Care Bill (HC Bill 168)

(a) if they include provision relating to Wales, may not be made without
the consent of the Welsh Ministers;

(b) if they include provision relating to Scotland, may not be made
without the consent of the Scottish Ministers;

(c) 5if they include provision relating to Northern Ireland, may not be
made without the consent of the Northern Ireland Department.

Interpretation

12 (1) This paragraph applies for the purposes of this Schedule.

(2) “Accommodation in England” means accommodation in England of a type
10specified in regulations under section 39 but not of a type specified in
regulations under this paragraph.

(3) “Accommodation in Wales” means accommodation in Wales of a type
specified in regulations under section 163 of the Social Services and Well-
being (Wales) Act 2014 but not of a type specified in regulations under this
15paragraph.

(4) “Accommodation in Scotland” means residential accommodation in
Scotland of a type which may be provided under or by virtue of section 12
or 13A of the Social Work (Scotland) Act 1968, or section 25 of the Mental
Health (Care and Treatment) (Scotland) Act 2003, but not of a type specified
20in regulations under this paragraph.

(5) “Accommodation in Northern Ireland” means residential or other
accommodation in Northern Ireland of a type which may be provided under
Article 15 of the Health and Personal Social Services (Northern Ireland)
Order 1972.

(6) 25“Local authority in England” means a local authority for the purposes of this
Part.

(7) “Local authority in Wales” means a local authority for the purposes of the
Social Services and Well-being (Wales) Act 2014.

(8) “Local authority in Scotland” means a council constituted under section 2 of
30the Local Government etc. (Scotland) Act 1994.

(9) “The Northern Ireland Department” means the Department of Health, Social
Services and Public Safety in Northern Ireland.

(10) “NHS accommodation” has the meaning given in section 39(6).

Consequential provision

13 35In section 163 of the Social Services and Well-being (Wales) Act 2014
(ordinary residence), at the end insert—

“(5) For provision about cross-border placements to and from England,
Scotland or Northern Ireland, see Schedule 1 to the Care Act 2014.

(5) Am ddarpariaeth ynghylch lleoliadau trawsffiniol i Loegr, yr Alban
40neu Ogledd Iwerddon neu o Loegr, yr Alban neu Ogledd Iwerddon,
gweler Atodlen 1 i Ddeddf Gofal 2014.”

Transitory provision

14 (1) Pending the commencement of Part 4 of the Social Services and Well-being
(Wales) Act 2014, this Schedule is to have effect with the modifications set
out in this paragraph.

(2) 5A reference to that Act in paragraphs 1, 3 and 4 is to be read as a reference to
Part 3 of the National Assistance Act 1948.

(3) In paragraph 2—

(a) the references in sub-paragraphs (1), (3) and (6) to discharging a duty
under section 21 of the Social Services and Well-being (Wales) Act
102014 by arranging for the provision of accommodation are to be read
as references to providing residential accommodation under Part 3
of the National Assistance Act 1948;

(b) the references in paragraph (a) of each of those sub-paragraphs to the
Social Services and Well-being (Wales) Act 2014 are to be read as
15references to Part 3 of the National Assistance Act 1948;

(c) sub-paragraphs (2), (4) and (7) are to be ignored; and

(d) in sub-paragraph (10), the references to sub-paragraph (4) and
paragraph (b) of sub-paragraph (4) are to be ignored.

(4) In paragraph 9, the reference to sections 34 and 36 of the Social Services and
20Well-being (Wales) Act 2014 is to be read as a reference to section 57 of the
Health and Social Care Act 2001.

(5) In paragraph 12, sub-paragraph (3) is to be read as if the following were
substituted for it—

“(3) Accommodation in Wales” means residential accommodation in
25Wales of a type that may be provided under Part 3 of the National
Assistance Act 1948 but not of a type specified in regulations
under this paragraph.”

(6) In that paragraph, sub-paragraph (7) is to be read as if the following were
substituted for it—

“(7) 30Local authority in Wales” means a local authority in Wales for the
purposes of Part 3 of the National Assistance Act 1948.”

(7) This paragraph does not affect the generality of section 122(2).

Section 43

SCHEDULE 2 Safeguarding Adults Boards

35Membership, etc.

1 (1) The members of an SAB are—

(a) the local authority which established it,

(b) a clinical commissioning group the whole or part of whose area is in
the local authority’s area,

(c) 40the chief officer of police for a police area the whole or part of which
is in the local authority’s area, and

(d) such persons, or persons of such description, as may be specified in
regulations.

(2) The membership of an SAB may also include such other persons as the local
authority which established it, having consulted the other members listed in
5sub-paragraph (1), considers appropriate.

(3) A local authority, having consulted the other members of its SAB, must
appoint as the chair a person whom the authority considers to have the
required skills and experience.

(4) Each member of an SAB must appoint a person to represent it on the SAB;
10and the representative must be a person whom the member considers to
have the required skills and experience.

(5) Where more than one clinical commissioning group or more than one chief
officer of police comes within sub-paragraph (1), a person may represent
more than one of the clinical commissioning groups or chief officers of
15police.

(6) The members of an SAB (other than the local authority which established it)
must, in acting as such, have regard to such guidance as the Secretary of
State may issue.

(7) Guidance for the local authority on acting as a member of the SAB is to be
20included in the guidance issued for the purposes of section 77(1).

(8) An SAB may regulate its own procedure.

Funding and other resources

2 (1) A member of an SAB listed in paragraph 1(1) may make payments towards
expenditure incurred by, or for purposes connected with, the SAB—

(a) 25by making the payments directly, or

(b) by contributing to a fund out of which the payments may be made.

(2) A member of an SAB listed in paragraph 1(1) may provide staff, goods,
services, accommodation or other resources for purposes connected with the
SAB.

30Strategic plan

3 (1) An SAB must publish for each financial year a plan (its “strategic plan”)
which sets out—

(a) its strategy for achieving its objective (see section 43), and

(b) what each member is to do to implement that strategy.

(2) 35In preparing its strategic plan, the SAB must—

(a) consult the Local Healthwatch organisation for its area, and

(b) involve the community in its area.

(3) In this paragraph and paragraph 4, “financial year”, in relation to an SAB,
includes the period—

(a) 40beginning with the day on which the SAB is established, and

(b) ending with the following 31 March or, if the period ending with that
date is 3 months or less, ending with the 31 March following that
date.

Annual report

4 (1) As soon as is feasible after the end of each financial year, an SAB must
publish a report on—

(a) what it has done during that year to achieve its objective,

(b) 5what it has done during that year to implement its strategy,

(c) what each member has done during that year to implement the
strategy,

(d) the findings of the reviews arranged by it under section 44
(safeguarding adults reviews) which have concluded in that year
10(whether or not they began in that year),

(e) the reviews arranged by it under that section which are ongoing at
the end of that year (whether or not they began in that year),

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

(g) 15where it decides during that year not to implement a finding of a
review arranged by it under that section, the reasons for its decision.

(2) The SAB must send a copy of the report to—

(a) the chief executive and the leader of the local authority which
established the SAB,

(b) 20the local policing body the whole or part of whose area is in the local
authority’s area,

(c) the Local Healthwatch organisation for the local authority’s area,
and

(d) the chair of the Health and Wellbeing Board for that area.

(3) 25“Local policing body” has the meaning given by section 101 of the Police Act
1996.

Section 73

SCHEDULE 3 Discharge of hospital patients with care and support needs

Cases where hospital patient is likely to have care and support needs after discharge

1 (1) 30Where the NHS body responsible for a hospital patient considers that it is
not likely to be safe to discharge the patient unless arrangements for meeting
the patient’s needs for care and support are in place, the body must give
notice to—

(a) the local authority in whose area the patient is ordinarily resident, or

(b) 35if it appears to the body that the patient is of no settled residence, the
local authority in whose area the hospital is situated.

(2) A notice under sub-paragraph (1) is referred to in this Schedule as an
“assessment notice”; and the local authority to which an assessment notice is
given is referred to in this Schedule as “the relevant authority”.

(3) 40An assessment notice—

(a) must describe itself as such, and

(b) may not be given more than seven days before the day on which the
patient is expected to be admitted to hospital.

(4) Before giving an assessment notice, the NHS body responsible for the
patient must consult—

(a) the patient, and

(b) where it is feasible to do so, any carer that the patient has.

(5) 5An assessment notice remains in force until—

(a) the patient is discharged (whether by the NHS body responsible for
the patient or by the patient himself or herself),

(b) the patient dies, or

(c) the NHS body responsible for the patient withdraws the notice by
10giving a notice (a “withdrawal notice”) to the relevant authority.

(6) A reference in this paragraph to a hospital patient includes a reference to a
person who it is reasonable to expect is about to become one.

Assessment notice given by responsible NHS body to local authority

2 (1) The NHS body responsible for a hospital patient, having given the relevant
15authority an assessment notice, must—

(a) consult the authority before deciding what it will do for the patient
in order for discharge to be safe, and

(b) give the authority notice of the day on which it proposes to discharge
the patient.

(2) 20A notice under sub-paragraph (1)(b) is referred to in this Schedule as a
“discharge notice”.

(3) A discharge notice must specify—

(a) whether the NHS body responsible for the patient will be providing
or arranging for the provision of services under the National Health
25Service Act 2006 to the patient after discharge, and

(b) if it will, what those services are.

(4) A discharge notice remains in force until—

(a) the end of the relevant day, or

(b) the NHS body responsible for the patient withdraws the notice by
30giving a withdrawal notice to the relevant authority.

(5) The “relevant day” is the later of—

(a) the day specified in the discharge notice, and

(b) the last day of such period as regulations may specify.

(6) A period specified under sub-paragraph (5)(b) must—

(a) 35begin with the day after that on which the assessment notice is given,
and

(b) last for a period of at least two days.

3 (1) The relevant authority, having received an assessment notice and having in
light of it carried out a needs assessment and (where applicable) a carer’s
40assessment, must inform the NHS body responsible for the patient—

(a) whether the patient has needs for care and support,

(b) (where applicable) whether a carer has needs for support,

(c) whether any of the needs referred to in paragraphs (a) and (b) meet
the eligibility criteria, and

(d) how the authority plans to meet such of those needs as meet the
eligibility criteria.

(2) Where, having carried out a needs assessment or carer’s assessment in a case
within section 27(4), the relevant authority considers that the patient’s needs
5for care and support or (as the case may be) the carer’s needs for support
have changed, it must inform the NHS body responsible for the patient of
the change.

Cases where discharge of the patient is delayed

4 (1) If the relevant authority, having received an assessment notice and a
10discharge notice, has not carried out a needs or (where applicable) carer’s
assessment and the patient has not been discharged by the end of the
relevant day, the NHS body responsible for the patient may require the
relevant authority to pay the specified amount for each day of the specified
period.

(2) 15If the relevant authority has not put in place arrangements for meeting some
or all of those of the needs under sections 18 to 20 that it proposes to meet in
the case of the patient or (where applicable) a carer, and the patient has for
that reason alone not been discharged by the end of the relevant day, the
NHS body responsible for the patient may require the relevant authority to
20pay the specified amount for each day of the specified period.

(3) If, in a case within sub-paragraph (1) or (2), the assessment notice ceases to
be in force, any liability arising under that sub-paragraph before it ceased to
be in force is unaffected.

(4) A payment under sub-paragraph (1) or (2) must be made to—

(a) 25the NHS body responsible for the patient, or

(b) in such a case as regulations may specify, the person specified.

(5) The “relevant day” has the meaning given by paragraph 2(5).

(6) A reference to a requirement to pay the specified amount is a reference to a
requirement to pay the amount specified in regulations; and the reference to
30the specified period is a reference to the period specified in or determined in
accordance with regulations.

(7) In specifying the amount of a payment, the Secretary of State must have
regard in particular to either or both of—

(a) costs to NHS bodies of providing accommodation and personal care
35to patients ready to be discharged, and

(b) costs to local authorities of meeting needs under sections 18 to 20 in
the case of persons who have been discharged.

Delegation to management of independent hospital

5 (1) An NHS body may make arrangements with any person connected with the
40management of an independent hospital for that person (or an employee of
that person) to do, on behalf of the NHS body and in accordance with the
arrangements, anything which is required or authorised to be done by the
NHS body by or under this Schedule in relation to hospital patients
accommodated in that hospital.

(2) Anything done or omitted to be done by or in relation to the authorised
person (or an employee of that person) under such arrangements is to be
treated as done or omitted to be done by or in relation to the NHS body.

(3) Nothing in this paragraph prevents anything being done by or in relation to
5the NHS body.

Adjustments between local authorities

6 (1) Regulations may modify, or otherwise make provision about, the
application of a provision of this Schedule in a case where it appears to the
NHS body responsible for a hospital patient that the patient is ordinarily
10resident in the area of another local authority.

(2) The regulations may, in particular, authorise or require a local authority—

(a) to accept an assessment notice given to it even though it may wish to
dispute that it was the correct authority to which to give the notice;

(b) to become the relevant authority in the patient’s case;

(c) 15to recover expenditure incurred—

(i) in the exercise of functions under this Schedule;

(ii) in meeting needs under sections 18 to 20 in a case under this
Schedule.

Meaning of “hospital patient”, “NHS hospital, “NHS body”, etc.

7 (1) 20A hospital patient is a person ordinarily resident in England who—

(a) is being accommodated at an NHS hospital, or at an independent
hospital as a result of arrangements made by an NHS body, and

(b) is receiving (or has received or can reasonably be expected to receive)
acute care.

(2) 25“NHS hospital” means a health service hospital (as defined by the National
Health Service Act 2006) in England.

(3) “Independent hospital” means a hospital (as defined by that Act) in the
United Kingdom which is not—

(a) an NHS hospital,

(b) 30a health service hospital as defined by section 206 of the National
Health Service (Wales) Act 2006,

(c) a health service hospital as defined by section 108 of the National
Health Service (Scotland) Act 1978, or

(d) a hospital vested in the Department of Health, Social Services and
35Public Safety in Northern Ireland or managed by a Health and Social
Care trust.

(4) “NHS body” means—

(a) an NHS trust established under section 25 of the National Health
Service Act 2006,

(b) 40an NHS foundation trust,

(c) the National Health Service Commissioning Board, or

(d) a clinical commissioning group.

(5) A reference to the NHS body responsible for a hospital patient is—

(a) if the hospital is an NHS hospital, a reference to the NHS body
managing it, or

(b) if the hospital is an independent hospital, a reference to the NHS
body that arranged for the patient to be accommodated in it.

(6) 5“Acute care” means intensive medical treatment provided by or under the
supervision of a consultant, that lasts for a limited period after which the
person receiving the treatment no longer benefits from it.

(7) Care is not “acute care” if the patient has given an undertaking (or one has
been given on the patient’s behalf) to pay for it; nor is any of the following
10“acute care”—

(a) care of an expectant or nursing mother;

(b) mental health care;

(c) palliative care;

(d) a structured programme of care provided for a limited period to help
15a person maintain or regain the ability to live at home;

(e) care provided for recuperation or rehabilitation.

(8) “Mental health care” means psychiatric services, or other services provided
for the purpose of preventing, diagnosing or treating illness, the
arrangements for which are the primary responsibility of a consultant
20psychiatrist.

Further provision about assessment notices, discharge notices, etc.

8 Regulations may—

(a) specify the form and content of an assessment notice, a discharge
notice or a withdrawal notice;

(b) 25specify the manner in which an assessment notice, a discharge notice
or a withdrawal notice may be given;

(c) specify when a discharge notice may be given;

(d) specify circumstances in which a withdrawal notice must be given;

(e) make provision for determining the day on which an assessment
30notice, a discharge notice or a withdrawal notice is to be regarded as
given.

Section 74

SCHEDULE 4

Part 1 After-care under the Mental Health Act 1983: direct payments

1 (1) 35Sections 31 (adults with capacity to request direct payments), 32 (adults
without capacity to request direct payments) and 33 (direct payments:
further provision) apply in relation to section 117 of the Mental Health Act
1983 but as if the following modifications were made to those sections.

(2) For subsection (1) of section 31, substitute—

“(1) 40This section applies where an adult to whom section 117 of the
Mental Health Act 1983 (after-care) applies requests the local
authority to make payments to the adult or a person nominated by

the adult that are equivalent to the cost of providing or arranging for
the provision of after-care services for the adult under that section.”

(3) In subsection (5) of that section—

(a) in paragraph (a), for “meeting the adult’s needs” substitute
5“discharging its duty under section 117 of the Mental Health Act
1983”, and

(b) in paragraph (b), for “to meet the adult’s needs” substitute “to
discharge its duty under that section”.

(4) In subsection (7) of that section, for “to meet the needs in question”
10substitute “to discharge its duty under section 117 of the Mental Health Act
1983”.

(5) For subsection (1) of section 32, substitute—

“(1) This section applies where—

(a) an adult to whom section 117 of the Mental Health Act 1983
15(after-care) applies lacks capacity to request the local
authority to make payments equivalent to the cost of
providing or arranging for the provision of after-care services
for the adult under that section, and

(b) an authorised person requests the local authority to make
20such payments to the authorised person.”

(6) In subsection (4)(a) of that section, for “the adult’s needs for care and
support” substitute “the provision to the adult of after-care services under
section 117 of the Mental Health Act 1983”.

(7) In subsection (6) of that section—

(a) 25in paragraph (a), for “meeting the adult’s needs” substitute
“discharging its duty under section 117 of the Mental Health Act
1983”, and

(b) in paragraph (b), for “to meet the adult’s needs” substitute “to
discharge its duty under that section”.

(8) 30In subsection (7) of that section, for “the provision of the care and support”
substitute “the provision of after-care services under section 117 of the
Mental Health Act 1983”.

(9) In subsection (9) of that section, for “to meet the needs in question”
substitute “to discharge its duty under section 117 of the Mental Health Act
351983”.

(10) In subsection (2)(a) of section 33, for “meet needs” substitute “discharge its
duty under section 117 of the Mental Health Act 1983”.

(11) For subsection (3) of that section, substitute—

“(3) A direct payment is made on condition that it be used only to pay for
40arrangements under which after-care services for the adult are
provided under section 117 of the Mental Health Act 1983.”

Part 2 Provision to be inserted in Social Services and Well-Being (Wales) Act 2014

“Direct payments: after-care under the Mental Health Act 1983

General

1 5Sections 34 (direct payments to meet an adult’s needs), 35 (direct
payments to meet a child’s needs) and 37 (direct payments: further
provision) apply in relation to section 117 of the Mental Health Act
1983 but as if the following modifications were made to those
sections.

10Modifications to section 34

2 For subsection (1) of section 34 substitute—

“(1) Regulations may require or allow a local authority to
make payments to an adult to whom section 117 of the
Mental Health Act 1983 (after-care) applies that are
15equivalent to the cost of providing or arranging for the
provision of after-care services for the adult under that
section.”

3 In subsection (3) of that section—

(a) in paragraph (a), for “who has needs for care and support
20(“A”)” substitute “in respect of the provision to the adult
(“A”) of after-care services under section 117 of the Mental
Health Act 1983”, and

(b) in paragraph (c)(i), for “of meeting A’s needs” substitute
“of discharging its duty towards A under section 117 of the
25Mental Health Act 1983”.

4 In subsection (4) of that section—

(a) in paragraph (a), for “who has needs for care and support
(“A”)” substitute “to whom section 117 of the Mental
Health Act 1983 applies (“A”)”, and

(b) 30in paragraph (d)(i), for “meeting A’s needs” substitute
“discharging its duty towards A under section 117 of the
Mental Health Act 1983”.

5 In subsection (5) of that section—

(a) in paragraph (a), for “A’s needs for care and support”
35substitute “the provision to A of after-care services under
section 117 of the Mental Health Act 1983”, and

(b) in paragraph (b), for “towards the cost of meeting A’s
needs for care and support” substitute “equivalent to the
cost of providing or arranging the provision to A of after-
40care services under section 117 of the Mental Health Act
1983”.