Care Bill [HL]

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.”

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

Page 9, line 4, leave out “another adult (an “adult needing care”)” and insert “an
adult (“an adult needing care”) or disabled child”

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.”

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 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 (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.”

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”

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”

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)).”

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

Page 12, line 33, leave out from “18” to “by” in line 40 and insert “is met”

Page 12, line 41, leave out “be exercised so as to”

Page 12, line 41, at end insert—

“( )   Services of an intimate nature can only be provided to the disabled person
and not to meet a carer’s need for support; and regulations may make
provision about what is, or is not, of an intimate nature for the purposes of
subsection (3).”

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.”

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.”

Page 15, line 38, at end insert—

“( )   After section 54(2) of the Health and Social Care Act 2001 (funding by
resident etc of more expensive accommodation) insert—

“(2A)    The regulations shall only restrict the right of residents to top up
their fees to the extent that is reasonable, and in particular they shall
not limit top-ups to residents using the 12 week property disregard
or the deferred payment scheme.””

Insert the following new Clause—

“Ministerial advisory committee

An independent ministerial advisory committee shall be set up to keep
under review the workings of the cap and the means-testing arrangements
set out in section 17.”

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).”

Page 17, line 22, leave out subsections (2) and (3)

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.”

Page 21, line 23, at end insert—

“(iii)   what can be done in the event of an emergency or if needs
change”

Page 21, line 23, at end insert—

“(g)   states the date agreed between the adult and local authority upon
when a review of the care and support plan will be offered”

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.”

Page 29, line 27, at end insert—

“( )   Regulations under this section must provide that—

(a)   a local authority shall direct anyone considering a deferred
payment arrangement to an appropriately qualified financial
adviser or to appropriately qualified financial advisers; and

(b)   any loan under this scheme shall be sufficient to pay for advice
under paragraph (a) above.

Page 30, line 12, at end insert—

“( )   The Secretary of State shall make available to all local authorities a model
deferred payment scheme and all local authorities must follow this model
unless they can show due cause not to.”

Page 31, line 39, at end insert “with a view to securing, so far as reasonably
practicable, the outcomes referred to in section 9(4)(b) or 10(5)(d)”

Page 31, line 44, at end insert—

“(8A)    Pending the adult’s move, the first authority must keep in contact with the
second authority in order to ascertain the progress that the second
authority is making in preparing to meet—

(a)   any needs for care and support under section 18 or 19 in the adult’s
case, and

(b)   where the adult is proposing to have a carer immediately after the
move, any needs for support under section 20 in the carer’s case.

(8B)   The first authority must keep the adult (and, where applicable, the carer)
informed about its contact under subsection (8A) with the second authority
and must involve the adult (and, where applicable, the carer) in the
contact.”

Leave out Clause 38 and insert the following new Clause—

“Arrangements to ensure continuity of provision

(1)   Until the second authority has complied with the conditions set out in
subsection (2), the first authority must—

(a)   continue to meet the adult’s needs for care and support, and the
needs for support of any carer who is continuing as the adult’s
carer, which it has been meeting, and

(b)   where it has been keeping a care account in the adult’s case,
continue to keep that account on the same basis as it has been
keeping it.

(2)   The conditions are that the second authority has—

(a)   carried out the assessment or assessments under section 37(6), and

(b)   taken the other steps required under this Part in the adult’s case.

(3)   The first authority may recover from the second authority the costs it incurs
in complying with the duty under subsection (1).

(4)   Regulations may specify matters to which the first authority must have
regard in performing the duty under subsection (1).”

Page 34, line 1, after “authority” insert “in England or the local authority in Wales”

Page 34, line 2, at end insert “; and for that purpose—

(a)   “local authority in England” means a local authority for the
purposes of this Part, and

(b)   “local authority in Wales” means a local authority for the purposes
of the Social Services and Well-being (Wales) Act 2013”

Page 34, line 3, leave out “accommodation under the National Health Service Act
2006” and insert “NHS accommodation”

Page 34, line 10, at end insert—

“(5A)    “NHS accommodation” means accommodation under—

(a)   the National Health Service Act 2006,

(b)   the National Health Service (Wales) Act 2006,

(c)   the National Health Service (Scotland) Act 1978, or

(d)   Article 5(1) of the Health and Personal Social Services (Northern
Ireland) Order 1972.”

Page 101, line 42, leave out “in a case within any of paragraphs 1 to 4”

Page 102, line 17, leave out “within” and insert “where there is a dispute about the
application of”

Page 102, line 19, at end insert—

“( )   After subsection (10) of that section insert—

“(10A)   A person who, as a result of Schedule 1 to the Care Act 2013
(cross-border placements), is treated as ordinarily resident in an
area in England, Wales or Northern Ireland (as the case may be)
is to be treated as ordinarily resident in that area for the purposes
of this section.

(10B)   A person who, as a result of that Schedule, is not treated as
ordinarily resident anywhere in England or Wales (as the case
may be) is not to be treated as ordinarily resident there for the
purposes of this section.”

Page 102, line 24, at end insert—

“Provision of NHS accommodation not to affect deemed ordinary residence etc.

7A    (1)   In a case where, as a result of this Schedule, an adult is treated as
ordinarily resident in an area in England, Wales or Northern Ireland (as
the case may be), the adult does not cease to be so treated merely because
the adult is provided with NHS accommodation.

(2)   In a case where, as a result of this Schedule, an adult is not treated as
ordinarily resident anywhere in England or Wales (as the case may be),
the adult continues not to be so treated even if the adult is provided with
NHS accommodation.

(3)   In a case where, as a result of this Schedule, no duty under a relevant
enactment applies, the duty does not apply merely because the adult in
question is provided with NHS accommodation; and for this purpose
“relevant enactment” means—

(a)   Part 2 of the Social Work (Scotland) Act 1968,

(b)   sections 25 to 27 of the Mental Health (Care and Treatment)
(Scotland) Act 2003,

(c)   the Health and Personal Social Services (Northern Ireland) Order
1972, or

(d)   the Health and Social Care (Reform) Act (Northern Ireland) 2009.

(4)   In a case where, as a result of paragraph 2(2), (4) or (7), an adult is treated
as remaining within, or as remaining outside but ordinarily resident in,
an area in Wales, the adult does not cease to be so treated merely because
the adult is provided with NHS accommodation.”

Page 102, line 24, at end insert—

“Direct payments

7B    (1)   Regulations may provide for this Schedule to apply, with such
modifications as may be specified, to a case where accommodation in
England, Wales, Scotland or Northern Ireland is provided for an adult
by means of direct payments made by an authority in another of the
territories.

(2)   The reference in sub-paragraph (1) to direct payments accordingly
includes a reference to direct payments made—

(a)   under section 34 or 36 of the Social Services and Well-being
(Wales) Act 2013,

(b)   as a result of a choice made by the adult pursuant to section 5 of
the Social Care (Self-directed Support) (Scotland) Act 2013, or

(c)   by virtue of section 8 of the Carers and Direct Payments Act
(Northern Ireland) 2002.”

Page 102, line 24, at end insert—

“PARTICULAR TYPES OF ACCOMMODATION

7C    (1)   Regulations may provide for this Schedule to apply, with such
modifications as may be specified, to a case where—

(a)   an adult has needs for care and support which can be met only if
the adult is living in accommodation of a type specified in the
regulations,

(b)   the adult is living in accommodation in England, Wales, Scotland
or Northern Ireland that is of a type so specified, and

(c)   the adult’s needs for care and support are being met by an
authority in another of the territories providing or arranging for
the provision of services other than the accommodation.

(2)   In section 5 of the Community Care and Health (Scotland) Act 2002 (the
title to which becomes “Local authority arrangements for residential
accommodation etc. outwith Scotland”), in subsection (1), at the end
insert “or for the provision in England and Wales or in Northern Ireland
of a service or facility of such other description as may be specified in the
regulations”.

Page 103, line 14, at end insert—

“( )   “NHS accommodation” has the meaning given in section 39(5A).”

Page 103, line 40, at end insert—

“( )   In paragraph 7B, the reference to sections 34 and 36 of the Social Services
and Well-being (Wales) Act 2013 is to be read as a reference to section 57
of the Health and Social Care Act 2001.”

Insert the following new Clause—

“Appealing decisions taken by the local authority

(1)   The local authority must have in place a procedure, which includes a
review element that is independent of the local authority, by which adults
or carers can appeal a decision made by the local authority about—

(a)   whether an adult or carer’s needs meet eligibility criteria under
section 13,

(b)   whether to charge for meeting needs under section 14,

(c)   the result of a financial assessment under section 17,

(d)   the content of a care and support plan or support plan under section
25,

(e)   the amount of a personal budget made under section 26 or
independent personal budget made under section 28,

(f)   the payment of an “additional cost” under section 30.

(2)   Regulations may make further provision about any aspect of the appeals
procedure mentioned in subsection (1).

(3)   Wherever a decision has been made of a type referred to in subsection (1),
the local authority must make the adult or carer aware of their right to
appeal the decision and how to request details of the appeals procedure.
Details of the procedure must be made available on request.”

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 to the
Health and Social Care Act 2008 (Regulated Activities) Regulations
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.”

Page 35, line 36, leave out subsection (3) and insert—

“(3)   “Abuse” includes—

(a)   physical abuse,

(b)   sexual abuse,

(c)   psychological abuse,

(d)   financial abuse and financial abuse includes—

(i)   having money or other property stolen,

(ii)   being defrauded,

(iii)   being put under pressure in relation to money or other
property, and

(iv)   having money or other property misused,

(e)   neglect and acts of omission,

(f)   discriminatory abuse, and

(g)   other as guidance may specify.”

Page 104, line 21, at end insert—

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

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.”

Page 105, line 42, at end insert—

“(e)   the Secretary of State”

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.”

Insert the following new Clause—

“Human Rights Act 1998: provision of “care and support services” to be public
function

(1)   A person (“P”) who provides regulated “social care” is to be taken for the
purposes of subsection (3)(b) of section 6 of the Human Rights Act 1998
(acts of public authorities) to be exercising a function of a public nature in
doing so.

(2)   This section applies to persons providing services regulated by the Care
Quality Commission.

(3)   In this section “social care” has the same meaning as in the Health and
Social Care Act 2008.”

Page 47, line 5, at beginning insert “When a child receiving services reaches the age
of 14 or”

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 7, after “18” insert “(whichever is sooner)”

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”

Page 47, line 40, 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.”

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;

(b)   the outcomes sought for him, 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.

(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 (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 58(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).”

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”.”

Page 48, line 38, at beginning insert “When a child receiving services reaches the
age of 14 or”

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 48, line 40, after “18” insert “(whichever is sooner)”

Page 48, line 46, 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 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)

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”

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”

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”.”

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)).”

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.”

Page 57, line 17, leave out from “person” to “in” in line 18 and insert “fraudulently
or negligently misrepresents or fails to disclose any material fact that they might
have reasonably been aware would have a bearing on expenditure incurred by the
local authority”

Insert the following new Clause—

“Initial funding assessment

Before enactment of Part 1, 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;

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

(d)   in particular the short and long term costs of setting the eligibility
criteria at the level set out in regulations.”

Page 59, line 10, at end insert—

“( )   In advance of the first five-yearly review, the Secretary of State must
prepare and publish a review of the working of Part I and its funding
before the date in subsection (4) and after consultation with interested
parties.”

Insert the following new Clause—

“Appeals on care and support decisions

The Secretary of State shall make regulations setting out a system for
appeal or review of decisions made about their care and support, on a
question of fact or law, including where a local authority—

(a)   makes a decision under section 13(1) that some or all of an adults
needs meet the eligibility criteria, or none of their needs meet the
eligibility criteria,

(b)   exercises its power to charge for meeting needs under section 14,

(c)   completes a financial assessment under section 17,

(d)   makes a determination under section 18 or 19 that it must or may
provide services to meet the adults care and support needs,

(e)   makes a determination under section 20 that it must or may provide
services to meet a carer’s needs for support,

(f)   makes any other decisions about an individual’s care and support
as shall be prescribed.”

Insert the following new Clause—

“Appeals on decisions for NHS continuing care

The Secretary of State shall make regulations setting out a system for
appeal or review of decisions made about NHS continuing care,
independent of the NHS, on a question of fact or law.”

Page 110, line 3, 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, including the content of the admission
process to that acute setting.”

Page 59, line 24, at end insert—

“(aa)   if, immediately before being detained, the person concerned
was ordinarily resident in Wales, for the area in Wales in
which he was ordinarily resident; or”

Page 59, leave out lines 25 to 27

Page 59, leave out lines 30 to 33 and insert—

“(4)   Where there is a dispute about where a person was ordinarily
resident for the purposes of subsection (3) above—

(a)   if the dispute is between local social services authorities in
England, section 40 of the Care Act 2013 applies to the
dispute as it applies to a dispute about where a person was
ordinarily resident for the purposes of Part 1 of that Act;

(b)   if the dispute is between local social services authorities in
Wales, section 164 of the Social Services and Well-being
(Wales) Act 2013 applies to the dispute as it applies to a
dispute about where a person was ordinarily resident for
the purposes of that Act;

(c)   if the dispute is between a local social services authority in
England and a local social services authority in Wales, it is
to be determined by the Secretary of State or the Welsh
Ministers.

(4A)   The Secretary of State and the Welsh Ministers shall make and
publish arrangements for determining which of them is to
determine a dispute under subsection (4)(c); and the arrangements
may, in particular, provide for the dispute to be determined by
whichever of them agree is to do so.”

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”

Page 60, line 28, after “purpose” insert “Part 1 of”

Page 60, line 29, at end insert—

“(7A)    In section 37 of the Social Services and Well-being (Wales) Act 2013 (direct
payments: further provision), at the end insert—

“(11)   The ways in which a local authority may discharge its duty under
section 117 of the Mental Health Act 1983 include by making direct
payments; and for that purpose Schedule A1 (which includes
modifications of sections 34 and 35 and this section) has effect.”

(7B)   Before Schedule 1 to that Act insert the Schedule A1 contained in Part 2 of
Schedule 4 to this Act.

(7C)   In section 163 of that Act (ordinary residence), after subsection (4) insert—

“(4A)    A person who is being provided with accommodation under
section 117 of the Mental Health Act 1983 (after-care) is to be treated
for the purposes of this Act as ordinarily resident in the area of the
local authority, or the local authority in England, on which the duty
to provide that person with services under that section is imposed.”

(7D)   In consequence of subsections (7) to (7B), in subsection (2C) of section 117
of the Mental Health Act 1983—

(a)   in paragraph (a), for “regulations under section 57 of the Health and
Social Care Act 2001 or” substitute “—

(i)   sections 31 to 33 of the Care Act 2013 (as
applied by Schedule 4 to that Act),

(ii)   sections 34, 35 and 37 of the Social Services
and Well-being (Wales) Act 2013 (as applied
by Schedule A1 to that Act), or

(iii)   regulations under”,

(b)   in paragraph (b), after “apart from” insert “those sections (as so
applied) or”.”

Page 60, line 33, at end insert—

“( )   In section 145 of the Mental Health Act 1983 (interpretation), for the
definition of “local social services authority” substitute—

““local social services authority” means—

(a)   an authority in England which is a local authority for
the purposes of Part 1 of the Care Act 2013, or

(b)   an authority in Wales which is a local authority for
the purposes of the Social Services and Well-being
(Wales) Act 2013.””

Page 111, line 13, leave out paragraph 2

Page 111, line 21, at end insert—

“PART 2

PROVISION TO BE INSERTED IN SOCIAL SERVICES AND WELL-BEING (WALES) ACT 2013

Insert the following new Clause—

“End of life care

After consultation, the Secretary of State may make regulations for
terminally ill persons to—

(a)   have their preference for place of death recorded by local health and
social care services and for that preference to be implemented
wherever practicable;

(b)   have their care and support needs and those of their carer treated as
urgent by the local authority responsible for assessing those needs;
and

(c)   be exempt from any local authority charges for adult social care.”

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.”

Page 63, line 26, at end insert—

“( )   In exercising any function to which an authorisation under this section
relates, the person authorised is subject to the same legal obligations as the
local authority.”

Page 63, line 30, after “as” insert “also”

Insert the following new Clause—

“Older Persons’ Commissioner

(1)   In the Health and Social Care Act 2008, after section 128 insert—

“PART 2A

OLDER PERSONS’ COMMISSIONER

128A          Establishment of an office of the Older Persons’ Commissioner

(1)   There shall be an office of the Older Persons’ Commissioner.

(2)   Schedule (The Older Persons’ CommissionerThe Older Persons’ Commissioner) shall have effect with
respect to the Older Persons’ Commissioner.

128B          Functions of the office of the Older Persons’ Commissioner

(1)   The Older Persons’ Commissioner has the function under this Part
of promoting the wellbeing, dignity and respect of older people and
safeguarding and promoting their rights and welfare.

(2)   In fulfilling their duties under subsection (1), the Older Persons’
Commissioner may review, and monitor the operation of,
arrangements falling within subsection (2), (3) or (4) for the purpose
of ascertaining whether, and to what extent, the arrangements are
effective in promoting the wellbeing, dignity and respect, and
safeguarding and promoting the rights and welfare of older people.

(3)   The arrangements falling within this subsection are the
arrangements made by the providers of regulated services in
England, or by the Secretary of State, for dealing with complaints or
representations in respect of such services made by or on behalf of
older people.

(4)   The arrangements falling within this subsection are arrangements
made by the providers of regulated services in England, or by the
Secretary of State, for ensuring that proper action is taken in
response to any disclosure of information which may tend to show
that, in the course of, or in connection with, the provision of
regulated services to older people—

(a)   that a criminal offence has been committed;

(b)   that a person has failed to comply with any legal obligation
to which he is subject;

(c)   that the health and safety of any person has been
endangered; or

(d)   that information tending to show that any matter falling
within one of the preceding paragraphs has been
deliberately concealed.

(5)   The arrangements falling within this subsection are arrangements
made (whether by providers of regulated services in England, by
the Secretary of State or by any other person) for making persons
available—

(a)   to represent the views and wishes of older people to whom
this Part applies; or

(b)   to ensure the adequate provision to older people of advice
and support of any prescribed kind.

(6)   The Secretary of State may, by regulations confer power on the
Older Persons’ Commissioner to require prescribed persons to
provide any information which the Older Persons’ Commissioner
considers it necessary or expedient to have for the purposes of his
functions under this section.

(7)   A statutory instrument containing regulations under subsection (5)
is not to be made unless a draft of the instrument has been laid
before, and approved by a resolution of, each House of Parliament.

128C          Examination of cases by the Older Persons’ Commissioner

(1)   The Secretary of State may, by regulations, make provision for the
examination by the Older Persons’ Commissioner of the cases of
particular older people.

(2)   The regulations may include provision about—

(a)   the types of case which may be examined;

(b)   the circumstances in which an examination may be made;

(c)   the procedure for conducting an examination, including
provision about the representation of parties;

(d)   the publication of reports following an examination.

(3)   The regulations may, for the purposes of enabling the Older
Persons’ Commissioner to examine or determine whether any
recommendation made in a report following an examination has
been complied with, make provision for—

(a)   requiring persons to provide the Older Persons’
Commissioner with information; or

(b)   requiring persons who hold or are accountable for
information to provide the Older Persons’ Commissioner
with explanations or other assistance,

for the purpose of an examination or for the purposes of for the purpose of an examination or for the purposes of
determining whether any recommendation made in a report determining whether any recommendation made in a report
following an examination has been complied with.following an examination has been complied with.

(4)   For the purposes mentioned in subsection (3), the Older Persons’
Commissioner shall have the same powers as the High Court in
respect of—

(a)   the attendance and examination of witnesses (including the
administration of oaths and affirmations and the
examination of witnesses abroad); and

(b)   the provision of information.

(5)   No person shall be compelled for the purposes mentioned in
subsection (3) to give any evidence or provide information which
he could not be compelled to give or provide in civil proceedings
before the High Court.

(6)   The regulations may make provision for the payment by the Older
Persons’ Commissioner of sums in respect of expenses or
allowances to persons who attend or provide information for the
purposes mentioned in subsection (3).

(7)   A statutory instrument containing the first regulations made under
subsection (1), (2) or (3) is not to be made unless a draft of the
instrument has been laid before, and approved by a resolution of,
each House of Parliament.

(8)   A statutory instrument that contains regulations made under
subsection (6) is subject to annulment in pursuance of a resolution
of either House of Parliament.

128D          Obstruction

(1)   The Older Persons’ Commissioner may certify an offence to the
High Court where—

(a)   a person, without lawful excuse, obstructs him or any
member of his staff in the exercise of any of his functions
under regulations made under section 128B(5) or 128C; or

(b)   a person is guilty of any act or omission in relation to an
examination under regulations made by under section 128C
which, if that examination were proceedings in the High
Court, would constitute contempt of court.

(2)   Where an offence is so certified the High Court may inquire into the
matter; and after hearing—

(a)   any witnesses who may be produced against or on behalf of
the person charged with the offence; and

(b)   any statement that may be offered in defence,

the High Court may deal with the person charged with the offence the High Court may deal with the person charged with the offence
in any manner in which it could deal with him if he had committed in any manner in which it could deal with him if he had committed
the same offence in relation to the High Court.the same offence in relation to the High Court.

128E          Further functions

(1)   The Older Persons’ Commissioner may, in connection with his
functions under this Part give advice and information to any
person.

(2)   Regulations may confer power on the Older Persons’
Commissioner to assist an older person—

(a)   in making a complaint or representation to or in respect of a
provider of regulated services in England; or

(b)   in any prescribed proceedings.

(3)   For the purposes of subsection (2), assistance includes—

(a)   financial assistance; and

(b)   arranging for representation, or the giving of advice or
assistance, by any person.

(4)   Regulations under subsection (2) may also provide for assistance to
be given on conditions, including (in the case of financial
assistance) conditions requiring repayment in specified
circumstances.

(5)   Regulations may, in connection with the Older Persons’
Commissioner’s functions under this Part, confer further functions
on the Commissioner.

(6)   Regulations may, in particular, include provision about the making
of reports on any matter connected with any of his functions.

(7)   Apart from identifying any person investigated, a report by the
Older Persons’ Commissioner shall not—

(a)   mention the name of any person, or

(b)   include any particulars which, in the opinion of the Older
Persons’ Commissioner, are likely to identify any person
and can be omitted without impairing the effectiveness of
the report,

unless, after taking account of the public interest (as well as the unless, after taking account of the public interest (as well as the
interests of any person who made a complaint and other persons), interests of any person who made a complaint and other persons),
the Older Persons’ Commissioner considers it necessary for the the Older Persons’ Commissioner considers it necessary for the
report to mention his name or include such particulars.report to mention his name or include such particulars.

(8)   For the purposes of the law of defamation, the publication of any
matter by the Older Persons’ Commissioner in a report is absolutely
privileged.

(9)   In subsection (1) of this section “proceedings” includes a procedure
of any kind and any prospective proceedings.

(10)   A statutory instrument containing the regulations under this
section is not to be made unless a draft of the instrument has been
laid before, and approved by a resolution of, each House of
Parliament.

128F          Restrictions

(1)   This Part does not authorise the Older Persons’ Commissioner to
enquire into or report on any matter so far as it is the subject of legal
proceedings before, or has been determined by, a court or tribunal.

(2)   This Part does not authorise the Commissioner to exercise any
function which by virtue of an enactment is also exercisable by the
prescribed person.

128G          Interpretation

(1)   For the purposes of this Part “regulated services” has the same
definition as “regulated activity” in section 8 of this Act as they
relate to older people.

(2)   This Part applies to any older person normally domiciled in
England.”

(2)   After Schedule 5, insert the following new Schedule—

Insert the following new Clause—

“Duty of candour

In section 20 of the Health and Social Care Act 2008 (regulation of regulated
activities), after subsection (5) insert—

“(5A)    Regulations under this section must make provision as to the
provision of information in a case where an incident of a specified
description affecting a person’s safety occurs in the course of the
person being provided with a service.””

Page 66, line 21, at end insert—

“( )   in so deciding in the case of an NHS trust, the Commission
must review the effectiveness of previous interventions
with that trust by the Trust Development Authority (or its
predecessor bodies) and consider whether to require the
Authority to advise the Secretary of State to appoint a trust
special administrator.”

Insert the following new Clause—

“Chief Inspectors

After paragraph 3 of Schedule 1 to the Health and Social Care Act 2008
insert—

“Chief Inspectors

3A    (1)   The non-executive members must—

(a)   appoint an executive member to be the Chief Inspector of
Hospitals,

(b)   appoint an executive member to be the Chief Inspector of
Adult Social Care, and

(c)   appoint an executive member to be the Chief Inspector of
General Practice.

(2)   Each of those executive members is to exercise such functions of
the Commission on its behalf as it determines.

(3)   When exercising functions under sub-paragraph (2), an
executive member must have regard to the importance of
safeguarding and promoting the Commission’s independence
from the Secretary of State.””

Insert the following new Clause—

“Independence of the Care Quality Commission

(1)   Part 1 of the Health and Social Care Act 2008 (the Care Quality
Commission) is amended as follows.

(2)   In section 48 (special reviews or investigations), omit subsection (7)
(Secretary of State’s power to make regulations as to procedure for
representations before publication of report).

(3)   In section 54 (studies as to economy, efficiency etc), in subsections (1) and
(3), omit “, with the approval of the Secretary of State,”.

(4)   After subsection (2) of that section, insert—

“(2A)    The Commission may not exercise the power under subsection
(1)(a), so far as it relates to the activity mentioned in subsection
(2)(d), without the approval of the Secretary of State.”

(5)   In section 55 (publication of results of studies under section 54), omit
subsection (2) (Secretary of State’s power to make regulations as to
procedure for representations before publication of report).

(6)   In section 57 (reviews of data, studies and research), in subsection (1), omit
“, with the approval of the Secretary of State,”.

(7)   In section 61 (inspections carried out for registration purposes), omit—

(a)   subsection (1) (Secretary of State’s power to make regulations
specifying frequency etc. of inspections), and

(b)   subsection (4) (Secretary of State’s power to make regulations as to
procedure for representations before publication of report).

(8)   In section 83 (annual reports), omit subsection (3) (Secretary of State’s
power to direct preparation of separate reports).

(9)   In paragraph 5 of Schedule 4 (inspection programmes etc.), omit—

(a)   in sub-paragraph (1) (preparation of programme etc.), “, or at such
times as the Secretary of State may specify by order,”, and

(b)   sub-paragraph (3) (Secretary of State’s power to specify form of
programme etc.).

(10)   In consequence of subsections (3) and (6), omit section 293(3) and (4) of the
Health and Social Care Act 2012.”

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 72, leave out lines 16 to 27

Page 72, line 28, leave out “or local authority”

Page 72, line 45, at end insert—

“( )   Indicators the Commission devises for the purposes of subsection
(5) should include indicators of the quality of services provided for
the identification and treatment of those conditions that most
frequently occur in a particular care setting.”

Page 73, line 14, at end insert—

“(13)   Consultation undertaken before the commencement of this section
is as effective for the purposes of subsection (9) as consultation
undertaken after that commencement.”

Page 73, line 16, at end insert—

“( )   In section 48 (special reviews and investigations), in subsection (1)—

(a)   omit “, with the approval of the Secretary of State,”, and

(b)   at the end insert “; but the Commission may not conduct a review
or investigation under subsection (2)(ba) or (bb) without the
approval of the Secretary of State.”

( )   Omit subsection (1A) of that section.

( )   In subsection (2) of that section, for “a periodic review” substitute “a review
under section 46”.

( )   In that subsection, after paragraph (ba) (but before the following “or”)
insert—

“(bb)   the exercise of the functions of English local authorities in
arranging for the provision of adult social services,”.

( )   After subsection (3) of that section insert—

“(3A)    A review or investigation under subsection (2)(b), in so far as it
involves a review or investigation into the arrangements made for
the provision of the adult social services in question, is to be treated
as a review under subsection (2)(bb) (and the requirement for
approval under subsection (1) is accordingly to apply).””

Page 73, line 25, at end insert—

“( )   in section 293 of the Health and Social Care Act 2012, omit
subsections (1) and (2);”

Insert the following new Clause—

“Periodic reviews and assessments of standards of employment and impact of
quality of care

The Commission shall have a duty to carry out periodic reviews and
assessments of standards of employment in health and social care
provision with particular emphasis on workforce conditions which
support continuity and quality of care, and are consistent with the
wellbeing principle as set out in section 1.”

Insert the following new Clause—

“Duty of candour

(1)   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.

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

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

Page 73, line 42, leave out “exercises functions in connection with the provision of”
and insert “provides”

Page 74, line 1, leave out “body (other than a public body) which” and insert
“person who”

Page 74, line 4, at end insert “, or

(c)   a person who provides health services or adult social care in
England all or part of the cost of which is paid for by means of a
direct payment under section 12A of the National Health Service
Act 2006 or under Part 1 of this Act.”

Page 74, line 35, leave out “care provider” and insert “person”

Page 74, line 35, leave out from “liable” to end of line 36 and insert “—

(a)   on summary conviction, to a fine;

(b)   on conviction on indictment, to imprisonment for not more than
two years or a fine (or both).”

Insert the following new Clause—

“Offences by bodies

(1)   Subsection (2) applies where an offence under section 84(1) is committed
by a body corporate and it is proved that the offence is committed by, or
with the consent or connivance of, or is attributable to neglect on the part
of—

(a)   a director, manager or secretary of the body, or

(b)   a person purporting to act in such a capacity.

(2)   The director, manager, secretary or person purporting to act as such (as
well as the body) is guilty of the offence and liable to be proceeded against
and punished accordingly (but section 85(2) does not apply).

(3)   The reference in subsection (2) to a director, manager or secretary of a body
corporate includes a reference—

(a)   to any other similar officer of the body, and

(b)   where the body is a local authority, to a member of the authority.

(4)   Proceedings for an offence under section 84(1) alleged to have been
committed by an unincorporated association are to be brought in the name
of the association (and not in that of any of the members); and rules of court
relating to the service of documents have effect as if the unincorporated
association were a body corporate.

(5)   In proceedings for an offence under section 84(1) brought against an
unincorporated association, section 33 of the Criminal Justice Act 1925 and
Schedule 3 to the Magistrates’ Courts Act 1980 apply as they apply in
relation to a body corporate.

(6)   A fine imposed on an unincorporated association on its conviction for an
offence under section 84(1) is to be paid out of the funds of the association.

(7)   Subsection (8) applies if an offence under section 84(1) is proved—

(a)   to have been committed by, or with the consent or connivance of, an
officer of the association or a member of its governing body, or

(b)   to be attributable to neglect on the part of such an officer or
member.

(8)   The officer or member (as well as the association) is guilty of the offence
and liable to be proceeded against accordingly (but section 85(2) does not
apply).”

Insert the following new Clause—

“Training for persons working in regulated activity

In section 20 of the Health and Social Care Act 2008 (regulation of regulated
activities), after subsection (4) insert—

“(4A)    Regulations made under this section by virtue of subsection (3)(d)
may in particular include provision for a specified person to set the
standards which persons undergoing the training in question must
attain.””

Page 112, line 6, at end insert—

“(0 )   The non-executive members of HEE must include a person who will
represent the interests of patients.”

Page 114, line 33, at end insert—

“(1A)    HEE may arrange for any of its committees, sub-committees or members
or any other person to exercise any of its functions on its behalf (but see
sub-paragraph (4)).”

Page 114, line 36, after “sub-paragraph” insert “(1A) or”

Page 115, line 1, after “LETB” insert “, or for a sub-committee, member or any other
person,”

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 Care Quality Commission or Monitor will be able to request to see the
report, under subsection (2), at any time.”

Insert the following new Clause—

“Regulation of health and care support workers

(1)   The Secretary of State shall, by regulations and in consultation with the
Care Quality Commission, HEE and such other persons as it considers
appropriate, ensure the establishment of a system of regulation of health
and care support workers.

(2)   For the purpose 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.”

Page 80, line 5, at end insert—

“( )   Subsections (1), (2) and (4) of section 89 (quality improvement in education
and training etc.) apply to an LETB in the exercise of its functions as they
apply to HEE in the exercise of its functions.”

Page 80, line 23, at end insert “, and

( )   a person who will represent the interests of patients.”

Page 80, line 24, leave out “The regulations” and insert “Regulations under
paragraph (b) of subsection (3)”

Page 80, line 24, leave out “that expertise” and insert “the expertise mentioned in
that paragraph”

Page 126, line 36, after “any” insert “of its committees, sub-committees or members
or any other”

Page 85, line 12, leave out “such research” and insert “research that is safe and
ethical (including by promoting transparency in research)”

Page 85, line 25, at end insert—

“( )   Promoting transparency in research includes promoting—

(a)   the registration of research;

(b)   the publication and dissemination of research findings and
conclusions;

(c)   the provision of access to data on which research findings or
conclusions are based;

(d)   the provision of information at the end of research to participants in
the research;

(e)   the provision of access to tissue used in research, for use in future
research.”

Page 132, line 45, leave out from second “a” to end of line 3 on page 133 and insert
“research ethics committee recognised or established by or on behalf of the Health
Research Authority under the Care Act 2013.”

Page 92, line 25, leave out “or duty”

Page 94, line 23, after “cases)” insert “or 71 (after-care under the Mental Health Act
1983)”.