A consultation document containing proposals for regulations and guidance made under the Personal Care At Home Bill has been published today. An impact assessment accompanying the consultation is also attached.
The consultation will last from 25 November 2009 until 23 February 2010, but the Department would very much welcome earlier responses, if possible, to reach us by 26 January.
- Download consultation document (PDF, 352K)
- Download easyread version of the consultation document (PDF, 2866K)
- Download easyread answers booklet (PDF, 670K)
- Download impact assessment (PDF, 4846K)
- Download equality impact assessment (PDF, 104K)
- Personal Care At Home Bill - on the Parliament website (opens new window)
http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_109139
PDF version 
The Government sometimes adds a provision to a Bill which enables the Government to repeal or amend it after it has become an Act of Parliament. The provision enables the amendment of primary legislation using delegated (or secondary) legislation. Such provisions are known as "Henry VIII clauses". The House of Lords Select Committee on the Scrutiny of Delegated Powers in its first report of 1992-93 defined a Henry VIII clause as: a provision in a Bill which enables primary legislation to be amended or repealed by subordinate legislation, with or without further Parliamentary scrutiny. [HL 57 1992-93, para 10] The clauses were so named from the Statute of Proclamations 1539, which gave King Henry VIII power to legislate by proclamation.
Related information can be found from the following links.
http://www.parliament.uk/site_information/glossary.cfm?ref=henryvi_6723
The Commission for Social Care Inspection (CSCI) have updated their advice booklet, Social care - choosing the right service for you, published 2 January 2008, which encourages people to ask the right questions, find out as much as possible about their options, and then make informed choices about their care.
If you are looking to find a social care service for yourself, a relative or friend in the UK, the Social care - choosing the right service for you booklet gives you the information you need to find and talk to the right people and will help you and your family ask the right questions and tell you what you need to think about before making any decisions.
The booklet is divided into nine sections, which include:
- What you need to do first?
- Whether you can get any help paying for care and about the new Direct Payment Scheme
- The importance of being in control of your care;
- How to choose the right care service for you;
- How to get the most from your care provider;
- What can you do if you are not satisfied?
- How to report abuse or neglect?
- What support is available for Carers;
- Links to other organisations that can help;
We have based the following advice on the information given in the CSCI advice booklet and have provided links throughout the article to other websites with contact details to help you find out more specific information.
To establish what sort of help you need, you are advised to contact your local council and arrange for them to carry out a care assessment. Everyone is entitled to a care assessment no matter what your financial situation. The assessment should take into account your personal wishes and advise you fully on all the options available. It emphasises your right to decide how you want to live your life, where you want to live and with whom. So, if you would like to remain in your own home, every effort should be made to make sure that happens. Likewise, if you would prefer or need to be in a care home that should be taken into account.
These are just some of the care services available:
- Providing home help,
- Arranging for someone to collect your pension;
- Arranging to take you to a day care centre so you have company during the day;
- Have a volunteer take you out, to the library, or to a club, or class;
- Offer advice on your welfare benefits,
- Give help to your Carer, your friend or relative who normally looks after you;
Unlike Health Care, Social Care is not free to everyone. Local Councils have a limited amount of money and consequentially, they may only have enough money to provide social care for people assessed to have substantial or critical needs. Even if your needs do match the levels set by your local council, the council will also want to carry out a financial assessment. Depending on your income, savings and assets, such as your home, you may have to pay for some or all of your care.
For non-residential care services the value of your home will not be included when working out your financial position, however, for residential care services (such as care homes) there are certain circumstances where the council will be able to ignore the value of your home or maybe able to offer you a loan whilst you decide what you want to do with your property. You may find it useful to obtain some independent financial advice before deciding how to manage your money.
Further information can be found at the Department Of Health website
Or you will need to contact your local Council to find out information on how they work out charges for non-residential care and support people services. All of the Local Councils can be found here on the "Directgov" website.
Please note if you refuse to disclose your financial details for the financial assessment you will be asked to pay the maximum charge for the services you receive.
It is important that you consider all of your options and only make your final decision when you are happy you have all the information you need.
For Free independent financial advice you can contact the NHFA or SAGA at the following links:
NHFA Care Fees advice
SAGA Care Funding advice
In 2007, the Government introduced a new scheme called 'Direct payments'. The new scheme gives everyone the option to control their own care. Basically, you are assessed to determine what care you need and what funding you will receive from your local council. Then, you can choose to have the money paid from the local council into a bank account in your name, which you then use to fund your care. This gives you complete control over what care you want to receive and payment for it. It makes you the customer, so, if you're not happy with the services of your care provider you have the power to change your provider.
If you do decide to opt for the Direct Payment scheme you will need to manage the money you receive quite carefully. You will be expected to account for all the expenditure and if you do decide to employ you own independent Carer you will need to make sure that you fulfill your obligations as an employer, eg, make sure you pay their National Insurance contributions and tax to the government. In most areas there are Direct Payment Support Services to help you with any queries you may have.
Please make sure you know what is required of you before you make a final decision and discuss the different options available with your Direct Payment Support Services first. At the moment this scheme is entirely optional, so if you have any doubts discuss them with your local Support Service.
The National Centre for Independent Living have the details of your Direct Payment Support Services. You can contact them by phone on: 0207 587 1663 or visit their website at www.ncil.org.uk
There are numerous different types of Care Services available including Care Homes and care services at home, also known as Domiciliary Agencies, which help you to stay as independent as possible in your own home. Some social care providers now offer extra care housing or sheltered housing to enable you to stay independent but provide care as and when you need it.These services enable you to choose when and where you want help and enable you to mix and match different services which can include respite care to give your carer regular short breaks.
All the Support services have to be registered with the Commission for Social Care Inspection (CSCI) and are regularly inspected and reports prepared. These reports are available for everyone to read and it is important that you do read these reports to find out more about the service you are interested in and to find out how good they are.
The CSCI have introduced a 'Star' quality rating for all support services, (from 0 to 3 stars) which will be shown on the new inspection reports. 3 Stars being excellent to 0 stars being poor. For more information please click here to read our specific article on the new scheme.
You can read the inspection reports for the care service providers on The Care Homes guide by clicking onto the 'Latest Inspection Report' link from each of the providers details. Alternatively, you can view their reports on the CSCI website www.csci.gov.uk.
It is important that you discuss your requirements fully with the care providers and visit the home before you commit or arrange for the care provider to visit you. It is important that you feel totally comfortable with the care you will receive and to understand exactly what services are going to be provided, how much it is going to cost with no hidden extras, and whether it is possible to speak to existing clients to get their feedback. You may even be able to set up a trial period with the social care service or arrange a short stay at the care home.
For more information on choosing the right care home - click here to read our article
Do not be afraid to ask any question you have or go back to them if you want any further information. A good care service will be very happy to answer any of your questions.
It is really important to make sure that you regularly talk to your Care Service Provider to let them know if you have any concerns or whether you have any changes to your needs. If you don't let them know, they can not provide you with the help you need.
It is also really important to build up a good relationship with your Care Service Provider, remember the more they know about you and the difficulties you are having they can suggest changes to your care plan and how their staff can help you. A good Care Service Provider will be continually training their staff, so they maybe able to offer alternative improved care options that may suit you better.
Your Care Service Provider will provide you with a written care plan, which should be reviewed regularly as your needs change. The Care Plan will set out exactly what the Care Providers will do for you, when and how.
The Government have a set of minimum standards that the Care Service Providers should meet. These standards require care providers to be polite, respectful and to make sure you are treated with dignity.
If they are providing food for you, they should provide you with a choice of food, when and where you want to eat it, and they should ensure it has been prepared in accordance to your faith and religion. Your mealtimes are an important part of the day and should be an enjoyable experience. Your carers should give you the time, space and help you need to make sure you enjoy your meals.
It is your life, so you should be able to get up when you want and go to sleep when you choose. Spend your money how you like, and have privacy when you have visitors.
Each care provider has to have a complaints procedure. Under the minimum standards you have a right to complain if you are not happy with the service you are receiving.
Each type of Care service has it's own standards to be met:
- Adult Placement Schemes
- Care Homes for Adult Placements
- Care homes for Adults 18-65
- Care Homes for Older people
- Care at Home [Domicillary Care]
- Nurses' Agencies
To obtain a copy of the minimum standards relevant for the type of care service you are using you can obtain it at the Department of Health website www.dh.gov.uk or by calling their customer service Centre on 020 7210 4850.
So what do you do if you're not happy with the care you are receiving?
If there is any care you receive that you are not happy with you should discuss it with your Care provider as soon as possible. Your Care provider will want to know and do something about it.
You should have received information from your Care Provider on what you need to do if you have a concern or a complaint. If you do not have this information you need to contact the manager or the owner, or if your care is being provided by a council run service you should contact your local council. All complaints and concerns are recorded along with a record of what has been done to resolve the concern or complaint. The care providers must give you a proper response within an agreed timescale.
If you do not get any satisfaction from your Care Provider to your concern or complaint you can get in contact with the Commission for Social Care Inspection and share your concern with them, so that at the very least they can check whether the service is meeting the national minimum standards and complying with the regulations. You may then feel that the service you are receiving from your Care Provider is not suitable and you can change your provider.
Abuse and neglect of people receiving social care services is a criminal offence. Although the information from the CSCI suggests that despite the media coverage, abuse and neglect of people using social case services is not widespread, they want to make sure that if it does happen it gets reported to either your local council, the police or the Commission for Social Care inspection.
Abuse can take many forms including, physical, verbal, or financial such as stealing someone's money. People can also suffer abuse and discrimination because of their disability, religion, cultural identity, or sexuality.
Neglecting someone who is unable to look after themselves is also extremely serious. This can take the form of giving someone a meal but failing to give them the knife, fork spoon so they can't eat it or leaving them in bed for too long so they develop bed sores.
If you have any concerns about the treatment or abuse of someone you know, please report it to the local council, police or the CSCI, they will all work very discretely to investigate. It is their priority to always protect people from further harm.
If you are a carer, are you able to get any financial help or some time off?
Family and friends make up 75% of the carers providing social care in the UK. For some carers this is a 24 hour responsibility. Not all carers are aware, but they are entitled to receive benefits and can have a 'carer's assessment' themselves. Carers are also entitled to four weeks paid holiday each year.
Carers UK, an organisation who make sure carers know about their rights and the help available to them, is aware of many carers who do not know about their rights or how to get help. Every year £740 million of carers' benefits are unclaimed.
Carers UK have produced a Free advice guides for carers setting out what rights carers have and how they can get:
- financial help -
Financial help can include grants for adaptions and repairs to your home, discounts to your council tax, help with your fuel bills and discounts to your TV licence.
- practical help -
Practical help can include: someone to sit with the person you care for while you go out for an hour, equipment to help you to lift the person you care for, information about local carers groups or arranging a break for yourself so that you can have a rest. The best place to start looking for this help, is your local social services department.
- help with combining work and caring -
It is helpful to have access to information and advice in your workplace. Some companies operate counselling services and have advice packs for carers and trade unions can also be a good source of information and support. It may be that all you really need is access to a telephone so that you can keep in touch with the person you care for.
To order a free copy of the guide call 0808 808 7777, alternatively you can download a copy of the guide here.
If you would like to have a carer's assessment, you should contact your local council for advice on what support they can offer. All of the Local Councils can be found here on the "Directgov" website. Alternatively their contact details will be in your local phone book.
For further information and help on specific issues please visit the Cares UK website: http://www.carersuk.org
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The booklet will be available from local councils, libraries, Doctors' surgeries, Citizens' Advice Bureaux and hospital Patient Advice and Liaison services.
If you would like to find out more about the Commission for Social Care Inspection please visit the CSCI website here (opens a new window).
London boroughs are concerned that the Government's social care proposals – as outlined in the Personal Care at Home Bill – have not been sufficiently thought through. As a result, there is a risk that perverse incentives could be created and that strongly performing councils are punished.
London Councils supports the principle of helping more people with care needs to stay in their own homes for as long as possible. However, there are a number of key concerns about the Government's proposals, including:
- the robustness of the Bill Impact Assessment;
- the feasibility of the proposed local government efficiencies;
- the creation of perverse incentives that disadvantage already strongly performing councils – particularly those in London, and;
- implementation pressures and workforce issues.
For more information on the Personal Care at Home Bill read the London Councils briefing below.
Follow the progress of the Bill through Parliament.
related documents
Personal Care at Home briefing (PDF, 110.76Kb)
http://www.londoncouncils.gov.uk/lobbying/health/Personalcareathome.htm
Bill Main Page
Copy of the Bill
Explanatory Notes
Commons Reasons
11.52 am
That the House do not insist on its Amendment 1, to which the Commons have disagreed for their Reason 1A.
The Commons disagree to Lords Amendment No. 1, for the following Reason-
1A: Because it would alter the financial arrangements made by the Commons, and the Commons do not offer any further Reason, trusting that this Reason may be deemed sufficient.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Thornton):
My Lords, with the leave of the House, I will also address Motions B and C. The Government have listened to local government and to the concerns expressed here and in another place. By accepting Lords Amendment 2, the Government recognise that a new Parliament may wish to confirm the arrangements for implementing this important first step towards a future national care service. Local authorities will still have the time that they have told us they need to implement the legislation most effectively, subject to parliamentary approval of the commencement order. This recognises the collective desire for more time to implement these measures and for more time to scrutinise them. It does so by requiring a commencement order to be laid and approved by both Houses before the Act can come into force.
In accepting Motion A, therefore, this House is accepting that Lords Amendment 1, due to its current wording, would delay the implementation of the scheme until June 2011 at the earliest. This is because it prevents regulations being made and signed by the Minister before laying until 1 April 2011 at the earliest. Many people in many places say that April 2011 implementation is what they want, and we have committed in another place to bringing in the regulations which would achieve this.
Accepting Motion C recognises that Lords Amendment 4 inserts what is known as a sunset clause and would require the Act resulting from this Bill to lapse at the end of two years after Royal Assent unless there were regulations in force. This is now not a necessary amendment. The White Paper now makes
8 Apr 2010 : Column 1668
clear that the personal care offer enabled by this Bill is an integral part of the staged route to a national care service.
It is clear from Reason 3A why Motion B is being moved. The amendment has been subject to debate in both this House and another place. The Minister for Care Services in another place, Phil Hope, applauded the quality of the debate in the House of Lords. He described it as being of our usual consistent high standard and it has led us to include, among other things, the transitional portability of assessment.
I hope that these proposals now clearly show that we have tried to achieve a consensus on the way forward. I beg to move.
My Lords, I moved the amendment to delay the implementation of the Bill until April next year in your Lordships' House, where it was carried by a huge majority. I was representing the views of local government as articulated by the Local Government Association, of which I am president. I might now be expected to be rather disappointed by the rejection of the amendment by the other place; however, by accepting subsequent Amendment 2, which was moved by the noble Lord, Lord Lipsey, the other place has provided the opportunity for implementation of the legislation at a later date than that proposed in my amendment. The Secretary of State, Andy Burnham, and the Minister of Health, Phil Hope, have given commitments that implementation will not begin before 1 April 2011. The Local Government Association has therefore expressed itself as very pleased with this change achieved by your Lordships, for which the LGA is most grateful.
That the House do not insist on its Amendment 3 to which the Commons have disagreed for their Reason 3A.
3: Page 2, line 31, at end insert-
"( ) This Act shall not come into force until the Secretary of State has commissioned an independent review of the affordability of the provisions contained within this Act and has laid the report of that review before both Houses of Parliament."
The Commons disagree to Lords Amendment No. 3, for the following Reason-
3A: Because it would involve a charge on public funds, and the Commons do not offer any further Reason, trusting that this Reason may be deemed sufficient.
That the House do not insist on its Amendment 4 to which the Commons have disagreed for their Reason 4A.
8 Apr 2010 : Column 1669
4: Insert the following new Clause-
"Expiry
(1) This Act shall cease to have effect at the end of the period of two years beginning with the day on which it is passed unless the condition in subsection (2) is satisfied.
(2) The condition is that regulations made under section 15 of the Community Care (Delayed Discharges etc.) Act 2003, having the effect of requiring the provision of personal care at home free of charge for periods of more than six weeks, are in force."
The Commons disagree to Lords Amendment No. 4, for the following Reason-
4A: Because it would alter the financial arrangements made by the Commons, and the Commons do not offer any further Reason, trusting that this Reason may be deemed sufficient.
http://www.publications.parliament.uk/pa/ld200910/ldhansrd/text/100408-0...
The Law Commission looks set to take forward plans to free social workers from adult care's "confusing and complex" assessment framework after they won "unanimous support" from sector leaders.
The commission's plans to introduce a single legal framework for assessment were strongly endorsed as part of its consultation on reforming the law on adult social care, which closed yesterday.
Currently, there are multiple and different duties to assess people for community care services, a situation the commission described as "overlapping, complex and confusing".
Law commissioner Frances Patterson, who is leading the review, said respondents strongly backed its proposal to institute a single duty to assess in law, which would be triggered when a person appears to have needs that can be met by community care services or direct payments.
This is similar but not identical to the current duty under section 47 of the National Health Service and Community Care Act 1990.
The commission is due to publish final plans to establish a single overarching statute for social care next April, bringing together 38 existing laws. It will be up to ministers to decide how this is taken forward.
Patterson said there was similarly strong backing for its proposal to streamline the system for determining eligibility for care services following assessment.
Other areas that received universal backing included:
• a duty to co-operate between councils and other agencies in social care.
• powers for councils to assess children over 16-years-old for adult services to smooth the transition process.
• a legal framework to enable users to move between areas and retain access to services.
She said: "The consultation process has gone extremely well, we are satisfied that it has been comprehensive."
Patterson said the biggest area of debate was how a new social care law would define the boundary between health and social care in law. She said: "It's one of the areas which has come up repeatedly. It's possibly not as clear cut as it appeared in our consultation paper."
The commission proposed to maintain the existing legal boundary between health and social care, which prohibits councils from providing services the NHS is under a duty to provide. However, Patterson said commentators said that the Law Commission's approach had not adequately addressed the interaction between health and social care and some health laws would also need to form part of the review.
Those responding had also expressed concerns about confidentiality following proposals to require statutory authorities to share information in safeguarding cases.
Some feared the suggestion that a duty be introduced to reduce future levels of need for care through preventive services may not be realistic because many of those with lifelong conditions will always require some assistance, Patterson said.
The commission's final report will be published on 28 April 2011 after the government asked for the date to be bought forward from the summer.
This is to ensure that the Law Commission's proposals can be co-ordinated with those of the commission on long-term care funding, which is yet to be appointed.
Related article
Law Commission to draft new adult social care law
Single adult social care law brought forward
http://www.communitycare.co.uk/Articles/2010/07/02/114830/backing-for-si...
Counsel and Care responds to government consultations on the care and support of older people. We do this in our own right and as members of coalition groups (see our partnerships). By ensuring that we participate in the key consultation exercises, we can continue to improve services for older people, their families and carers.
Read Counsel and Care's responses to key consultations in 2010:
Charging for Residential Accommodation Guidance April 2010
Personal care at home regulations and guidance January 2010
Direct payments in healthcare January 2010
Assessments of quality 2010/11
http://www.counselandcare.org.uk/influence/consultation2010/
http://www.londoncouncils.gov.uk/HealthAndAdultServices/consultationsand...
http://www.mssociety.org.uk/downloads/Microsoft_Word_-_Personal_care_at_...
http://www.learningdisabilitycoalition.org.uk/download/LDC%20Response%20...
http://www.counselandcare.org.uk/assets/library/documents/Personal_Care_...
http://www.mencap.org.uk/page.asp?id=10624
http://www.cpa.org.uk/cpa/consultation_building_society_for_all_ages.pdf
http://benefits.tcell.org.uk/forums/personal-care-home-consultation-gove...
http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/index.htm