Care Bill [HL]

Page 80, line 35, at end insert—

“( )   The HRA shall also have the function of encouraging the translation of
research into innovative practice.”

The above-named Lords give notice of their intention to oppose the Question that Clause 97
stand part of the Bill.

Page 81, line 25, at end insert—

“( )   the Medical Royal Colleges;”

Page 81, line 25, at end insert—

“( )   the General Medical Council, the General Dental Council and the
Nursing and Midwifery Council;”

Page 81, line 28, at end insert—

“( )   the Chief Nursing Officer of the Department of Health”

Page 81, line 38, after “research” insert “, including that undertaken by the research
and development committees of NHS trusts”

Page 81, line 39, at end insert—

“( )   In promoting the co-ordination and standardisation of practice in the
United Kingdom relating to the regulation of health and social care
research, as defined in section 97(2) and (3) above, of any changes proposed
in the system for setting pharmaceutical prices.”

Page 82, line 11, after “2006” insert “, providers commissioned to deliver services
for the NHS”

Page 82, line 12, leave out from “must” to end and insert “follow guidance under
subsection (6) unless there is good reason not to do so”

Page 82, line 12, leave out “have regard to” and insert “comply with”

Page 82, line 14, at end insert “and transparency in reporting clinical trials”

Insert the following new Clause—

“Human Tissue and Embryo Authority

(1)   There shall be a body corporate called the Human Tissue and Embryo
Authority.

(2)   The Authority shall consist of—

(a)   a chairman and deputy chairman, and

(b)   such number of other members as the Secretary of State appoints.

(3)   The Authority shall keep proper accounts and proper records in relation to
the accounts and shall prepare for each accounting year a statement of
accounts.

(4)   The annual statement of accounts shall comply with any direction given by
the Secretary of State, with the approval of the Treasury, as to the
information to be contained in the statement, the way in which the
information is to be presented or the methods and principles according to
which the statement is to be prepared.

(5)   Not later than five months after the end of an accounting year, the
Authority shall send a copy of the statement of accounts for that year to the
Secretary of State and to the Comptroller and Auditor General.

(6)   The Comptroller and Auditor General shall examine, certify and report on
every statement of accounts received by him under subsection (5) and shall
lay a copy of the statement and of his report before each House of
Parliament.

(7)   The Secretary of State and the Comptroller and Auditor General may
inspect any records relating to the accounts.

(8)   In this section “accounting year” means the period beginning with the day
when the Authority is established and ending with the following
31st March, or any later period of twelve months ending with the
31st March; and Schedule 1 to this Act (which deals with the membership
of the Authority, etc) shall have effect.

(9)   The Authority shall prepare—

(a)   a report for the period beginning with the 1st August preceding the
day when the Authority is established (or if that date is a
1st August, beginning with that date) and ending with the next
31st March, and

(b)   a report for each succeeding period of 12 months ending with
31st March.

(10)   The Authority shall send each report to the Secretary of State as soon as
practicable after the end of the period for which it is prepared.

(11)   A report prepared under subsection (9) for any period shall deal with the
activities of the Authority in the period and the activities the Authority
proposes to undertake in the succeeding period of twelve months.

(12)   The Secretary of State shall lay before each House of Parliament a copy of
every report received by him under subsection (10).

(13)   The following provisions of the Human Fertilisation and Embryology Act
1990 are repealed—

(a)   sections 5 to 10, and

(b)   section 11(1)(a) and (aa).

(14)   Save for the provision in subsection (13), references in the Human
Fertilisation and Embryology Act 1990 to “the Authority” shall be taken to
be references to the Human Tissue and Embryo Authority.

(15)   The Care Quality Commission may grant the following licences—

(a)   licences under paragraph 1 of Schedule 2 to the Human Fertilisation
and Embryology Act 1990 authorising activities in the course of
providing treatment services,

(b)   licences under paragraph 1A of that Schedule authorising activities
in the course of providing non-medical fertility services.

(16)   Sections 12, 13 and 13A of, and paragraph 4 of Schedule 2 to, the Human
Fertilisation and Embryology Act 1990 have effect in the case of all licences
granted under subsection (15) as they would do for licences granted under
that Act.

(17)   Section 13 of the Human Tissue Act 2004 is repealed.

(18)   Save for the provision in subsection (17), references in the Human Tissue
Act 2004 to “the Authority” shall be taken to be references to the Human
Tissue and Embryo Authority.

(19)   In Schedule 5 (power to modify or transfer functions) to the Public Bodies
Act 2011 omit—

(a)   the entry for the Human Fertilisation and Embryology Authority,
and

(b)   the entry for the Human Tissue Authority.”

Page 62, line 7, at end insert—

“( )   “Significant improvement” is to be defined in regulations.”

Page 62, line 17, at end insert—

“(c)   send a copy of the warning notice to Monitor in the case of
an NHS foundation trust and the Trust Development
Authority in the case of an NHS trust”

Page 62, line 25, at end insert—

“(c)   must in the case of an NHS trust require the Trust
Development Authority to consider advising the Secretary
of State to appoint a trust special administrator to run the
trust and ensure high quality sustainable services for the
future”

Page 62, line 25, at end insert—

“( )   The Commission must ensure that there is consistency in—

(a)   the assessment of different NHS trusts and NHS foundation trusts;
and

(b)   the approach to tackling quality failures between different
providers.”

Page 62, line 25, at end insert—

“( )   The Commission must define how the process of assessing the quality of
health care for the purpose of a warning notice under section 29A is to
apply to multi-site trusts offering a wide range of services.”

Page 62, line 28, leave out paragraph (a)

Page 62, line 43, at end insert—

“(2B)    Where Monitor issues a licence condition following a warning
notice under section 29A of the Health and Social Care Act 2008, it
must set out the criteria which have guided its issuing of such a
licence condition.”

Page 62, line 43, at end insert—

“(2C)    Where Monitor issues a licence condition following a warning
notice under section 29A of the Health and Social Care Act 2008, the
relevant NHS foundation trust shall have a right to appeal that
licence condition.”

The above-named Lords give notice of their intention to oppose the Question that Clause 75
stand part of the Bill.

Page 63, line 20, at end insert—

“( )   After that subsection insert—

“( )   The regulator and the Care Quality Commission must follow a
transparent and evidence-based process in making judgments
under this section.

( )   Either body will be required to publish on request the criteria which
have informed a decision under this section.””

Page 63, line 20, at end insert—

“( )   After that subsection insert—

“( )   The regulator must ensure that there is a well-publicised appeals
process available in the event of any disagreement with a proposed
appointment of a trust special administrator under this section.””

Page 63, line 37, leave out “regulator” and insert “Secretary of State”

Page 63, line 38, at end insert—

“( )   The Commission and the Trust Development Authority must act in
accordance with equivalent arrangements to those for foundation
trusts when appointing a trust special administrator to run an NHS
trust.”

Page 63, line 38, at end insert—

“( )   In subsection (4) of that section, for “the reference in subsection (1) to the
Secretary of State is to be read as a reference” substitute “the references in
subsections (1) and (3A) to the Secretary of State are to be read as
references”.

( )   In paragraph 24 of Schedule 14 to the Health and Social Care Act 2012
(abolition of NHS trusts in England: consequential amendments to section
65N of the National Health Service Act 2006), after sub-paragraph (2)
insert—

“(2A)    In subsection (3A), for “the Secretary of State” substitute “the
regulator”.””

The above-named Lords give notice of their intention to oppose the Question that Clause 76
stand part of the Bill.

Page 64, line 8, leave out “(2A)” and insert “(5)”

Page 64, line 11, leave out “(2AA) Nor” and insert “(5A) Nor, in the case of an NHS
foundation trust,”

Page 64, line 16, leave out “(2B)” and insert “(6)”

Page 64, line 18, leave out “(2A) or (2AA)” and insert “(5) or (5A)”

Page 65, line 10, at end insert—

“( )   In paragraph 15(4) of Schedule 14 to the Health and Social Care Act 2012
(abolition of NHS trusts in England: consequential amendments to section
65F of the National Health Service Act 2006)—

(a)   in the new subsection (2A) to be inserted by paragraph 15(4), in
paragraph (a), for “65DA” substitute “65DA(1)(a)”,

(b)   after that new subsection, insert—

“(2AA)   Nor may the administrator provide the draft report to the
regulator under subsection (1) without having obtained
from the Care Quality Commission a statement that it
considers that the recommendation in the draft report
would achieve that part of the objective set out in section
65DA(1)(aa).”, and

(c)   in the new subsection (2B) to be inserted by paragraph 15(4)—

(i)   after “Where the Board” insert “or the Care Quality
Commission”,

(ii)   for “to that effect” substitute “to the effect mentioned in
subsection (2A) or (2AA)”, and

(iii)   after “, the Board” insert “or (as the case may be) the
Commission”.”

Lord Warner gives notice of his intention to oppose the Question that Clause 77 stand part
of the Bill.

Page 66, line 13, at end insert—

“( )   a Chief Inspector of Hospitals,

“( )   a Chief Primary and Community Care Inspector,”

Insert the following new Clause—

“National Reporting and Learning System

The National Reporting and Learning System shall come under the control
of the Care Quality Commission.”

Insert the following new Clause—

“Staffing numbers and skills mix

The Care Quality Commission shall, in carrying out its functions, have
regard to any official guidance on staffing numbers and skills mix.”

Page 67, line 19, at end insert “including their integration with other relevant
services”

Page 67, line 26, at end insert—

“( )   that reviews and performance assessment will also apply to
commissioners of healthcare services, specifically Clinical
Commissioning Groups and NHS England”

Page 67, line 33, at end insert “including their integration with other relevant
services”

Page 67, line 43, at end insert “providing such indicators as enable fair comparisons
to be made on the performance of providers of similar classes of services”

Page 68, line 12, at end insert—

“( )   use an indicator to measure the adequacy of health and
wellbeing support for staff by registered service providers
in respect of regulated activities”

Page 68, line 29, at end insert—

“( )   Before the commencement of this section, a pilot of review and
performance assessments must be conducted in numbered regions and for
a fixed duration to be determined in regulations.

( )   The pilot shall be independently evaluated, with the evaluation report laid
before Parliament and approved by resolution of both Houses of
Parliament.”

The above-named Lords give notice of their intention to oppose the Question that Clause 80
stand part of the Bill.

Insert the following new Clause—

“Review by the Office for Budget Responsibility

Before enactment of Part 1 or the provisions in section 80 relating to
performance ratings for local authorities, the Secretary of State must ask the
Office for Budget Responsibility to complete by the end of 2014 a review of
the funding of adult social care that assesses—

(a)   the adequacy of current public funding of these services;

(b)   the proposals for funding the provisions in this Act; and

(c)   the implications of the Act and its funding for the NHS over the
next five years.”

Insert the following new Clause—

“Duty of candour

  Every organisation registered with the Care Quality Commission to
provide health or social care services must be honest, open and truthful in
all their dealing with patients and the public.

  Organisational interests of those so registered must never be allowed to
outweigh the duty to be honest, open and truthful.

  Where death or serious harm has been or may have been caused to a patient
by an act or omission of the organisation or its staff, the patient (or any
lawfully entitled personal representative or other authorised person)
should be—

(a)   informed of the incident;

(b)   given full disclosure of the surrounding circumstances; and

(c)   be offered an appropriate level of support,

whether or not the patient or representative has asked for this
information.”

Page 69, line 2, at end insert—

“( )   Under the terms of registration the Commission must require a care
provider to ensure that all personnel exercise a duty of candour in their
contacts with patients, service users and their families or representatives.”

Page 69, line 31, leave out subsection (6)

Page 1, line 4, at end insert—

“( )   The Secretary of State in making regulations or issuing guidelines under
this Part must have regard to the general duty of local authorities, in
exercising a function under this Part in the case of an individual, to
promote that individual’s well-being.”

Page 2, line 31, at end insert—

“( )   In exercising any function under this Part, the Secretary of State shall also
have regard to the principles of well-being for individuals in subsection
(2).”

Page 3, line 2, at end insert—

“( )   the importance of identifying housing options required to exercise
that duty”

Page 3, line 32, after “provision” insert “and housing provision”

Page 3, line 41, at end insert—

“( )   In pursuit of integrating care and support with other relevant services, a
local authority is enabled to participate in any form of joint working or
funding with such services without let or hindrance.”

Page 4, line 11, at end insert—

“( )   A local authority must only offer a financial product to pay for care to
people who have received regulated financial advice or are customers who
have opted out of taking regulated financial advice.”

Page 4, leave out lines 19 to 21 and insert—

“(d)   the range of financial support and advice available independently
of the local authority that is likely to be relevant to adults who have
needs for care and support or are making plans for meeting needs
for care and support that might arise and, for all care self-funders,
a referral to regulated financial advice on matters related to paying
for their care,”

Page 4, line 19, leave out “independent financial” and insert “information and”

Page 4, line 21, after “arise,” insert “including mandatory regulated financial
advice for those taking out a care-related financial product, and”

Page 4, line 23, at end insert—

“( )   available housing options, and the choice of providers, available in
the authority’s area”

Page 5, line 35, at end insert—

“( )   housing options for meeting adults’ needs for care and support.”

Page 6, line 35, at end insert—

“( )   ensuring the early and co-ordinated assessment of an adult who
may have care and support needs following discharge from
hospital or other acute care setting.”

Page 7, line 15, leave out “adult” and insert “individual”

Page 7, line 16, after “carer,” insert “a carer of a child or a young carer,”

Page 7, line 22, leave out “adult” and insert “individual”

Page 7, line 23, after “carer,” insert “a carer of a child or a young carer,”

Page 7, line 30, at end insert—

“( )   “Carer of a child” means a person who is a carer for the purposes of section
57.

“( )   “Young carer” has the same meaning as in section 60.”

Page 8, line 25, at end insert—

“(e)   housing options to contribute to the achievement of those
outcomes”

Page 12, line 22, at end insert—

“( )   In making regulations under this section, the Secretary of State must have
regard to—

(a)   the well-being principles in section 1,

(b)   preventing the need for NHS services,

(c)   establishing criteria for service provision that applies to all local
authorities in England without variation in charging policies
between areas,

(d)   making available funding to meet the requirements of paragraph
(c).”

Page 13, line 46, at end insert—

“( )   The Secretary of State has a duty to make people aware of the terms of the
cap on the cost of care through a national public awareness campaign.”

Page 14, line 2, leave out “earnings” and insert “care costs”

Page 14, line 11, leave out “earnings” and insert “care costs”

Page 14, line 12, leave out “earnings” and insert “care costs”

Page 15, line 23, at end insert—

“( )   The regulations must provide that where the financial resources of a carer
who has needs for support or of the adult needing care (whether in terms
of income, capital or a combination of both) as calculated in accordance
with the regulations exceed the financial limit, payments by the local
authority shall be tapered in such a way that each complete increase of £500
in resources held by the carer or adult over and above the financial limit
shall result in a reduction of annual payments of £1.”

Page 15, line 23, at end insert—

“(10A)   The regulations must provide that where the financial resources of a carer
who has needs for support or of the adult needing care (whether in terms
of income, capital or a combination of both) as calculated in accordance
with the regulations exceed the financial limit, a reduction of annual
payments of £1 shall be made for each complete increase by a sum that the
Secretary of State may from time to time specify in resources held by the
carer or adult over and above the financial limit.

(10B)   When specifying a sum for the purposes of subsection (10A), the Secretary
of State must ensure that any such sum is greater than £250.”

Insert the following new Clause—

“Corporate responsibility for neglect

(1)   This section applies where a person registered under Chapter 2 of Part 1 of
the Health and Social Care Act 2008 (a “registered care provider”) in
respect of the carrying on of a regulated activity (within the meaning of that
Part) has reasonable cause to suspect that an adult in their care is
experiencing, or is at risk of, abuse and neglect.

(2)   The registered care provider must make (or cause to be made) whatever
enquiries it thinks necessary to enable it to decide whether any action
should be taken in the adult’s case and, if so, what and by whom.

(3)   Where abuse or neglect is suspected, the registered care provider is
responsible for informing the Safeguarding Adults Board in its area and
commits an offence if (without reasonable cause) it fails to do so.

(4)   A registered care provider is guilty of an offence if the way in which its
activities are managed or organised by its board or senior management
neglects or is a substantial element in the existence and or possibility of
abuse or neglect occurring.”

Page 43, leave out lines 20 to 24 and insert—

“(1)   When a child receiving services reaches the age of 14, or a local authority
receives a request from the child, or a parent or carer of the child, to assess
the child’s needs for care and support (whichever is sooner), the authority
must, if the consent condition is met, assess—”

Page 43, line 40, at end insert—

“( )   “Child receiving services” means a child—

(a)   for whom, or for whose family or for a member of whose family,
services are being provided under section 17 of the Children Act
1989,

(b)   for whom services are being provided under arrangements made
under section 2 of the Chronically Sick and Disabled Persons Act
1970 (welfare services),

(c)   for whom services are being provided under section 117 of the
Mental Health Act 1983 (after-care services),

(d)   for whom care is being provided under the National Health Service
Act 2006,

(e)   for whom, or for whose family or for a member of whose family,
services are being provided under such enactment as may be
specified in regulations.”

Page 44, line 12, at end insert—

“( )   The child’s needs assessment must be completed before the child reaches
the age of 16, or within two years of the commencement of services being
provided to the child, whichever is later.”

[Withdrawn]

Insert the following new Clause—

“Transition plans

(1)   When a local authority has completed an assessment under this section and
is satisfied that the child has needs for care and support, is likely to have
needs for care and support after becoming 18, and has determined what
those needs are likely to be, the local authority must, before the child
reaches 16 or within two years of the child beginning to receive services
(whichever is later)—

(a)   secure that a transition plan is prepared for the child or young
person, and

(b)   once a transition plan has been prepared, it must maintain the plan.

(2)   For the purposes of this Part, a transition plan is a plan specifying, for the
proceeding five years of the child or young person’s life—

(a)   any health care and social care provision reasonably required by
him or her;

(b)   the outcomes sought for him or her, including intentions to enter
further or higher education, enter the workplace or move to
independent or assisted living;

(c)   the housing provision required by him or her.

(3)   “Health care provision” means the provision of health care services as part
of the comprehensive health service in England continued under section
1(1) of the National Health Service Act 2006.

(4)   Regulations may make provision about the preparation and content of
transition plans.

(5)   Where a local authority is required to secure that a transition plan is
prepared for a child or young person, it must consult the child’s parent or
the young person about the content of the plan during the preparation of a
draft of the plan.

(6)   The local authority must then send the draft plan to the child or parent or
carer.

(7)   The local authority must send a copy of the finalised transition plan to the
child or parent or carer.

(8)   A transition plan shall be maintained until the young person reaches the
age of 25.

(9)   A local authority in England and its partner commissioning bodies must
make arrangements about the health, care and housing provision to be
secured for children and young people for whom a transition plan is
prepared and maintained.

(10)   Where an education, health and care plan (“EHC plan”) is being prepared
for a child or young person by a local authority under Part 3 of the Children
and Families Act 2013, and a transition plan is already maintained for the
child or young person, the transition plan must become part of the EHC
plan.

(11)   Where an EHC plan is already maintained for a child or young person by
a local authority and a child’s needs assessment is undertaken under
section 55(1), the local authority must ensure that the child or young
person’s EHC plan includes the transition plan as set out under subsection
(2).”

Insert the following new Clause—

“Continuity of a transition plan when a child moves

(1)   This section applies where—

(a)   a child’s needs assessment has been carried out by a local authority
(“the first authority”) under section 55(1) and a transition plan
under section (Transition plans) (1) is being maintained;

(b)   the child or parent or carer of the child notifies another local
authority (“the second authority”) (or that authority is notified on
the child’s behalf) that the child intends to move to the area of the
second authority, and

(c)   the second authority is satisfied that the child or parent or carer
intention is genuine.

(2)   The second authority must—

(a)   provide the child or parent or carer with such information as it
considers appropriate, and

(b)   notify the first authority that it is satisfied as mentioned in
subsection (1)(c).

(3)   The first authority, having received the notification under subsection (2)(b),
must provide the second authority with—

(a)   a copy of any transition plan prepared for the child;

(b)   a copy of the most recent child’s needs assessment in the child’s
case; and

(c)   such other information relating to the child as the second authority
may request.

(4)   The second authority must undertake a child’s needs assessment.

(5)   In carrying out an assessment under subsection (4), the second authority
must have regard to the transition plan provided under section (Transition
plans).

(6)   This Part applies to an assessment under subsection (4) as it applies to a
child’s needs assessment.

(7)   Where the child’s needs identified by a child’s needs assessment under
subsection (6) carried out by the second authority are different from those
specified in the transition plan provided under subsection (3)(a), the
second authority must provide a written explanation of the difference to—

(a)   the child,

(b)   the parent,

(c)   the carer, and

(d)   any other person to whom the child asks the authority to provide
the explanation.

(8)   Regulations may specify steps which a local authority must take for the
purpose of being satisfied as mentioned in subsection (1)(c).

(9)   In this section—

(a)   a reference to moving to an area is a reference to moving to that area
with a view to becoming ordinarily resident there, and

(b)   a reference to remaining in an area is a reference to remaining
ordinarily resident there.”

Insert the following new Clause—

“Case where assessments not complete on day of move

(1)   If, on the day of the intended move as mentioned in section (Continuity of a
transition plan when a child moves) (1)(b), the second authority has yet to
carry out the assessment under section (Continuity of a transition plan when
a child moves) (4), or has done so but has yet to take the other steps required
under this Part in the child’s case, it must maintain the transition plan
which the first authority has been maintaining.

(2)   The second authority must—

(a)   provide the child or parent or carer with such information as it
considers appropriate, and

(b)   notify the first authority that it is satisfied as mentioned in section
(Continuity of a transition plan when a child moves) (1)(c).

(3)   The first authority is not required to maintain the child’s transition plan for
so long as the second authority is subject to the duty under subsection (1).

(4)   Where, having complied with the duty under subsection (1), the second
authority is not required to maintain the child’s transition plan under
section (Transition plans) because the child is still ordinarily resident in the
area of the first authority, the second authority may recover from the first
authority the costs it incurs in complying with the duty under
subsection (1).

(5)   Regulations may specify matters to which the second authority must have
regard in deciding how to perform the duty under subsection (1).”

Insert the following new Clause—

“Disputes about ordinary residence or continuity of care

(1)   Any dispute about where a child is ordinarily resident for the purposes of
this Part, or any dispute between local authorities under section (Continuity
of a transition plan when a child moves) about the application of that section,
is to be determined by—

(a)   the Secretary of State, or

(b)   where the Secretary of State appoints a person for that purpose (the
“appointed person”), that person.

(2)   The Secretary of State or appointed person may review a determination
under subsection (1), provided that the review begins within three months
of the date of the determination.

(3)   Having carried out a review under subsection (2), the Secretary of State or
appointed person must—

(a)   confirm the original determination, or

(b)   substitute a different determination.

(4)   Regulations may make further provision about resolution of disputes of the
type mentioned in subsection (1); the regulations may, for example,
include—

(a)   provision for ensuring that care and support is provided to the
child while the dispute is unresolved;

(b)   provision requiring the local authorities in dispute to take specified
steps before referring the dispute to the Secretary of State or (as the
case may be) the appointed person;

(c)   provision about the procedure for referring the dispute to the
Secretary of State or appointed person;

(d)   where a review of a determination has been carried out under
subsection (2) and a different determination substituted, provision
requiring a local authority to take specified steps (including paying
specified amounts) in relation to the period before the
determination was substituted.”

Page 45, leave out lines 6 to 10 and insert—

“(1)   When a child receiving services reaches the age of 14, or a local authority
receives a request from a carer of a child to assess the carer’s needs for
support (whichever is sooner), the authority must assess—”

Page 45, line 16, leave out from “support” to end of line 19 and insert “the authority
must assess”

Page 46, line 10, at end insert—

“( )   The child’s carer’s assessment must be completed before the child reaches
the age of 16, or within two years of the commencement of services being
provided to the child, whichever is later.”

Page 47, line 3, leave out “may” and insert “must”

Page 47, line 5, leave out “power” and insert “duty”

Page 47, line 8, leave out “whether or”

Page 47, line 8, leave out “exercise the power” and insert “comply with the duty”

Page 102, line 37, at end insert—

“( )   specify matters which the local authority and relevant partners
must have regard to in carrying out an assessment of a person
who may have care needs following discharge from a hospital or
other acute care setting.”

Page 56, leave out lines 4 to 11 and insert—

(5)   In this section, “after-care services” means services to reduce the
likelihood of the person requiring admission to a hospital again for
treatment for mental disorder.””