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Lord Hunt of Kings Heath : I consider that the essential elements of this matter are fully covered by existing legislation and departmental guidance. First, the legislation places an obligation on councils to make arrangements for people assessed to be in need of care who lack the means to finance their admission or lack the capacity to make their own arrangements. That is clearly right and proper; councils must target the most vulnerable residents for support. Secondly, as I said earlier, the departmental guidance reiterates that existing law provides that councils may not, on the grounds of a person's financial resources, refuse to undertake an assessment of care needs for anyone. That is the position under Section 47 of the National Health Service and Community Care Act 1990. In that sense, the position is covered.

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I turn to consider other elements of the amendment. In my opinion, it would be wasteful of councils' scarce resources to ask them to become involved in making arrangements for admission to residential care of all residents, irrespective of their real need for support. I believe that it may distract councils from priority work, and some residents may regard it as a rather intrusive measure on the part of councils into their affairs. In that sense, councils should be able to consider what alternative provision people have available to them.

However, with regard to the question of the responsibility of councils, I repeat that it is quite clear that they may not, on the grounds of financial resources, refuse to undertake an assessment of anyone's care needs.

Baroness Greengross: I thank the Minister for that reassurance. I think that it depends on how the local authority feels. There may be a need for a tightening of the controls at a later stage, and I hope that that will be kept under review. Meanwhile, in the circumstances, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Earl Howe moved Amendment No. 279:


    Page 62, line 4, leave out lines 4 to 6.

The noble Earl said: Clause 60 provides for the Secretary of State to review the amount by which a person's resources can be disregarded by local authorities in determining whether he or she is eligible for support when in residential accommodation. The Explanatory Notes makes it clear that this clause will enable the link with the capital limit of £16,000 to be broken so that more people are able to take up the offer of a charge on their own home to pay for accommodation. As I understand it, it would also facilitate the three-month disregard of someone's property after a stay in hospital. For many people, that very valuable breathing space will be needed to assess whether the residential care in question is to be permanent or long term.

The NHS Plan states that the three-month assessment will,


    "keep open the possibility of returning home after a period of support and rehabilitation, should people be able and wish to do so".

That gives rise to an apparent difficulty, in relation to which I should be grateful for the Minister's clarification. If that section of the NHS Plan is to be interpreted to mean that the first three months in a residential setting are a temporary stay, according to current guidelines, the test for that should be completely different. The guidelines state that residents regarded as temporary are unable to claim income support until their capital falls below £8,000--not £16,000, as for permanent residents. Does that mean that, for practical purposes, the capital limits for temporary and permanent stays are to become the same?

I should be glad if the Minister would clarify a further point. What is meant by the word "resources" in this clause? Does it cover both property and capital?

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It seems to me that the power given to the Secretary of State to make regulations determining the meaning of "resources" would enable him to discriminate between resources in terms of property and resources in terms of other capital. Many people have chosen not to buy a house, but to rent accommodation, and hold all their capital in stock market investments. Would such a person find that all his capital was being taken into account in the means test from the outset? That would seem unfair. A fairer position would be to set the disregard at a certain level of capital or all of a person's capital. I beg to move.

Lord Hunt of Kings Heath: Under Section 47 of the NHS and Community Care Act 1990, councils have an obligation to assess a person's need in respect of services that they have a power to provide to that person. The law currently provides that, if a person has a need for residential accommodation and care and attention is not otherwise available, the council shall provide it. The ability of the person to provide for themselves is a relevant factor to take into account in determining whether to provide residential accommodation. Resources, particularly a person's home, may be taken into account.

The clause paves the way for the introduction of our deferred payment scheme, as it enables regulations to be made requiring councils to disregard certain resources when determining whether they have care and attention otherwise available to them. We intend to specify in such regulations a person's main or only home.

Subsection (2A) says that certain resources, which we will specify in regulations to be a person's main home, shall be disregarded from the consideration of whether someone has care and attention available to them. Subsection (2B) says that the council shall calculate the person's resources in accordance with regulations. The amendment would delete that paragraph. That would enable a council to assess a person's resources as it saw fit. In particular, it would mean that a council could take into account resources disregarded by the means test to deny a person residential accommodation under Section 21. In other words, it could result in fewer rather than more people being entitled to Part 3 accommodation. The amendment would not help those people who would rather take out a deferred payment arrangement with their council than sell their home on admission to residential care.

Those who may be able to return home should be admitted on a temporary basis. The three-month disregard applies to people who are admitted on a permanent basis.

Earl Howe: I thank the Minister for that reply. This was meant to be a probing amendment. I appreciate the effect of removing subsection (2A). That was not my intention. I merely wanted to tease out some of the factual background to the proposals. I am still in a little doubt about how much capital is taken into account for residents regarded as temporary. If the

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Minister has any further information on that, perhaps he would care to write to me, as the amendment was prompted by an outside party. In view of the hour, I shall leave it there. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 60 agreed to.

Earl Howe moved Amendment No. 280:


    After Clause 60, insert the following new clause--


"Carers and local authorities
( ) Where it is considered that a person receiving community care services is to be rehabilitated to receive treatment in his own home by a carer, the carer shall be deemed to have asked the local authority for assessment according to section 1 of the Carers and Disabled Children Act 2000.
( ) For the purposes of this section, the provider of the community care services shall have a duty to inform the carer of his right to an assessment under the Carers and Disabled Children Act 2000.
( ) For the purposes of this section "carer" shall have the meaning given in section 1 of the Carers and Disabled Children Act 2000."

The noble Earl said: Before the noble Baroness, Lady Greengross, berates me, I realise that the amendment is flawed, but I shall speak to it because it contains an important point.

The amendment would ensure that the needs of a person's carer were considered before an elderly patient was returned home. I do not think that there is any disagreement with the general proposition that as far as possible people should be enabled and encouraged to stay in their own homes while they rehabilitate. However, moving home has implications for carers. It would be perverse to reduce the burden on the NHS by increasing rehabilitation if that simply resulted in the burden of continuing care falling on the unpaid carers, who could not cope with it. An explicit duty should be placed on health services to consider the effect on carers. That is the purpose of the amendment.

I believe that the noble Baroness, Lady Greengross, will say that carers should not be forced to undergo an assessment if they do not wish it. Certainly I had not intended that carers' wishes should be overridden in that sense. My main concern is that every carer should have the right to an assessment and should have that right communicated to them at what will be a particularly demanding time for them.

We should remember what emerged from the research carried out by the Carers National Association some three years ago. It was found that one in four carers felt that the person whom they cared for had not been discharged from hospital at the right time. In 80 per cent of those cases, the carer felt that the patient had been discharged too soon. In addition, in order to reinforce that point, one in four people discharged from hospital were readmitted within two months.

I hope that the Minister will be sympathetic to the thrust of the amendment. I beg to move.


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