Care Bill [Lords]

Written evidence submitted by David Hawker (CB 10)

I am writing to inform you about a problem with local authority policies on medication handling in social care. I am aware that medication handling is not currently addressed within the Care Bill. I would like to suggest that you consider including brief legislation in the Bill to clarify Parliament's position.

The problem is that, at present, it appears that carers in England are often not permitted to help disabled clients take non-prescribed medicines of their choosing.

This problem came to my attention because my mother has been receiving personal care in her own home, in Leicestershire, for several years. As well as taking prescribed medicines, she uses several substances which her GP cannot prescribe, such as herbal medicine, creams and tinctures, and dietary supplements. Her GP has no objection to any of these substances and has confirmed that my mother has full mental capacity to use them. But because of her physical disability, she cannot take some of the substances without assistance.

In September last year, my mother's care provider decided that carers may not assist her with non-prescribed medicines in any way. Social Care has confirmed that the provider's decision was consistent with Leicestershire County Council's policy. They see it as following from the Care Quality Commission's guidance (specifically The Health & Social Care Act 2008 Regulations 2010, Regulation 13), though I cannot see that their view is supported by medical opinion or written policy, or by the regulation they cite. I understand that many care providers and other local authorities agree with Leicestershire's position. The reasons for the view seem to be driven by fear of carers being held responsible for harming service users, even those who have full mental capacity, and who therefore hold full responsibility for the choices they make.

I am concerned that care providers are not supporting their clients to make their own decisions about treatment. Providers' refusal to assist mentally competent service users in their choices seems like an attack on personal freedom, as well as a failure of person-centred care, service integration, and disability support.

This is not a unique issue affecting one person, one provider, or one local authority that we could effectively address through local authority or omburdsman complaints procedures. Rather, it seems to be a common view among local authorities that paid carers should never help their clients use non-prescribed medicines, even when medical practitioners do not object and the service user has full mental capacity. Does the Care Bill Committee share that view? If not, it appears that local authorities are lacking guidance to form sensible policy in this area. Will you include legislation in the Care Bill to clarify Parliament's view?

January 2014

Prepared 10th January 2014