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Baroness Greengross: I support the amendment in the spirit in which it was moved by the noble Earl. I

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believe that we have received some clarification on it. I understand that the noble Earl does not mean that being deemed to have asked for an assessment will lead to a carer who does not wish to be assessed having to be assessed. I take that point.

I am also delighted that during the course of this debate the needs of carers have, for the first time, been spoken of in this way. I am sure that if the noble Baroness, Lady Pitkeathley, were here, she would echo the points raised about the needs of carers. We all look forward to seeing her back in this House very soon. I support the amendment.

Lord Hunt of Kings Heath: First, I thank the noble Baroness for her kind remarks in relation to my noble friend Lady Pitkeathley. I echo that we very much look forward to her return to our midst. I hope that carers will become involved in the new accountability and public involvement arrangements for the health service and, in particular, that they will become members of patients' forums.

The Government agree fully with the sense of the amendment moved by the noble Earl, Lord Howe. It may be worth informing the Committee that the Carers and Disabled Children Act 2000 comes into force on 1st April 2001. Guidance in relation to the Act issued under Section 7(1) of the Local Authority Social Services Act 1970 was published by my department on 1st March this year. That section states that local authorities must,

    "in the exercise of their social services functions ... act under the [Section 7(1)] guidance of the Secretary of State",

which, as we know, is statutory guidance.

The Government's aim is to ensure that all carers are aware of their right to an assessment under the provision of the Carers and Disabled Children Act. That has been achieved by instructing those who carry out assessments of people with carers to inform the carer of his right to ask for an assessment. In order to ensure that the carer has been made aware of that right, the assessor should also give him a copy of a new leaflet, How to Get Help in Looking After Someone: A Carer's Guide to a Carer's Assessment. That leaflet was drawn up in partnership with the Carers National Association and 1 million leaflets have been made available to local councils, social services and all other outlets.

Therefore, I hope that we are meeting the spirit of the noble Earl's suggestion in that carers will be notified of their right to an assessment. I hope that that will be helpful to them.

Earl Howe: That is a very helpful reply. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Clement-Jones moved Amendment No. 281:

    After Clause 60, insert the following new clause--

In section 21 of the Act 1948 (duties of local authorities to provide accommodation) there shall be inserted--

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"(9) Where a person--
(a) has previously made his own arrangements for receipt of care and attention in a residential care or nursing home,
(b) has requested an assessment under section 47 of the National Health Service and Community Care Act 1990, inter alia, with a view to obtaining community care services, including accommodation provided under section 21(1), and
(c) the authority has assessed that person as being in need of such care and attention under section 21(1),
any liability of that person to make any payments under existing arrangements, or alternative arrangements which may be made, shall cease either at the date that the request for the assessment is notified to the local authority, or if later at the date at which the person becomes financially eligible for assistance (under regulations made for the purposes of section 22), and liability shall pass to the local authority to fund that care and attention from that date.
(10) Regulations may provide for criteria as to whether the existing arrangements continue.
(11) The Authority may in respect of any payment made by them in pursuance of subsection (9) above, recover from that person such an amount in accordance with regulations made for the purposes of section 22.
(12) A person will be entitled to recover any monies paid in excess of the amount for which he is liable in accordance with the regulations made for the purposes of section 22 from the date at which the local authority became liable under subsection (9).""

The noble Lord said: This amendment is designed principally to address the problem of delay in assessment. The new clause aims to ensure that residents who have placed themselves in a home but who have reached the capital limit, which from April this year will be £18,500, are able to access the funding that they require at that point from local authorities. Such residents often face long delays in obtaining funding from local authorities. I have come across examples, which I shall not go into at this time of night, from both NACAB and Age Concern which illustrate that this is a serious problem. It would be conditional on their assessment confirming that such accommodation is needed.

The amendment is worded in such a way that if a person applied to a local authority and there were delays in the local authority's carrying out the assessment, it would be responsible for the fees as soon as the person reached the capital limit. It also contains provisions to refund the resident any expenses that he or she may have incurred outwith the means test.

The amendment is designed to assess the serious issue of delay. The Minister for Health in another place addressed that point to some degree during the Bill's Committee stage when he said that he thought that the guidance was adequate and that legal rights were adequate. Having considered what was said in another place, the guidance does not seem to be adequate because many local authorities appear to have delays and considerable problems are caused. People in residential homes find that their capital resources are reduced to below the capital limit, which is totally unfair.

If the Government do not agree to alter the primary legislation in the way that the amendment proposes, it appears that at the very least the guidance should be strengthened. I beg to move.

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11.30 p.m.

Lord Hunt of Kings Heath: The problem lies not with the guidance but with that number of local authorities that do not ensure that the guidance is implemented. I assure the noble Lord that when the department is notified that a local authority has not done the right thing, we have acted quickly to remind it of its responsibilities. If someone has been asked to contribute to the cost of residential care outside the means test, it is the department's view that there is a clear liability and responsibility on the local authority to put that right.

When councils delay providing due financial support and the resident loses out financially, he or she has recourse through the local authority complaints procedure, the local government ombudsman and, ultimately, the courts. The law is clear on that.

We have issued statutory guidance that leaves no room for doubt. In view of what has been said in another place and in Committee tonight, I agree that we have to stamp out bad practice. The Government will therefore again remind councils of their statutory duties at the earliest opportunity.

Lord Clement-Jones: I thank the Minister for that very positive reply, which was precisely what the amendment was designed to elicit. Reference to stamping out bad practice is exactly what is needed. I thank the Minister and look forward to the issuing of those reminders to local authorities. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 61 [Funding by resident etc. of more expensive accommodation]:

[Amendment No. 282 not moved.]

On Question, Whether Clause 61 shall stand part of the Bill?

Baroness Barker: This clause is welcome in one sense in that it will enable people who wish to enter residential accommodation that is more expensive than a local authority is prepared to pay to do so. However, I am worried about the lack of safeguards for those who use their own resources to do so. Having listened to the Minister's comments, I am also still concerned about the effect that the clause may have on the economy of the care home sector. In other debates, the noble Earl, Lord Howe, has discussed the great difficulties in that sector. One consideration in this context relates to people who use their resources to fund the additional cost of their care. When their money or their means have run down to the point at which they return to the local authority level, will the care home reduce the costs as they otherwise would have done?

I believe that much of this Bill is good but there are some areas that bear further examination. Is work being undertaken by the department concerning what constitutes realistic fee levels for residential and nursing care homes to ensure that they are reasonable? What safeguards are there to ensure that this provision does not force up the price of homes for those who are

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self-funding or who make their own contracts? What safeguards are there to ensure that local authorities comply with the choice of accommodation and that the fee levels quoted by local authorities reflect the cost of residential and nursing accommodation that is available in an area? We need to ensure that residents are not routinely expected to top up the costs of local authority accommodation.

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