARL HOWE

 

Page 5, line 26, at end insert—

“( )   In arranging for the provision by persons other than it of services for
meeting care and support needs, a local authority must have regard to the
importance of promoting the well-being of adults in its area with needs for
care and support and the well-being of carers in its area.”

Clause 6

EARL HOWE

 

Page 6, line 6, at end insert—

“( )   The following are examples of persons with whom a local authority may
consider it appropriate to co-operate for the purposes of subsection (2)—

(a)   a person who provides services to meet adults’ needs for care and
support, services to meet carers’ needs for support or services,
facilities or resources of the kind referred to in section 2(1);

(b)   a person who provides primary medical services, primary dental
services, primary ophthalmic services, pharmaceutical services or
local pharmaceutical services under the National Health Service
Act 2006;

(c)   a person in whom a hospital in England is vested which is not a
health service hospital as defined by that Act;

(d)   a private registered provider of social housing.”

 

Page 6, line 44, at end insert—

“( )   the Minister of the Crown exercising functions in relation to social
security, employment and training, so far as those functions are
exercisable in relation to England;”

Clause 9

EARL HOWE

 

Page 8, line 27, leave out paragraph (d)

 

Page 8, line 36, at end insert—

“( )   When carrying out a needs assessment, a local authority must also
consider—

(a)   whether, and if so to what extent, matters other than the provision
of care and support could contribute to the achievement of the
outcomes that the adult wishes to achieve in day-to-day life, and

(b)   whether the adult would benefit from the provision of anything
under section 2 or 4 or of anything which might be available in the
community.”

Clause 10

BARONESS TYLER OF ENFIELD

 

Page 9, line 4, after “adult” insert “or young person”

EARL HOWE

 

Page 9, line 21, leave out paragraph (f)

 

Page 9, line 31, at end insert—

“( )   When carrying out a carer’s assessment, a local authority must also
consider—

(a)   whether, and if so to what extent, matters other than the provision
of support could contribute to the achievement of the outcomes that
the carer wishes to achieve in day-to-day life, and

(b)   whether the carer would benefit from the provision of anything
under section 2 or 4 or of anything which might be available in the
community.”

After Clause 10

BARONESS BARKER

 

Insert the following new Clause—

“Duty to provide independent advocacy

(1)   A local authority has a duty to provide an independent advocate to assist
any qualifying adult under this Act for the purposes of assessment,
supporting planning and/or review processes, or both.

(2)   An adult is a qualifying adult if—

(a)   the adult’s needs for care and support are being assessed under
section 9 or a care and support plan is being prepared for the adult
under section 25 or a review of the adult’s needs is conducted under
section 27, and

(b)   the local authority considers that without the assistance of an
advocate the adult will experience substantial difficulty in relation
to one or more of the following—

(i)   understanding, retaining, using or weighing the
information relevant to the process of assessment, care and
support planning or review;

(ii)   expressing or communicating their own views or wishes
and feelings;

(c)   the adult is an individual to whom section 11(2)(a) or 11(2)(b) of the
Act applies (refusal of assessment where an adult lacks capacity or
is experiencing, or is at risk of, abuse or neglect), or

(d)   the adult is a carer for whom the local authority is undertaking a
carers assessment in accordance with section 10(1) and the local
authority considers that without the assistance of an advocate the
carer will experience substantial difficulty in relation to one or more
of the following—

(i)   understanding, retaining, using or weighing the
information relevant to the process of assessment, support
planning or review;

(ii)   expressing or communicating their own views or wishes
and feelings.

(3)   Regulations may be made to—

(a)   the appointment of advocates;

(b)   the skills or qualifications of advocates;

(c)   the duties of advocates;

(d)   the right of access for advocates to the adult;

(e)   the duty to take account of representations by the advocate on
behalf of the adult;

(f)   the right of access for advocates to the adult’s relevant personal
data including records held by local authorities and health
authorities;

(g)   additional circumstances in which an advocate must be provided.”

Clause 12

EARL HOWE

 

Page 10, line 39, leave out from “which” to “jointly” in line 40 and insert “the
assessment may or must be carried out by a person (whether or not an officer of
the authority) who has expertise in a specified matter or is of such other
description as is specified,”

 

Page 10, line 46, after “matter” insert “or is of such other description as is specified”

BARONESS MEACHER

 

Page 11, line 3, at end insert—

“(h)   specify circumstances in which a person’s social care needs are to
be regarded as complex and stipulate that social work-qualified
staff should always be used in the assessment of complex needs as
defined”

EARL HOWE

 

Page 11, line 23, leave out subsection (5) and insert—

“(5)   A local authority may combine a needs or carer’s assessment with an
assessment it is carrying out (whether or not under this Part) in relation to
another person only if the adult to whom the needs or carer’s assessment
relates agrees and—

(a)   where the combination would include an assessment relating to
another adult, that other adult agrees;

(b)   where the combination would include an assessment relating to a
child (including a young carer), the consent condition is met in
relation to the child.

(5A)   The consent condition is met in relation to a child if—

(a)   the child has capacity or is competent to agree to the assessments
being combined and does so agree, or

(b)   the child lacks capacity or is not competent so to agree but the local
authority is satisfied that combining the assessments would be in
the child’s best interests.”

 

Page 11, line 26, leave out from “in” to “, the” in line 27 and insert “relation to the
adult to whom the assessment relates or in relation to a relevant person”

 

Page 11, line 37, at end insert—

“( )   A person is a “relevant person”, in relation to a needs or carer’s assessment,
if it would be reasonable to combine an assessment relating to that person
with the needs or carer’s assessment (as mentioned in subsection (5)).”

Clause 13

EARL HOWE

 

Page 12, line 1, leave out paragraph (b)

Clause 14

EARL HOWE

 

Page 13, line 13, at end insert “; and the regulations may in particular (in reliance
on section 112(6)) specify—

(a)   different amounts for different descriptions of care and support;

(b)   different amounts for different descriptions of support.”

 

Page 13, line 13, at end insert—

“( )   Regulations under subsection (7) may make provision as to cases or
circumstances in which an adult is to be treated as having income that
would, or as having income that would not, fall below the amount
specified in the regulations if a charge were to be made.”

Clause 17

EARL HOWE

 

Page 15, line 14, leave out “provide that where” and insert “make provision as to
cases or circumstances in which, if”

 

Page 15, line 22, leave out “provide that where” and insert “make provision as to
cases or circumstances in which, if”

 

Page 15, line 38, leave out “financial resources at or” and insert “, or as not having,
financial resources”

 

Page 15, line 38, at end insert—

“( )   The regulations may make provision as to cases or circumstances in which
a local authority is to be treated as—

(a)   having carried out a financial assessment in an adult’s case, and

(b)   being satisfied on that basis that the adult’s financial resources
exceed, or that they do not exceed, the financial limit.”

Clause 19

EARL HOWE

 

Page 17, line 5, at end insert—

“( )   A local authority may meet an adult’s needs under subsection (3) where,
for example, the adult is terminally ill (within the meaning given in section
82(4) of the Welfare Reform Act 2012).”

Clause 24

EARL HOWE

 

Page 21, line 1, leave out subsection (3) and insert—

“(3)   Where a local authority is not going to meet an adult’s needs for care and
support, it must nonetheless prepare an independent personal budget for
the adult (see section 28) if—

(a)   the needs meet the eligibility criteria,

(b)   at least some of the needs are not being met by a carer, and

(c)   the adult is ordinarily resident in the authority’s area or is present
in its area but of no settled residence.”

Clause 25

EARL HOWE

 

Page 22, line 20, leave out subsection (11) and insert—

“(11)   A local authority may combine a care and support plan or a support plan
with a plan (whether or not prepared by it and whether or not under this
Part) relating to another person only if the adult for whom the care and
support plan or the support plan is being prepared agrees and—

(a)   where the combination would include a plan prepared for another
adult, that other adult agrees;

(b)   where the combination would include a plan prepared for a child
(including a young carer), the consent condition is met in relation to
the child.

(11A)   The consent condition is met in relation to a child if—

(a)   the child has capacity or is competent to agree to the plans being
combined and does so agree, or

(b)   the child lacks capacity or is not competent so to agree but the local
authority is satisfied that the combining the plans would be in the
child’s best interests.”

After Clause 41

BARONESS GREENGROSS

 

Insert the following new Clause—

“Power of access for confidential interview

Adult safeguarding access order

(1)   An authorised officer may apply to a court for an order (an adult
safeguarding access order) in relation to a person living in any premises
within a local authority’s area.

(2)   The purposes of an adult safeguarding access order are—

(a)   to enable the authorised officer and any other person
accompanying the officer to speak in private with a person
suspected of being an adult at risk of abuse or neglect,

(b)   to enable the authorised officer to assess the mental capacity of a
person suspected of being an adult at risk of abuse,

(c)   to enable the authorised officer to ascertain whether that person is
making decisions freely, and

(d)   to enable the authorised officer properly to assess whether the
person is an adult at risk of abuse or neglect and to make a decision
as required by section 41(2) on what, if any, action should be taken.

(3)   When an adult safeguarding access order is in force the authorised officer,
a constable and any other specified person accompanying the officer in
accordance with the order, may enter the premises specified in the order for
the purposes set out in subsection (2).

(4)   The court may make an adult safeguarding access order if satisfied that—

(a)   the authorised offcer has reasonable cause to suspect that a person
is an adult who is experiencing or at risk of abuse or neglect,

(b)   it is necessary for the authorised officer to gain access to the person
in order to make whatever enquiries thought necessary and to
make a decision as required by section 41(2) on what, if any, action
should be taken,

(c)   exercising the power of access conferred by the order will not result
in the person being at greater risk of abuse or neglect.

(5)   An adult safeguarding access order must—

(a)   specify the premises to which it relates,

(b)   provide that the authorised officer may be accompanied by a
constable,

(c)   specify the period for which the order is to be in force.

(6)   Other conditions may be attached to an adult safeguarding access order,
for example—

(a)   specifying restrictions on the time that the power of access
conferred by the order may be exercised,

(b)   providing for the authorised officer to be accompanied by another
specified person,

(c)   requiring notice of the order to be given to the occupier of the
premises and to the person suspected of being an adult at risk of
abuse.

(7)   A constable accompanying the authorised officer may use reasonable force
if necessary in order to fulfil the purposes of an adult safeguarding access
order set out in subsection (2).

(8)   On entering the premises in accordance with an adult safeguarding access
order the authorised officer must—

(a)   state the object of the visit,

(b)   produce evidence of the authorisation to enter the premises, and

(c)   provide an explanation to the occupier of the premises of how to
complain about how the power of access has been exercised.

(9)   In this section “an authorised officer” means a person authorised by a local
authority for the purposes of this section, but regulations may set
restrictions on the persons or categories of persons who may be
authorised.”

 

Insert the following new Clause—

“Duty to report adults at risk of abuse

(1)   If a relevant partner of a local authority has reasonable cause to suspect that
the local authority would be under a duty to make enquiries under section
41, it must inform the local authority of that fact.

(2)   If the person that the relevant partner has reasonable cause to suspect
would be the subject of enquiries under section 41 and appears to be within
the area of a local authority other than the one of which it is a relevant
partner, it must inform that other local authority.

(3)   If a local authority has reasonable cause to suspect that a person within its
area at any time would be the subject of enquiries under section 41 and is
living or proposing to live in the area of another local authority (including
a local authority in Wales, Scotland or Northern Ireland), it must inform
that other local authority.

(4)   In this section “relevant partner”, in relation to a local authority, means—

(a)   the local policing body and the chief officer of police for a police
area any part of which falls within the area of the local authority,

(b)   any other local authority with which the authority agrees that it
would be appropriate to co-operate under this section,

(c)   any provider of probation services that is required by arrangements
under section 3(2) of the Offender Management Act 2007 to act as a
relevant partner of the authority,

(d)   any provider of regulated activities as listed in Schedule 1 of the
Health and Social Care Act 2008 (Regulated Activities) Regulation
2010,

(e)   a local health board for an area any part of which falls within the
area of the authority,

(f)   an NHS Trust providing services in the area of the authority,

(g)   any other such person, or a person of such description, as
regulations may specify.”

 

Insert the following new Clause—

“Neglecting or ill-treating an adult at risk of abuse

Any person who knowingly causes or permits an adult to suffer, or inflicts
physical pain or mental suffering upon an adult who has care and support
needs, or having the care or custody of that adult, knowingly causes or
permits the person or health of that adult to be injured, including through
the neglect of their care and support or health needs, or knowingly causes
or permits that person to be placed in a situation that endangers his or her
person or health, is liable—

(a)   on summary conviction, to imprisonment for term not exceeding 12
months or a fine not exceeding the statutory maximum or both;

(b)   on conviction on indictment, to imprisonment for a term not
exceeding 5 years or a fine or both.”

Schedule 2

BARONESS GREENGROSS

 

Page 104, line 21, at end insert—

“(e)   staff, from the establishing local authority, qualified in social
work”

EARL HOWE

 

Page 105, line 34, at end insert—

“( )   what it has done during that year to implement the findings of
reviews arranged by it under that section, and

( )   where it decides during that year not to implement a finding of a
review arranged by it under that section, the reasons for its
decision.”

Clause 44

BARONESS GREENGROSS

 

Page 36, line 35, at end insert—

“( )   A SAB is required to appoint a social work-qualified individual to
supervise the carrying out of a review as stated.”

Clause 58

EARL HOWE

 

Page 47, line 5, leave out from “Where” to “after” in line 7 and insert “it appears to
a local authority that a child is likely to have needs for care and support”

 

Page 47, line 8, leave out “may” and insert “must”

 

Page 47, line 16, leave out subsection (3)

 

Page 47, line 19, leave out from beginning to “the” in line 20

 

Page 47, line 25, at end insert—

“( )   Where a child refuses a child’s needs assessment and the consent condition
is accordingly not met, the local authority must nonetheless carry out the
assessment if the child is experiencing, or is at risk of, abuse or neglect.”

 

Page 47, line 26, leave out from beginning to “must” and insert “Where a local
authority, having received a request to carry out a child’s assessment from the
child concerned or a parent or carer of the child, decides not to comply with the
request, it”

Clause 59

EARL HOWE

 

Page 48, line 6, leave out paragraph (d)

 

Page 48, line 14, at end insert—

“( )   When carrying out a child’s needs assessment, a local authority must also
consider whether, and if so to what extent, matters other than the provision
of care and support could contribute to the achievement of the outcomes
that the child wishes to achieve in day-to-day life.”

 

Page 48, leave out line 16 and insert “child”

 

Page 48, line 24, at end insert—

“( )   But in a case where the child is not competent or lacks capacity to
understand the things which the local authority is required to give under
subsection (3), that subsection is to have effect as if for “must give the child”
there were substituted “must give the child’s parents”.”

Clause 60

EARL HOWE

 

Page 48, line 38, leave out from “Where” to “after” in line 40 and insert “it appears
to a local authority that a carer of a child is likely to have needs for support”

 

Page 49, line 1, leave out subsection (2)

 

Page 49, line 10, leave out “or (2)”

 

Page 49, line 11, at end insert—

“(3A)    Where a child’s carer refuses a child’s carer’s assessment, the local
authority is not required to carry out the assessment (and subsection (1)
does not apply in the carer’s case).

(3B)   Where, having refused a child’s carer’s assessment, a child’s carer requests
the assessment, subsection (1) applies in the carer’s case (and subsection
(3A) does not).

(3C)   Where a child’s carer has refused a child’s carer’s assessment and the local
authority concerned thinks that the carer’s needs or circumstances have
changed, subsection (1) applies in the carer’s case (but subject to further
refusal as mentioned in subsection (3A).”

 

Page 49, leave out lines 12 and 13 and insert “Where a local authority, having
received a request to carry out a child’s carer’s assessment from the carer
concerned, decides not to comply with the request, it must give the carer—”

 

Page 49, line 17, leave out subsection (5)

Clause 61

EARL HOWE

 

Page 50, line 10, leave out paragraph (f)

 

Page 50, line 21, at end insert—

“( )   When carrying out a child’s carer’s assessment, a local authority must also
consider whether, and if so to what extent, matters other than the provision
of support could contribute to the achievement of the outcomes that the
carer wishes to achieve in day-to-day life.”

 

Page 50, leave out line 23 and insert “carer”

Clause 63

EARL HOWE

 

Page 50, line 44, leave out from “Where” to “after” in line 1 on page 51 and insert
“it appears to a local authority that a young carer is likely to have needs for
support”

 

Page 51, line 2, leave out “may” and insert “must”

 

Page 51, line 10, leave out subsection (3)

 

Page 51, leave out line 13

 

Page 51, line 20, at end insert—

“( )   Where a young carer refuses a young carer’s assessment and the consent
condition is accordingly not met, the local authority must nonetheless carry
out the assessment if the young carer is experiencing, or is at risk of, abuse
or neglect.”

 

Page 51, line 21, leave out from beginning to “must” and insert “Where a local
authority, having received a request to carry out a young carer’s assessment from
the young carer concerned or a parent of the young carer, decides not to comply
with the request, it”

Clause 64

EARL HOWE

 

Page 52, line 7, leave out paragraph (f)

 

Page 52, line 14, leave out “whether” and insert “the extent to which”

 

Page 52, line 16, leave out “whether” and insert “the extent to which”

 

Page 52, line 23, at end insert—

“( )   When carrying out a young carer’s assessment, a local authority must also
consider whether, and if so to what extent, matters other than the provision
of support could contribute to the achievement of the outcomes that the
young carer wishes to achieve in day-to-day life.”

 

Page 52, leave out line 25 and insert “young carer”

 

Page 52, line 33, at end insert—

“( )   But in a case where the young carer is not competent or lacks capacity to
understand the things which the local authority is required to give under
subsection (3), that subsection is to have effect as if for “must give the
young carer” there were substituted “must give the young carer’s parents”.

Clause 65

EARL HOWE

 

Page 53, line 6, leave out subsections (2) and (3) and insert—

“(2)   A local authority may combine a child’s needs assessment or young carer’s
assessment with an assessment it is carrying out (whether or not under this
Part) in relation to another person only if the consent condition is met in
relation to the child to whom the child’s needs or young carer’s assessment
relates and—

(a)   where the combination would include an assessment relating to
another child, the consent condition is met in relation to that other
child;

(b)   where the combination would include an assessment relating to an
adult, the adult agrees.

(3)   A local authority may combine a child’s carer’s assessment with an
assessment it is carrying out (whether or not under this Part) in relation to
another person only if the adult to whom the child’s carer’s assessment
relates agrees and—

(a)   where the combination would include an assessment relating to
another adult, that other adult agrees, and

(b)   where the combination would include an assessment relating to a
child, the consent condition is met in relation to that child.

(3A)   The consent condition is met in relation to a child if—

(a)   the child has capacity or is competent to agree to the assessments
being combined and does so agree, or

(b)   the child lacks capacity or is not competent so to agree but the local
authority is satisfied that combining the assessments would be in
the child’s best interests.”

 

Page 53, line 24, leave out from “in” to “, the” in line 25 and insert “relation to the
person to whom the assessment relates or in relation to a relevant person”

 

Page 53, line 30, at end insert—

“( )   A person is a “relevant person”, in relation to a child’s needs, child’s carer’s
or young carer’s assessment, if it would be reasonable to combine an
assessment relating to that person with the child’s needs, child’s carer’s or
young carer’s assessment (as mentioned in subsections (2) and (3)).”

After Clause 66

EARL HOWE

 

Insert the following new Clause—

“Independent advocacy support: involvement in assessments, plans etc.

(1)   This section applies where a local authority is required by a relevant
provision to involve an individual in its exercise of a function.

(2)   The authority must, if the condition in subsection (4) is met, arrange for a
person who is independent of the authority (an “independent advocate”) to
be available to represent and support the individual for the purpose of
facilitating the individual’s involvement; but see subsection (5).

(3)   The relevant provisions are—

(a)   section 9(5)(a) and (b) (carrying out needs assessment);

(b)   section 10(7)(a) (carrying out carer’s assessment);

(c)   section 25(3)(a) and (b) (preparing care and support plan);

(d)   section 25(4)(a) and (b) (preparing support plan);

(e)   section 27(2)(b)(i) and (ii) (revising care and support plan);

(f)   section 27(3)(b)(i) and (ii) (revising support plan);

(g)   section 59(2)(a) and (b) (carrying out child’s needs assessment);

(h)   section 61(3)(a) (carrying out child’s carer’s assessment);

(i)   section 64(3)(a) and (b) (carrying out young carer’s assessment).

(4)   The condition is that the local authority considers that, were an
independent advocate not to be available, the individual would experience
substantial difficulty in doing one or more of the following—

(a)   understanding relevant information;

(b)   retaining that information;

(c)   using or weighing that information as part of the process of being
involved;

(d)   communicating the individual’s views, wishes or feelings (whether
by talking, using sign language or any other means).

(5)   The duty under subsection (2) does not apply if the local authority is
satisfied that there is a person—

(a)   who would be an appropriate person to represent and support the
individual for the purpose of facilitating the individual’s
involvement, and

(b)   who is not engaged in providing care or treatment for the
individual in a professional capacity or for remuneration.

(6)   For the purposes of subsection (5), a person is not to be regarded as an
appropriate person unless—

(a)   where the individual has capacity or is competent to consent to
being represented and supported by that person, the individual
does so consent, or

(b)   where the individual lacks capacity or is not competent so to
consent, the local authority is satisfied that being represented and
supported by that person would be in the individual’s best
interests.

(7)   Regulations may make provision in connection with the making of
arrangements under subsection (2); the regulations may in particular—

(a)   specify requirements that must be met for a person to be
independent for the purposes of subsection (2);

(b)   specify matters to which a local authority must have regard in
deciding whether an individual would experience substantial
difficulty of the kind mentioned in subsection (4);

(c)   specify circumstances in which the exception in subsection (5) does
not apply;

(d)   make provision as to the manner in which independent advocates
are to perform their functions;

(e)   specify circumstances in which, if an assessment under this Part is
combined with an assessment under this Part that relates to another
person, each person may or must be represented and supported by
the same independent advocate or by different independent
advocates;

(f)   provide that an independent advocate may, in such circumstances
or subject to such conditions as may be specified, examine and take
copies of relevant records relating to the individual.

(8)   This section does not restrict the provision that may be made under any
other provision of this Act.

(9)   “Relevant record” means—

(a)   a health record (within the meaning given in section 68 of the Data
Protection Act 1998 (as read with section 69 of that Act)),

(b)   a record of, or held by, a local authority and compiled in connection
with a function under this Part or a social services function (within
the meaning given in section 1A of the Local Authority Social
Services Act 1970),

(c)   a record held by a person registered under Part 2 of the Care
Standards Act 2000 or Chapter 2 of Part 1 of the Health and Social
Care Act 2008, or

(d)   a record of such other description as may be specified in the
regulations.”

 

Insert the following new Clause—

“Independent advocacy support: safeguarding enquiries and reviews

(1)   This section applies where there is to be—

(a)   an enquiry under section 42(2),

(b)   a review under section 44(1) of a case in which condition 2 in section 44(3) is met or a review under section 44(4).

(2)   The relevant local authority must, if the condition in subsection (3) is met,
arrange for a person who is independent of the authority (an “independent
advocate”) to be available to represent and support the adult to whose case
the enquiry or review relates for the purpose of facilitating his or her
involvement in the enquiry or review; but see subsections (4) and (6).

(3)   The condition is that the local authority considers that, were an
independent advocate not to be available, the individual would experience
substantial difficulty in doing one or more of the following—

(a)   understanding relevant information;

(b)   retaining that information;

(c)   using or weighing that information as part of the process of being
involved;

(d)   communicating the individual’s views, wishes or feelings (whether
by talking, using sign language or any other means).

(4)   The duty under subsection (2) does not apply if the local authority is
satisfied that there is a person—

(a)   who would be an appropriate person to represent and support the
adult for the purpose of facilitating the adult’s involvement, and

(b)   who is not engaged in providing care or treatment for the adult in
a professional capacity or for remuneration.

(5)   For the purposes of subsection (4), a person is not to be regarded as an
appropriate person unless—

(a)   where the adult has capacity to consent to being represented and
supported by that person, the adult does so consent, or

(b)   where the adult lacks capacity so to consent, the local authority is
satisfied that being represented and supported by that person
would be in the adult’s best interests.

(6)   If the enquiry or review needs to begin as a matter of urgency, it may do so
even if the authority has not yet been able to comply with the duty under
subsection (2) (and the authority continues to be subject to the duty).

(7)   “Relevant local authority” means—

(a)   in a case within subsection (1)(a), the authority making the enquiry
or causing it to be made;

(b)   in a case within subsection (1)(b), the authority which established
the SAB arranging the review.”

Clause 71

EARL HOWE

 

Page 59, line 35, after “services”” insert “, in relation to a person,”

 

Page 59, line 37, leave out “mental disorder of the person concerned” and insert
“person’s mental disorder”

 

Page 59, line 41, leave out “the” and insert “mental”

Clause 74

EARL HOWE

 

Page 62, line 41, at end insert—

“( )   The Secretary of State must have regard to the general duty of local
authorities under section 1(1) (promotion of individual well-being)—

(a)   in issuing guidance for the purposes of subsection (1);

(b)   in making regulations under this Part.”

After Clause 89

LORD WILLIS OF KNARESBOROUGH

BARONESS EMERTON

 

Insert the following new Clause—

“Mandatory training and certification for health and care support workers and
nursing assistants

(1)   HEE must develop a mandatory training curriculum and certification
standards, with two levels, for health and care support workers who are
delivering direct care to service users and for nursing assistants.

(2)   For the purposes of subsection (1), a health or care support worker shall be
an individual who works in support of health or care professionals and
delivers direct care to service users.

(3)   The training curriculum, under subsection (1), will have—

(a)   a basic level; and

(b)   an advanced level,

of certification in health and care standards.of certification in health and care standards.

(4)   Providers of health or care services must be reponsible for ensuring that all
health and care support workers hold a certificate in health and care
standards.

(5)   Any individual working directly with patients or clients must have
completed training and hold, at least, a basic level certificate in health and
care standards.

(6)   A nursing assistant must have completed training and hold an advanced
level certificate in health and care standards.

(7)   The training curriculum and certification standards set out in subsection (1)
will be set by the Nursing and Midwifery Council and approved by HEE.

(8)   Employers must retain a register of individuals who hold any certificate in
health and care standards.

(9)   It is an offfence for any employer to employ—

(a)   an individual to work directly with patients or clients who is not
registered as holding at least a basic level certificate in health and
care standards; or

(b)   a nursing assistant who is not registered as holding an advanced
level certificate in health and care standards.”

 

Insert the following new Clause—

“Safeguarding patients

(1)   The first duty that a health or care service provider must consider for any
decision is patient safety.

(2)   Health or Care service providers must publish a report containing staffing
levels based on evidence of safe staffing levels supported by acuity and
dependency levels for each patient.

(3)   The report must relate safe staffing levels to patient outcomes and
mortality rates.

(4)   The report must be presented to the hospital management board or any
other relevant board of management.

(5)   The frequency of the report will be determined by the Secretary of State.

(6)   The CQC or Monitor will be able to request to see the report, under
subsection (2) at any time.”

Clause 112

EARL HOWE

 

Page 92, line 25, leave out “or duty”

Prepared 3rd October 2013