Care Bill (HL Bill 45)

(c) for subsections (5) and (6) substitute—

“(5) In subsections (1) and (3) above, “appropriate establishment”
means an establishment of such description or conforming to
such requirements as may be specified in regulations under
5subsection (1).”

(5) Regulations may make further provision in relation to arrangements of the
kind referred to in this paragraph.

Placements from Northern Ireland to England, Wales or Scotland

4 (1) Where there are arrangements under Article 15 of the Health and Personal
10Social Services (Northern Ireland) Order 1972 for the provision of
accommodation in England, the adult in question—

(a) is to be treated for the purposes of that Order and the Health and
Social Care (Reform) Act (Northern Ireland) 2009 as ordinarily
resident in the area of the relevant Health and Social Care trust, and

(b) 15is accordingly not to be treated for the purposes of Part 1 of this Act
as ordinarily resident anywhere in England.

(2) Where there are arrangements under Article 15 of the Health and Personal
Social Services (Northern Ireland) Order 1972 for the provision of
accommodation in Wales, the adult in question—

(a) 20is to be treated for the purposes of that Order and the Health and
Social Care (Reform) Act (Northern Ireland) 2009 as ordinarily
resident in the area of the relevant Health and Social Care trust, and

(b) is accordingly not to be treated for the purposes of the Social Services
and Well-being (Wales) Act 2013 as ordinarily resident anywhere in
25Wales.

(3) Where there are arrangements under Article 15 of the Health and Personal
Social Services (Northern Ireland) Order 1972 for the provision of
accommodation in Scotland—

(a) the adult in question is to be treated for the purposes of that Order
30and the Health and Social Care (Reform) Act (Northern Ireland) 2009
as ordinarily resident in the area of the relevant Health and Social
Care trust, and

(b) no duty under Part 2 of the Social Work (Scotland) Act 1968 or
sections 25 to 27 of the Mental Health (Care and Treatment)
35(Scotland) Act 2003 applies in the adult’s case.

(4) The reference to the relevant Health and Social Care trust is a reference to the
Health and Social Care trust in whose area the adult in question was
ordinarily resident immediately before the making of arrangements of the
kind referred to in this paragraph.

(5) 40Regulations may make further provision in relation to arrangements of the
kind referred to in this paragraph.

(6) The regulations may specify circumstances in which, in a case within sub-
paragraph (3), specified duties under Part 2 of the Social Work (Scotland)
Act 1968 are nonetheless to apply in the case of the adult concerned (and
45paragraph (b) of that sub-paragraph is to be read accordingly).

Dispute resolution

5 (1) Any dispute about the application of any of paragraphs 1 to 4 to an adult’s
case is to be determined in accordance with this paragraph.

(2) If the dispute is between a local authority in England and a local authority
5in Wales, it is to be determined by the Secretary of State or the Welsh
Ministers.

(3) If the dispute is between a local authority in England and a local authority
in Scotland, it is to be determined by the Secretary of State or the Scottish
Ministers.

(4) 10If the dispute is between a local authority in England and a Health and Social
Care trust, it is to be determined by the Secretary of State or the Northern
Ireland Department.

(5) If the dispute is between a local authority in Wales and a local authority in
Scotland, it is to be determined by the Welsh Ministers or the Scottish
15Ministers.

(6) If the dispute is between a local authority in Wales and a Health and Social
Care trust, it is to be determined by the Welsh Ministers or the Northern
Ireland Department.

(7) If the dispute is between a local authority in Scotland and a Health and
20Social Care trust, it is to be determined by the Scottish Ministers or the
Northern Ireland Department.

(8) In Article 36 of the Health and Personal Social Services (Northern Ireland)
Order 1972, after paragraph (2) insert—

“(2A) Any question under this Order as to the ordinary residence of a
25person is to be determined by the Department.”

(9) Regulations must make provision for determining which of the persons
concerned is to determine the dispute; and the regulations may, in
particular, provide for the dispute to be determined by whichever of them
agree is to do so.

(10) 30Regulations may make provision for the determination of disputes between
more than two parties.

(11) Regulations may make further provision about determination of disputes
under this paragraph or under regulations under sub-paragraph (10); the
regulations may, for example, include—

(a) 35provision requiring parties to a dispute to take specified steps before
referring the dispute for determination under this paragraph;

(b) provision about the procedure for referring the dispute under this
paragraph.

Financial adjustments

6 (1) 40This paragraph applies where—

(a) an adult has been provided with accommodation in England, Wales,
Scotland or Northern Ireland in a case within any of paragraphs 1 to
4, and

(b) it transpires (whether following the determination of a dispute
under paragraph 5 or otherwise) that an authority in another of the
territories was, for some or all of the time that the accommodation
was being provided, liable to provide the adult with
5accommodation.

(2) The authority which made the arrangements may recover from the authority
in the other territory the amount of any payments it made towards the
making of the arrangements at a time when the other authority was liable to
provide the adult with accommodation.

(3) 10A reference to an authority is a reference to a local authority in England,
Wales or Scotland or a Health and Social Care trust in Northern Ireland.

7 (1) In section 86 of the Social Work (Scotland) Act 1968 (adjustments between
authorities providing accommodation), in subsections (1) and (10), after “a
local authority in England or Wales” insert “and to a Health and Social Care
15trust in Northern Ireland”.

(2) In subsection (2) of that section, after “the ordinary residence of a person
shall” insert “, in a case within any of paragraphs 1 to 4 of Schedule 1 to the
Care Act 2013 (cross-border placements), be determined in accordance with
paragraph 5 of that Schedule; and in any other case, the question shall”.

(3) 20In section 97 of that Act (extent)—

(a) in subsection (1), for “sections 86 and 87” substitute “section 87”, and

(b) after that subsection insert—

“(1A) Section 86 of this Act shall extend to England and Wales and
to Northern Ireland.”.

25Regulations

8 Regulations under this Schedule—

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

(b) if they include provision relating to Scotland, may not be made
30without the consent of the Scottish Ministers;

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

Interpretation

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

(2) 35“Accommodation in England” means accommodation in England of a type
specified in regulations under section 39 but not of a type specified in
regulations under this paragraph.

(3) “Accommodation in Wales” means accommodation in Wales of a type
specified in regulations under section 163 of the Social Services and Well-
40being (Wales) Act 2013 but not of a type specified in regulations under this
paragraph.

(4) “Accommodation in Scotland” means residential accommodation in
Scotland of a type which may be provided under or by virtue of section 12
or 13A of the Social Work (Scotland) Act 1968, or section 25 of the Mental

Health (Care and Treatment) (Scotland) Act 2003, but not of a type specified
in regulations under this paragraph.

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

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

(7) “Local authority in Wales” means a local authority for the purposes of the
10Social Services and Well-being (Wales) Act 2013.

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

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

15Consequential provision

10 In section 163 of the Social Services and Well-being (Wales) Act 2013
(ordinary residence), at the end insert—

“(5) For provision about cross-border placements to and from England,
Scotland or Northern Ireland, see Schedule 1 to the Care Act 2013.

(5) 20Am ddarpariaeth ynghylch lleoliadau trawsffiniol i Loegr, yr Alban
neu Ogledd Iwerddon neu o Loegr, yr Alban neu Ogledd Iwerddon,
gweler Atodlen 1 i Ddeddf Gofal 2013.”

Transitory provision

11 (1) Pending the commencement of Part 4 of the Social Services and Well-being
25(Wales) Act 2013, this Schedule is to have effect with the modifications set
out in this paragraph.

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

(3) In paragraph 2—

(a) 30the references in sub-paragraphs (1), (3) and (6) to discharging a duty
under section 21 of the Social Services and Well-being (Wales) Act
2013 by arranging for the provision of accommodation are to be read
as references to providing residential accommodation under Part 3
of the National Assistance Act 1948;

(b) 35the references in paragraph (a) of each of those sub-paragraphs to the
Social Services and Well-being (Wales) Act 2013 are to be read as
references to Part 3 of the National Assistance Act 1948;

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

(d) in sub-paragraph (10), the references to sub-paragraph (4) and
40paragraph (b) of sub-paragraph (4) are to be ignored.

(4) In paragraph 9, sub-paragraph (3) is to be read as if the following were

substituted for it—

“(3) Accommodation in Wales” means residential accommodation in
Wales of a type that may be provided under Part 3 of the National
Assistance Act 1948 but not of a type specified in regulations
5under this paragraph.”

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

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

(6) 10This paragraph does not affect the generality of section 111(2).

Section 43

SCHEDULE 2 Safeguarding Adults Boards

Membership, etc.

1 (1) The members of an SAB are—

(a) 15the local authority which established it,

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

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

(d) 20such persons, or persons of such description, as may be specified in
regulations.

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

(3) 25A local authority, having consulted the other members of its SAB, must
appoint as the chair a person whom the authority considers to have the
required skills and experience.

(4) Each member of an SAB must appoint a person to represent it on the SAB;
and the representative must be a person whom the member considers to
30have the required skills and experience.

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

(6) 35The members of an SAB (other than the local authority which established it)
must, in acting as such, have regard to such guidance as the Secretary of
State may issue.

(7) Guidance for the local authority on acting as a member of the SAB is to be
included in the guidance issued for the purposes of section 74(1).

(8) 40An SAB may regulate its own procedure.

Funding and other resources

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

(a) by making the payments directly, or

(b) 5by contributing to a fund out of which the payments may be made.

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

Strategic plan

3 (1) 10An SAB must publish for each financial year a plan (its “strategic plan”)
which sets out—

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

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

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

(a) 15consult the Local Healthwatch organisation for its area, and

(b) involve the community in its area.

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

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

(b) 20ending with the following 31 March or, if the period ending with that
date is 3 months or less, ending with the 31 March following that
date.

Annual report

4 (1) As soon as is feasible after the end of each financial year, an SAB must
25publish a report on—

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

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

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

(d) 30the findings of the reviews arranged by it under section 44
(safeguarding adults reviews) which have concluded in that year
(whether or not they began in that year), and

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

(2) 35The SAB must send a copy of the report to—

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

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

(c) 40the Local Healthwatch organisation for the local authority’s area,
and

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

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

Section 70

SCHEDULE 3 Discharge of hospital patients with care and support needs

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

1 (1) Where the NHS body responsible for a hospital patient considers that it is
5not likely to be safe to discharge the patient unless arrangements for meeting
the patient’s needs for care and support are in place, the body must give
notice to—

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

(b) if it appears to the body that the patient is of no settled residence, the
10local authority in whose area the hospital is situated.

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

(3) An assessment notice—

(a) 15must describe itself as such, and

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

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

(a) 20the patient, and

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

(5) An assessment notice remains in force until—

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

(b) 25the patient dies, or

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

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

30Assessment notice given by responsible NHS body to local authority

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

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

(b) 35give the authority notice of the day on which it proposes to discharge
the patient.

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

(3) A discharge notice must specify—

(a) 40whether the NHS body responsible for the patient will be providing
or arranging for the provision of services under the National Health
Service Act 2006 to the patient after discharge, and

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

(4) A discharge notice remains in force until—

(a) the end of the relevant day, or

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

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

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

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

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

(a) begin with the day after that on which the assessment notice is given,
10and

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

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

(a) 15whether the patient has needs for care and support,

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

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

(d) how the authority plans to meet such of those needs as meet the
20eligibility criteria.

(2) Where, having carried out a needs assessment or carer’s assessment in a case
within section 27(4), the relevant authority considers that the patient’s needs
for care and support or (as the case may be) the carer’s needs for support
have changed, it must inform the NHS body responsible for the patient of
25the change.

Cases where discharge of the patient is delayed

4 (1) If the relevant authority, having received an assessment notice and a
discharge notice, has not carried out a needs or (where applicable) carer’s
assessment and the patient has not been discharged by the end of the
30relevant day, the NHS body responsible for the patient may require the
relevant authority to pay the specified amount for each day of the specified
period.

(2) If the relevant authority has not put in place arrangements for meeting some
or all of those of the needs under sections 18 to 20 that it proposes to meet in
35the case of the patient or (where applicable) a carer, and the patient has for
that reason alone not been discharged by the end of the relevant day, the
NHS body responsible for the patient may require the relevant authority to
pay the specified amount for each day of the specified period.

(3) If, in a case within sub-paragraph (1) or (2), the assessment notice ceases to
40be in force, any liability arising under that sub-paragraph before it ceased to
be in force is unaffected.

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

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

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

(5) 45The “relevant day” has the meaning given by paragraph 2(5).

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

(7) 5In specifying the amount of a payment, the Secretary of State must have
regard in particular to either or both of—

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

(b) costs to local authorities of meeting needs under sections 18 to 20 in
10the case of persons who have been discharged.

Delegation to management of independent hospital

5 (1) An NHS body may make arrangements with any person connected with the
management of an independent hospital for that person (or an employee of
that person) to do, on behalf of the NHS body and in accordance with the
15arrangements, anything which is required or authorised to be done by the
NHS body by or under this Schedule in relation to hospital patients
accommodated in that hospital.

(2) Anything done or omitted to be done by or in relation to the authorised
person (or an employee of that person) under such arrangements is to be
20treated as done or omitted to be done by or in relation to the NHS body.

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

Adjustments between local authorities

6 (1) Regulations may modify, or otherwise make provision about, the
25application of a provision of this Schedule in a case where it appears to the
NHS body responsible for a hospital patient that the patient is ordinarily
resident in the area of another local authority.

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

(a) to accept an assessment notice given to it even though it may wish to
30dispute that it was the correct authority to which to give the notice;

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

(c) to recover expenditure incurred—

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

(ii) in meeting needs under sections 18 to 20 in a case under this
35Schedule.

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

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

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

(b) 40is receiving (or has received or can reasonably be expected to receive)
acute care.

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

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

(a) an NHS hospital,

(b) a health service hospital as defined by section 206 of the National
5Health Service (Wales) Act 2006,

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

(d) a hospital vested in the Department of Health, Social Services and
Public Safety in Northern Ireland or managed by a Health and Social
10Care trust.

(4) “NHS body” means—

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

(b) an NHS foundation trust,

(c) 15the National Health Service Commissioning Board, or

(d) a clinical commissioning group.

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

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

(b) 20if the hospital is an independent hospital, a reference to the NHS
body that arranged for the patient to be accommodated in it.

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

(7) 25Care is not “acute care” if the patient has given an undertaking (or one has
been given on the patient’s behalf) to pay for it; nor is any of the following
“acute care”—

(a) care of an expectant or nursing mother;

(b) mental health care;

(c) 30palliative care;

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

(e) care provided for recuperation or rehabilitation.

(8) “Mental health care” means psychiatric services, or other services provided
35for the purpose of preventing, diagnosing or treating illness, the
arrangements for which are the primary responsibility of a consultant
psychiatrist.

Further provision about assessment notices, discharge notices, etc.

8 Regulations may—

(a) 40specify the form and content of an assessment notice, a discharge
notice or a withdrawal notice;

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

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

(d) 45specify circumstances in which a withdrawal notice must be given;