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Lord Laming: I, too, support Amendment No. 44. I regret that I did not think of this earlier because I should like to go a little further. It seems to me that it is extremely important that relatives are informed when such events take place. Very often relatives need to be involved in placing residents in alternative establishments. It would be terrible if homes were to be closed and health authorities were not informed and they, in turn, did not inform the relatives. Therefore, I hope that the Government will feel able to strengthen that provision.
Lord Hunt of Kings Heath: I shall respond first to Amendment No. 40. We do not consider it appropriate to require the national care standards commission to publish the applications from all establishments and agencies seeking registration. Where applications, for example, to establish a care home require planning permission from the local authority, those applications are publicly available.
Amendment No. 42 requires the registering authority to take account of the ground for any prior refusals or cancellations of registrations when considering an application. It will clearly be vital that the registration authority takes account of any prior instances of refusals or cancellations of registrations when considering new applications. That will be part of routine operating practice. However, in our view, Clause 11 does not require amendment as proposed by the noble Lord to secure that that happens.
I fully agree with the intent behind Amendment No. 43 that the new commission should aim to ensure that registered services are kept in business through meeting required standards. Perhaps I may say in answer to the noble Earl that inspectors will be directed to use a system of formal written warnings giving proprietors of care homes and other registered services every opportunity to come up to scratch wherever possible and when life and limb are not at stake.
That system will be set out in directions to the commission under Clause 6(2) and is not needed on the face of the Bill. In the event that cancellation procedures are considered necessary by the registration authority, the tribunal will provide independent scrutiny of the steps taken to ensure compliance.
It is right to say that it is the responsibility of registered persons to maintain services at the required level, not that of the registration authority, although I take the points which the noble Earl raised.
I turn now to Amendment No. 44. Members of the Committee have pointed out an inconsistency in the way in which a local authority is treated compared with the treatment of a health authority. I always note the comments of the NHS Confederation and the view it puts forward. On reflection, I prefer to take away the amendment, think about it and perhaps return with an amendment on Report because I believe that a very valid point has been raised.
I confess that the noble Earl lost me when he talked about the differences between recorded delivery and registered delivery. My understanding was that the point that he raised had been met adequately as both registered post and recorded delivery require the signature of the recipient to prove delivery. That was certainly deemed to be sufficient under subsection (1) of Section 54 of the Registered Homes Act 1984. Although the noble Earl raised a particular case, I am not aware that that has caused problems in relation to the operation of the Registered Homes Act 1984. Perhaps he can enlighten me on that.
Earl Howe : I am afraid I cannot produce any examples of where the provisions of the Registered Homes Act have failed in that respect. I had understood that there was a crucial difference between recorded delivery and registered post. Registered post guarantees delivery, whereas recorded delivery does not. It is merely a service that involves the signature of the recipient being provided to the postman or postwoman to acknowledge the fact that the postman or postwoman has done his or her job. If necessary, the sender of the letter can thereby obtain confirmation that the letter has been delivered. There is no comeback and no redress against the Post Office and I do not believe that the system provides as much proof against error as registered post. However, I take note of what the Minister said.
Perhaps the Minister can amplify something else that he helpfully indicated in his earlier reply about the commission and the way in which it will seek to ensure that an establishment that has not fulfilled all the requirements that it ought to can be brought back into line. Clearly, some offences will warrant a harsher response from the commission than others which are relatively trivial. Perhaps it is too early for the Minister to say, although it would be interesting to know, what the commission's policy is likely to be and how proactive it can be in assisting establishments to put their houses in order, so to speak.
Lord Hunt of Kings Heath: That is a helpful intervention by the noble Earl. I am sure that he knows more about the postal services than I do. No doubt, we shall have other opportunities to discuss this crucial matter during the passage of the Bill through the House.
The noble Earl also raised a much more substantive point about the way in which the commission will conduct its business. Perhaps I can reiterate that in situations where the residents of a particular establishment are at risk because the standards in one way or another are so bad, clearly it is right that the commission should be enabled to take action forthwith. In terms of taking action leading to the cancellation of registration, the commission can ask a justice of the peace to issue an emergency order to cancel registration or vary or impose a condition of registration. If the situation has not reached that level of seriousness, the inspectors can be directed to use a system of formal written warnings. In that case, proprietors of care homes and other registered services are given opportunities to sort out the problems that have been so identified.
The word "proportionality" comes to mind in relation to how the commission will deal with those matters in the future. We will talk later about the amendments to Schedule 1, but the quality of leadership within the commission and the members appointed to the board will be crucial in setting within the regulatory framework and any directions given by the Secretary of State the right kind of judgments to enable us to have a tough regulatory regime but, equally, one which is fair to the establishments. There must be a sense of proportionality in dealing with problems ranging from minor ones which can be dealt with quickly to major ones which have to be dealt with through urgent action.
Lord Clement-Jones: And gratitude comes from many in this House for that reply. I thank the Minister also for his reply to Amendment No. 44. I shall take care to ensure that all my amendments are supported by the NHS Confederation in the future.
Lord Rix: My heart is not in this amendment; I am inclined to sympathise with the Government. Planning permission has been posted outside my house three times in the past seven years saying that I was going to make a large extension. My house is numbered eight; the permission was being sought for numbers 10, three and four. I am aware therefore that mistakes can take place.
Also, our local paper is of such a standard that it goes into the recycling bin immediately it comes through the door, along with a lot of other junk mail. I feel therefore that local papers are not perhaps the best medium for disseminating the fact that registration is taking place. There may be other methods and perhaps I can return to this later. However, at this time of night, and with my doubts, I beg leave to withdraw the amendment.
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