A
BILL
[AS AMENDED IN COMMITTEE]
TO
Make provision to reform the law relating to care and support for adults and
the law relating to support for carers; to make provision about safeguarding
adults from abuse or neglect; to make provision about care standards; to
establish and make provision about Health Education England; to establish
and make provision about the Health Research Authority; and for connected
purposes.
Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and
consent of the Lords Spiritual and Temporal, and Commons, in this present
Parliament assembled, and by the authority of the same, as follows:—
(1)
5The general duty of a local authority, in exercising a function under this Part in
the case of an individual, is to promote that individual’s well-being.
(2)
“Well-being”, in relation to an individual, means that individual’s well-being
so far as relating to any of the following—
(a) physical and mental health, emotional well-being and personal dignity;
(b) 10protection from abuse and neglect;
(c)
control by the individual over day-to-day life (including over care and
support, or support, provided to the individual and the way in which
it is provided);
(d) participation in work, education, training or recreation;
(e) 15social and economic well-being;
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(f) domestic, family and personal relationships;
(g) suitability of living accommodation;
(h) the individual’s contribution to society.
(3)
In exercising a function under this Part in the case of an individual, a local
5authority must have regard to the following matters in particular—
(a)
the importance of beginning with the assumption that the individual is
best-placed to judge the individual’s well-being;
(b) the individual’s views, wishes and feelings;
(c)
the importance of preventing or delaying the development of needs for
10care and support or needs for support and the importance of reducing
needs of either kind that already exist;
(d)
the need to ensure that decisions about the individual are made having
regard to all the individual’s circumstances (and are not based only on
the individual’s age or appearance or any condition of the individual’s
15or aspect of the individual’s behaviour which might lead others to
make unjustified assumptions about the individual’s well-being);
(e)
the importance of the individual participating as fully as possible in
decisions relating to the exercise of the function concerned and being
provided with the information and support necessary to enable the
20individual to participate;
(f)
the importance of achieving a balance between the individual’s well-
being and that of any friends or relatives who are involved in caring for
the individual;
(g) the need to protect people from abuse and neglect;
(h)
25the need to ensure that any restriction on the individual’s rights or
freedom of action that is involved in the exercise of the function is kept
to the minimum necessary for achieving the purpose for which the
function is being exercised.
(4) “Local authority” means—
(a) 30a county council in England,
(b)
a district council for an area in England for which there is no county
council,
(c) a London borough council, or
(d) the Common Council of the City of London.
(1)
A local authority must provide or arrange for the provision of services,
facilities or resources, or take other steps, which it considers will—
(a)
contribute towards preventing or delaying the development by adults
in its area of needs for care and support;
(b)
40contribute towards preventing or delaying the development by carers
in its area of needs for support;
(c) reduce the needs for care and support of adults in its area;
(d) reduce the needs for support of carers in its area.
(2) In performing that duty, a local authority must have regard to—
(a)
45the importance of identifying services, facilities and resources already
available in the authority’s area and the extent to which the authority
could involve or make use of them in performing that duty;
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(b)
the importance of identifying adults in the authority’s area with needs
for care and support which are not being met (by the authority or
otherwise);
(c)
the importance of identifying carers in the authority’s area with needs
5for support which are not being met (by the authority or otherwise).
(3) Regulations may—
(a)
permit a local authority to make a charge for providing or arranging for
the provision of services, facilities or resources, or for taking other
steps, under this section;
(b)
10prohibit a local authority from making a charge it would otherwise be
permitted to make by virtue of paragraph (a).
(4)
The regulations may in particular (in reliance on section 112(6)) make
provision by reference to services, facilities or resources which—
(a) are of a specified type;
(b) 15are provided in specified circumstances;
(c) are provided to an adult of a specified description;
(d) are provided for a specified period only.
(5)
A charge under the regulations may cover only the cost that the local authority
incurs in providing or arranging for the provision of the service, facility or
20resource or for taking the other step.
(6)
In cases where a local authority performs the duty under subsection (1) jointly
with one or more other local authorities in relation to the authorities’ combined
area—
(a)
references in this section to a local authority are to be read as references
25to the authorities acting jointly, and
(b)
references in this section to a local authority’s area are to be read as
references to the combined area.
(7)
Sections 21 (exception for persons subject to immigration control), 22
(exception for provision of health services) and 23 (exception for provision of
30housing etc.) apply in relation to the duty under subsection (1), but with the
modifications set out in those sections.
(8) “Adult” means a person aged 18 or over.
(1)
A local authority must exercise its functions under this Part with a view to
35ensuring the integration of care and support provision with health provision
and health-related provision where it considers that this would—
(a)
promote the well-being of adults in its area with needs for care and
support and the well-being of carers in its area,
(b)
contribute to the prevention or delay of the development by adults in
40its area of needs for care and support or the development by carers in
its area of needs for support, or
(c)
improve the quality of care and support for adults, and of support for
carers, provided in its area (including the outcomes that are achieved
from such provision).
(2) 45“Care and support provision” means—
(a) provision to meet adults’ needs for care and support,
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(b) provision to meet carers’ needs for support, and
(c)
provision of services, facilities or resources, or the taking of other steps,
under section 2.
(3)
“Health provision” means provision of health services as part of the health
5service.
(4)
“Health-related provision” means provision of services which may have an
effect on the health of individuals but which are not—
(a) health services provided as part of the health service, or
(b)
services provided in the exercise of social services functions (as defined
10by section 1A of the Local Authority Social Services Act 1970).
(1)
A local authority must establish and maintain a service for providing people in
its area with information and advice relating to care and support for adults and
support for carers.
(2)
15The service must provide information and advice on the following matters in
particular—
(a)
the system provided for by this Part and how the system operates in the
authority’s area,
(b)
the choice of types of care and support, and the choice of providers,
20available to those who are in the authority’s area,
(c) how to access the care and support that is available,
(d)
how to access independent financial advice on matters likely to be
relevant to adults who have needs for care and support or are making
plans for meeting needs for care and support that might arise, and
(e)
25how to raise concerns about the safety or well-being of an adult who
has needs for care and support.
(3)
In providing information and advice under this section, a local authority must
in particular seek to ensure that what it provides is sufficient to enable adults—
(a)
to identify matters that are or might be relevant to their personal
30financial position that could be affected by the system provided for by
this Part, and
(b) to make plans for meeting needs for care and support that might arise.
(4)
Information and advice provided under this section must be accessible to, and
proportionate to the needs of, those for whom it is being provided.
(5)
35In cases where a local authority performs the duty under subsection (1) jointly
with one or more other local authorities by establishing and maintaining a
service for their combined area—
(a)
references in this section to a local authority are to be read as references
to the authorities acting jointly, and
(b)
40references in this section to a local authority’s area are to be read as
references to the combined area.
(1)
A local authority must promote the efficient and effective operation of a market
in services for meeting care and support needs with a view to ensuring that any
45person in its area wishing to access services in the market—
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(a)
has a variety of providers to choose from who (taken together) provide
a variety of services;
(b) has a variety of high quality services to choose from;
(c)
has sufficient information to make an informed decision about how to
5meet the needs in question.
(2)
In performing that duty, a local authority must have regard to the following
matters in particular—
(a)
the need to ensure that the authority has, and makes available,
information about the providers of services for meeting care and
10support needs and the types of services they provide;
(b)
the need to ensure that it is aware of current and likely future demand
for such services and to consider how providers might meet that
demand;
(c)
the importance of enabling adults with needs for care and support, and
15carers with needs for support, who wish to do so to participate in work,
education or training;
(d)
the importance of ensuring the sustainability of the market (in
circumstances where it is operating effectively as well as in
circumstances where it is not);
(e)
20the importance of fostering continuous improvement in the quality of
such services and the efficiency and effectiveness with which such
services are provided and of encouraging innovation in their provision.
(3)
In having regard to the matters mentioned in subsection (2)(b), a local
authority must also have regard to the need to ensure that sufficient services
25are available for meeting the needs for care and support of adults in its area and
the needs for support of carers in its area.
(4)
In meeting an adult’s needs for care and support or a carer’s needs for support,
a local authority must have regard to its duty under subsection (1).
(5)
In cases where a local authority performs the duty under subsection (1) jointly
30with one or more other local authorities in relation to persons who are in the
authorities’ combined area—
(a)
references in this section to a local authority are to be read as references
to the authorities acting jointly, and
(b)
references in this section to a local authority’s area are to be read as
35references to the combined area.
(6) “Services for meeting care and support needs” means—
(a) services for meeting adults’ needs for care and support, and
(b) services for meeting carers’ needs for support.
(7)
The references in subsection (6) to services for meeting needs include a
40reference to services, facilities or resources the purpose of which is to
contribute towards preventing or delaying the development of those needs.
(1)
A local authority must co-operate with each of its relevant partners, and each
relevant partner must co-operate with the authority, in the exercise of—
(a)
45their respective functions relating to adults with needs for care and
support,
(b) their respective functions relating to carers, and
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(c)
functions of theirs the exercise of which is relevant to functions referred
to in paragraph (a) or (b).
(2)
A local authority must co-operate, in the exercise of its functions under this
Part, with such other persons as it considers appropriate who exercise
5functions, or are engaged in activities, in the authority’s area relating to adults
with needs for care and support or relating to carers.
(3)
A local authority must make arrangements for ensuring co-operation
between—
(a)
the officers of the authority who exercise the authority’s functions
10relating to adults with needs for care and support or its functions
relating to carers,
(b)
the officers of the authority who exercise the authority’s functions
relating to housing (in so far as the exercise of those functions is
relevant to functions referred to in paragraph (a)),
(c)
15the Director of Children’s Services at the authority (in so far as the
exercise of functions by that officer is relevant to the functions referred
to in paragraph (a)), and
(d)
the authority’s director of public health (see section 73A of the National
Health Service Act 2006).
(4)
20The references in subsections (1) and (3)(a) to a local authority’s functions
include a reference to the authority’s functions under sections 58 to 65
(transition for children with needs etc.).
(5)
The duties under subsections (1) to (3) are to be performed for the following
purposes in particular—
(a)
25promoting the well-being of adults with needs for care and support and
of carers in the authority’s area,
(b)
improving the quality of care and support for adults and support for
carers provided in the authority’s area (including the outcomes that are
achieved from such provision),
(c)
30smoothing the transition to the system provided for by this Part for
persons in relation to whom functions under sections 58 to 65 are
exercisable,
(d)
protecting adults with needs for care and support who are
experiencing, or are at risk of, abuse or neglect, and
(e)
35identifying lessons to be learned from cases where adults with needs
for care and support have experienced serious abuse or neglect and
applying those lessons to future cases.
(6) Each of the following is a relevant partner of a local authority—
(a)
where the authority is a county council for an area for which there are
40district councils, each district council;
(b)
any local authority, or district council for an area in England for which
there is a county council, with which the authority agrees it would be
appropriate to co-operate under this section;
(c) each NHS body in the authority’s area;
(d)
45the chief officer of police for a police area the whole or part of which is
in the authority’s area;
(e)
the Minister of the Crown exercising functions in relation to prisons, so
far as those functions are exercisable in relation to England;
(f) a relevant provider of probation services in the authority’s area;
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(g)
such person, or a person of such description, as regulations may
specify.
(7) The reference to an NHS body in a local authority’s area is a reference to—
(a)
the National Health Service Commissioning Board, so far as its
5functions are exercisable in relation to the authority’s area,
(b)
a clinical commissioning group the whole or part of whose area is in the
authority’s area, or
(c)
an NHS trust or NHS foundation trust which provides services in the
authority’s area.
(8)
10“Prison” has the same meaning as in the Prison Act 1952 (see section 53(1) of
that Act).
(9)
“Relevant provider of probation services” has the meaning given by section 325
of the Criminal Justice Act 2003.
(1)
15Where a local authority requests the co-operation of a relevant partner, or of a
local authority which is not one of its relevant partners, in the exercise of a
function under this Part in the case of an individual with needs for care and
support or in the case of a carer, a carer of a child or a young carer, the partner
or authority must comply with the request unless it considers that doing so—
(a) 20would be incompatible with its own duties, or
(b) would otherwise have an adverse effect on the exercise of its functions.
(2)
Where a relevant partner of a local authority, or a local authority which is not
one of its relevant partners, requests the co-operation of the local authority in
its exercise of a function in the case of an individual with needs for care and
25support or in the case of a carer, a carer of a child or a young carer, the local
authority must comply with the request unless it considers that doing so—
(a) would be incompatible with its own duties, or
(b) would otherwise have an adverse effect on the exercise of its functions.
(3)
A person who decides not to comply with a request under subsection (1) or (2)
30must give the person who made the request written reasons for the decision.
(4)
“Relevant partner”, in relation to a local authority, has the same meaning as in
section 6.
(5) “Carer of a child” means a person who is a carer for the purposes of section 60.
(6) “Young carer” has the same meaning as in section 63.
(1)
The following are examples of what may be provided to meet needs under
sections 18 to 20—
(a) accommodation in a care home or in premises of some other type;
(b) 40care and support at home or in the community;
(c) counselling and other types of social work;
(d) goods and facilities;
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(e) information, advice and advocacy.
(2)
The following are examples of the ways in which a local authority may meet
needs under sections 18 to 20—
(a) by arranging for a person other than it to provide a service;
(b) 5by itself providing a service;
(c) by making direct payments.
(3)
“Care home” has the meaning given by section 3 of the Care Standards Act
2000.
(1)
Where it appears to a local authority that an adult may have needs for care and
support, the authority must assess—
(a) whether the adult does have needs for care and support, and
(b) if the adult does, what those needs are.
(2)
15An assessment under subsection (1) is referred to in this Part as a “needs
assessment”.
(3)
The duty to carry out a needs assessment applies regardless of the authority’s
view of—
(a) the level of the adult’s needs for care and support, or
(b) 20the level of the adult’s financial resources.
(4) A needs assessment must include an assessment of—
(a)
the impact of the adult’s needs for care and support on the matters
specified in section 1(2),
(b) the outcomes that the adult wishes to achieve in day-to-day life,
(c)
25whether, and if so to what extent, the provision of care and support
could contribute to the achievement of those outcomes, and
(d)
whether, and if so to what extent, other matters (including, in
particular, the adult’s own capabilities and any support available to the
adult from friends, family or others) could contribute to the
30achievement of those outcomes.
(5) A local authority, in carrying out a needs assessment, must involve—
(a) the adult,
(b) any carer that the adult has, and
(c)
any person whom the adult asks the authority to involve or, where the
35adult lacks capacity to ask the authority to do that, any person who
appears to the authority to be interested in the adult’s welfare.
(6) This section is subject to section 11(1) to (4) (refusal by adult of assessment).
(1)
Where it appears to a local authority that a carer may have needs for support
40(whether currently or in the future), the authority must assess—
(a)
whether the carer does have needs for support (or is likely to do so in
the future), and
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(b) if the carer does, what those needs are (or are likely to be in the future).
(2)
An assessment under subsection (1) is referred to in this Part as a “carer’s
assessment”.
(3)
“Carer” means an adult who provides or intends to provide care for another
5adult (an “adult needing care”); but see subsections (8) and (9).
(4)
The duty to carry out a carer’s assessment applies regardless of the authority’s
view of—
(a) the level of the carer’s needs for support, or
(b)
the level of the carer’s financial resources or of those of the adult
10needing care.
(5) A carer’s assessment must include an assessment of—
(a)
whether the carer is able, and is likely to continue to be able, to provide
care for the adult needing care,
(b)
whether the carer is willing, and is likely to continue to be willing, to do
15so,
(c)
the impact of the carer’s needs for support on the matters specified in
section 1(2),
(d) the outcomes that the carer wishes to achieve in day-to-day life,
(e)
whether, and if so to what extent, the provision of support could
20contribute to the achievement of those outcomes, and
(f)
whether, and if so to what extent, other matters (including, in
particular, the carer’s own capabilities and any support available to the
carer from friends, family or others) could contribute to the
achievement of those outcomes.
(6) 25A local authority, in carrying out a carer’s assessment, must have regard to—
(a) whether the carer works or wishes to do so, and
(b)
whether the carer is participating in or wishes to participate in
education, training or recreation.
(7) A local authority, in carrying out a carer’s assessment, must involve—
(a) 30the carer, and
(b) any person whom the carer asks the authority to involve.
(8)
An adult is not to be regarded as a carer if the adult provides or intends to
provide care—
(a) under or by virtue of a contract, or
(b) 35as voluntary work.
(9)
But in a case where the local authority considers that the relationship between
the adult needing care and the adult providing or intending to provide care is
such that it would be appropriate for the latter to be regarded as a carer, that
adult is to be regarded as such (and subsection (8) is therefore to be ignored in
40that case).
(10)
The references in this section to providing care include a reference to providing
practical or emotional support.
(11) This section is subject to section 11(5) to (7) (refusal by carer of assessment).