Contracting Out (Local Authorities Social Services Functions) (England) Order 2011

Baroness Thornton Excerpts

Monday 13th June 2011 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, the purpose of the order is to allow local authorities taking part in two pilot programmes to contract to outside organisations certain adult social services functions conferred on them by a variety of legal provisions. The pilots are, first, adult social work practices pilots and, secondly, right to control pilots. In short, the SWP pilots will test various models of social worker-led organisations undertaking adult social care functions for which local authorities are currently statutorily responsible. The right to control pilots will test the exercise of disabled people’s right to manage the state support they receive to live their daily lives. I will explain each pilot programme in greater detail as I go along.

The Government’s vision for adult social care set out a new agenda for adult social care based on a shift of power away from the state to the citizen by putting people, personalised services and outcomes centre stage. We are committed to the devolution of decision-making close to those who are responsible for the service delivered and, wherever possible, into the hands of those who are the service beneficiaries. This is an integral component of our wider personalisation agenda. We also want to ensure that individuals, carers, families and communities work together with local services, balancing family and community action with state support. Again, this is an integral component of our big society vision.

Since 2008, the Department for Education has funded SWP pilots to deliver services for children and young people in care. The pilots have seen the creation of independent, social worker-led organisations, including social workers moving out of public sector employment to form their own employee-owned social enterprises. The pilots also co-ordinate and monitor services provided to the children and young people in the SWP. They are independent of the local authority, but work closely with it and in partnership with other providers. The local authority pays the SWPs for the services provided.

Last November, my right honourable friend the Secretary of State announced that the Government wanted to test this concept in the adult social care sector, with pilots running for two years starting this summer. The emerging evidence from the Department for Education pilots strongly suggests that both clients and staff will benefit from service delivery by SWPs. That is why we are giving local authorities this opportunity to test the potential benefits of the SWP model and adopt a completely innovative approach to delivering services for adults and their carers.

We want not only to improve the experiences and outcomes for people in vulnerable circumstances, but also to empower social workers to do their jobs effectively, and we want to reduce the unnecessary bureaucracy that so often gets in the way. The programme will bring people who need health and care support closer to those who provide the services they need by reducing bureaucracy and encouraging innovation and personalised services. It will also give social workers the freedom to run their own organisations in the way they want within the constraints of their contract with the local authority. Evidence shows that staff working in employee-owned organisations have greater job satisfaction, leading to lower staff turnover and capacity for greater innovation.

SWPs will discharge the functions of the local authority in providing adult social care services and be responsible for providing the support to people receiving services from the SWP to achieve better experiences and better outcomes. They will also be responsible for undertaking delegated social work functions, managing day-to-day support, co-ordinating and monitoring service provision, and of course this will differ between the pilot sites. The local authority will keep its strategic and corporate responsibilities and will manage the contract and partnership with the SWP. I will speak a little later about concerns that noble Lords may have about possible risks associated with the delegation of these functions.

The SWP pilots will give local authorities a unique opportunity to test the potential benefits of various models and to adopt innovative approaches to delivering services for adults and their carers. The Department of Health is providing funding in the region of £1 million to help the pilots get up and running and to provide initial support. The pilots are an opportunity to test different models to see what works well and what does not, and they will be evaluated fully both during and at the end of the two-year period.

Primary legislation specifically allowed councils taking part in the Department for Education pilot programme to delegate their statutory functions in relation to looked-after children to SWPs. There is no equivalent legislation to allow the delegation of adult social care functions. However, the Deregulation and Contracting Out Act 1994 allows the making of orders allowing such delegation, and that is why we are seeking to introduce the order under discussion today.

The right to control, introduced by the previous Government in the Welfare Reform Act 2009, gives disabled adults greater choice and control over certain state support they receive to go about their daily lives. The right is based on the principle that disabled people are the experts in their own lives and they can decide what support they need and how it should be delivered. It is essentially a variant relating solely to disabled people within the general concept of personalisation.

The right is being tested in eight local authorities in England. These trailblazers, funded by the Office for Disability Issues, will evaluate the best ways to implement the right and will be used to inform decisions about whether and how to roll out the right more widely. Disabled people accessing the right to control will have a right to be told how much money they are eligible to receive for their support. They will be able to choose, in consultation with the public authority delivering the funding stream, how that money is used to meet agreed outcomes. They will be able to choose different degrees of control over their support.

One local authority has asked us whether it could test the delegation of its statutory duty to review social care assessments to third parties such as user-led organisations. As part of their vision for adult social care, the Government have stated their expectation that by April 2013 councils will provide personal budgets for everyone eligible for ongoing social care, preferably as a direct payment. Evidence shows that people who have their circumstances reviewed by fellow service users under appropriate supervision are far more likely to have their care and support needs met to their satisfaction and to request direct payment of their personal budgets to enable them to make their own support arrangements. We were therefore happy to agree to the request and the order allows delegation of the assessment functions under Section 47 of the NHS and Community Care Act 1990, which is also available to the councils piloting SWPs.

I said earlier that I would address concerns that noble Lords might have about the powers provided by the order. I fully understand how the delegation of council functions to outside bodies might raise concerns about potential risks to service users. It is always a balancing act when people are given the freedom to try new ways of doing things with the aim of improving other people’s quality of life. On the one hand, might service users be exposed to unnecessary risks, while on the other, might they not benefit from being able to make more decisions for themselves? Functions in social work practices have to be carried out by or under the supervision of a registered social worker or, in the case of right to control, by a person with requisite competencies or qualifications. I should like to assure noble Lords that accountability for the care delivered to vulnerable people will not change. Each local authority will retain overall responsibility for the services delivered by the SWP it contracts to, just as it does in relation to other local services. In this respect, the contract between the local authority and the SWP will be critical. We expect councils to monitor closely the outcomes of the practices, identifying issues early and providing support, while allowing them the scope to innovate and make decisions about the best packages of support and services for their population. Any potential risks will, of course, be reflected in any recommendations coming out of the separate evaluations.

In conclusion, we see this order as an important marker of progress in the developing world of personalisation. On the back of persistent requests from within the sector for greater freedom of choice and control for both staff and service users, this order has the support of councils and their representatives, as well as service users and their carers. It will enable the release of new partnerships and new ways of working to the benefit of individuals and their communities as a whole. I commend the order to the House.

[Baroness Thornton]

My Lords, I thank the Minister for introducing the order and explaining its purpose so well. It is one of those orders the name of which belies its importance and its comprehensibility. As the Minister explained, the order is similar to one concerning children’s services from some years ago. Its purpose is designed to pilot flexibility at local authority level and test innovative approaches to delivering services to adults and their carers. As it is designed to foster new ways of delivering care on the ground with the caring and cared-for—in other words, user-led services—we would all agree that it is a good thing.

The meat of the order is in Article 3(2). Most of my questions centre on the practical details of delivery and how to ensure the safety of the adults concerned. The Minister has addressed some of those already. The noble Earl said that one local authority in the pilot involved the right to control. I wonder which authority that is, which seven authorities have been chosen and how they were chosen.

I am interested in the right to control. I should be grateful if the Minister could explain in more detail what the interface between the trailblazers funded by the ODI is. What benefits could there be to using those powers with the right to control, which is being explained in this order? I am not quite clear on how those would work. How will continued support and resources for co-production with disabled service users—an essential component of successful delivery of right to control—be maintained if there is a marriage between the two regimes?

How will the local authority authorise the third party to undertake social services functions? What criteria will they use, given that no guidance is to be made available with this order? Perhaps the Minister could paint us a picture or give us an example of that.

I should be grateful if the Minister could untangle the approved provider and independent mental capacity advocate by explaining who will be doing what under this proposed regime. Given that social work is regulated, as the Minister explained, can he confirm that that same framework will apply under this order? Can he confirm who—I assume it will be the local authority—will approve the individuals, businesses, charities and social enterprises that participate to ensure that their practice is of the highest standard when they deal with this most vulnerable sector of the community? If things are not working out properly for the person in receipt of care under this order, who would they go to and how would they do that?

Finally, if the person who is undertaking the functions under this order is not a registered social worker, what check will there be on their qualifications to carry out the functions required? I should be grateful if the Minister could explain who is undertaking the monitoring and reporting, and how long it will take. What does the Minister envisage the next steps would then be?