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Lord Northbourne: It may be for the convenience of the Committee to take my Amendments Nos. 47, 48, 76, 121 and 147 with this group. They address the same issues in perhaps a more general way. In the context of the Government's understandable desire to create national minimum standards, my amendments refer to different minimum standards being relevant to different categories of need and of agency or establishment. The amendments tabled by the noble Lord, Lord Rix, refer to the provision of different services for the different categories of service users. Those tabled by the noble Lord, Lord Clement-Jones,
relate to the problem of autism and special requirements for special disabilities or conditions. However, the issue is one and the same.I am not satisfied that the Bill empowers the Minister to set different minimum standards for the different categories of establishment, of people or of service users. I envisaged different levels of medical intervention such as those referred to by the Minister during our discussion on a light level of plastic surgery as against more intensive surgery.
The needs of old people are clearly distinct from those of children. My interest is in the different categories of children and I happen to be a trustee of the Caldecote Community, which contains extremely damaged children. The ratio of adults to children is two to one and the cost per child per year is £75,000. At the other end of the scale are the homes in which the children are less demanding and their needs can be met at less expense.
I cannot see how, without different standards, the Government can meet the different levels of need. That is unless the standard they set is so low as to accommodate anyone and that would amount to little more than having a roof over their heads, hot water and drainage. On the other hand, an unnecessary and unattainable level of sophistication should not be applied.
If there is any doubt that the Bill gives the Minister the necessary powers to create different categories of minimum standards, we should put it right now. If we have it wrong and set it in tablets of stone by approving the Bill, we shall be faced with the need for primary legislation.
8.45 p.m.
Lord Clement-Jones: Members of the Committee have made clear the purpose of these amendments. I want to speak in particular to Amendment No. 69, standing in my name and that of my noble friend Lady Nicholson, and to Amendment No. 77, so cogently introduced by the noble Lord, Lord Astor of Hever.
As the noble Lord, Lord Northbourne, made clear, it is a matter of laying down standards and regulations which are specific to particular establishments or service users. The regulations must be flexible but specific, rather than be laid in a blanket form. I was struck by the example given by the noble Lord, Lord Astor, of the young man who had a need for space and an absence of clutter in his bedroom. That clearly illustrates the kind of specifics that we must reach. I look forward to hearing whether the Minister believes that the Bill can give such a level of flexibility.
Amendment No. 69 attempts to discover whether it is possible for regulations to apply to particular categories of establishment or agency, or particular establishments or agencies, rather than provide a simple set of standards which applies across the board. It is important that the Minister is satisfied that the Bill is sufficiently specific in order for us to go forward with confidence in the belief that all the people whom we are
trying to protect and for whom we are trying to provide high quality services will be adequately catered for.
Lord Hunt of Kings Heath: This is an important group of amendments. I share the view of Members of the Committee that it is important that the regulatory system should recognise the specific needs of particular people and client groups. I hope to reassure them that, in agreeing the legislation, regulation can be targeted at those who are receiving a particular type of care. However, we must strike a balance in order to ensure clear, enforceable standards at a national level. I believe that, in the provisions of the Bill and the detail which will be prescribed under it, we have struck that balance.
I turn first to Amendment No. 28. We expect the commission to furnish information about the service provided for particular categories of people. The commission will be inspecting a range of services such as homes for children, older people and those with mental health problems. While doing so, it will learn about the availability and quality of provision of services for those and other groups of people. The information and knowledge gained by the commission will allow it to help policy makers. We expect it to provide a variety of information about the quality and availability of care services, including services for particular groups of people, as well as breaking down the analysis in other ways.
Clause 7 is drafted widely in order to allow the commission to provide different kinds of information. It allows the commission to report information it believes to be important and it allows the Secretary of State to request specific information. I do not believe that the amendment increases that ability and therefore I do not believe that it is necessary.
I turn to Amendment No. 69 and make it clear that the regulations will recognise, for example, that suitable requirements for the premises of a care home will differ from those of a private clinic. Regulations made under Clause 20(1)(g), relating to the number and type of persons working at an establishment or agency, will have to recognise the different staffing needs of children's homes compared with those of a private hospital. The need for regulations to be applied appropriately and for different regulations to be made under the same power was borne in mind as the Bill was being drafted. Accordingly, Clause 94 provides that any power to make regulations under the Bill,
- "may be exercised either in relation to all cases to which the power extends, or in relation to all those cases subject to specified exceptions, or in relation to any specified cases or classes of case."
I emphasise that, when it comes to considering the different sorts of standards for different types of care home catering for different types of people, that does not mean to say that the standards expected will be
completely different. It is quite likely that there will be some core standards common to all care homes, but beyond that there will be additional standards specific to different categories of care home. The same will apply to children's homes and other establishments and agencies. Clause 21 as drafted already allows the Government to prepare and publish different sets of national minimum standards for different types of establishments and agencies.In relation to Amendments Nos. 75 and 77, I believe that the points raised by Members are covered. The noble Lord, Lord Astor, raised some pertinent points about the particular issue of autism. I am satisfied that under the Bill and the regulations we can make specific standards for homes looking after people with autism. As with other arrangements for national minimum standards, of course we shall wish to discuss with those most intimately concerned--both the users and the providers of care--the range and extent of those particular standards. I shall certainly make sure that the noble Lord's comments are very much borne in mind as we take the work of the commission forward.
I turn now to Amendments Nos. 47 and 48, which essentially cover the same ground. Clause 3 of the Bill gives a general definition of a care home as being an establishment which provides accommodation together with nursing or personal care for people who are, or have been, suffering from an illness, who are disabled or infirm or who are, or have been, dependent on drugs or alcohol. That over-arching definition encompasses a whole variety of different possible care homes for different users.
However, that is not to say that a single care home will be able to take any type of client no matter what his or her needs. We do not believe that that would be at all appropriate. As I have said, people will have different needs and require different types of care. The needs of the young adult with a physical disability will be different from those of an older person with Alzheimer's disease. Obviously different types of care home will be needed to accommodate them. Homes will be registered to provide certain types of care only, which will be specified in the registration certificates.
I am grateful to the noble Lord for tabling the amendment because it enables me to say a little more about how that will actually work out in practice. People applying for registration will be required to give certain information in their applications. That will include the type of care that they wish to provide as well as the numbers of people they wish to accommodate, their age range, and so on. The commission may then grant the application either unconditionally or subject to such conditions as it thinks fit, provided, of course, that the establishment meets the relevant regulations and standards. In the case of a care home, the commission will always impose registration conditions relating to the category of care that the home may provide, the maximum number of residents it may accommodate and their age range. Those will be the minimum conditions of registration placed on all care homes.
As Clause 10 already allows the Government to make the necessary regulations, I hope that the noble Lord will accept that these particular amendments are not needed.
I turn now to Amendment No. 76. I reiterate that Clause 21 as drafted already allows the Government to prepare and publish different sets of national minimum standards for different types of establishments and agencies. That point is well covered.
I turn to Amendment No. 147. I again agree with the noble Lord that there will need to be different standards for different categories of schools. For example, one would not expect boarding schools for children with special needs to have the same standards as mainstream boarding schools. One would clearly expect staff to demonstrate different skills. Clause 86 as it stands already provides the powers that we need to ensure that there are appropriate standards for the full range of different types of boarding schools.
On Amendment No. 121, I can assure the noble Lord that the clause provides for all three types of persons listed in it to be included in the definition of social care workers. It is a drafting convention to indicate alternatives as "(a), (b), (c)" and not as "(a), or (b), or (c)". I hope that on those grounds the noble Lord will feel that that amendment is not necessary.
In conclusion, I very much take the points that all Members of the Committee who have taken part in the debate have raised. The standards required must fit the purpose of the particular establishment being inspected and registered. I hope that I have indicated that the Bill as drafted allows that to happen.
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