“In general, I think he is able to cope with the normal activities of daily living. This may be compromised if his pain was not controlled adequately.”
“…the duration of his ongoing requirement for physiotherapy treatment is at present unpredictable, as this will depend on his response to treatment. In any case, the duration and nature of his symptoms suggest that his condition will require ongoing self-management following discharge from physiotherapy.”
“Difficulties with Cov. City Council: may have benefits suspended and no more accommodation because he is no longer seen to have a life threatening illness as in remission. Discussed. Plans to see Cov. Refugee Centre and a solicitor”
“Under considerable pressure about accommodation. Council have withdrawn flat now that health has improved. Symptoms of dizziness have recurred.”
“…he does require specialist NHS treatment and follow-up and care needs are more than the average healthy person and need for supported social housing is important to maintain optimal health in light of his chronic health problems”
“…Mr S’s current state of remission from Follicular Non-Hodgkins lymphoma (‘NHL’) was greatly assisted by his ability to benefit from stable accommodation and financial support whilst he underwent treatment. If that support is withdrawn, the consequences are extreme stress and physical neglect which will very likely precipitate a relapse of NHL.”
“His condition is quite unlike the circumstances of an average healthy person, in that he is always at risk of relapse of disease progression.”
“The position is that this authority is always prepared to conduct a reassessment or review when the circumstances warrant it; or where there has been a change of circumstances or where the passage of time causes the authority to consider whether its original assessment remains sound. However, whilst taking account of the medical report dated29th October 2008 which you copied to us, we can see nothing in the circumstances of your client’s case which would warrant such a reassessment or review.”
“The points you seek to make are contrary to [and they refer to numbered points]. A medical need is not a need for care and attention. A future need for medical treatment or otherwise is not a need for care and attention. Your client does not need to be looked after, he is not in need of care and attention, he is not entitled therefore to a service under Section 21. We see no qualification in the judgment of the House of Lords which would permit continued reliance on the case of Pajaziti contrary to the clear guidance given as to how the term care and attention is to be interpreted.”
“residential accommodation for persons aged eighteen or over who by reason of age, illness, disability or any other circumstances are in need of care and attention which is not otherwise available to them.”
“Paragraph 1 does not prevent the exercise of a power or the performance of a duty if, and to the extent that, its exercise or performance is necessary for the purpose of avoiding a breach of -- (a) a person’s Convention rights;”
“The main issue is the precise meaning of the words “in need of care and attention which is not otherwise available to them". It may well be that those who drafted section 21(1)(a) in 1948 assumed that it only applied to people who needed extra care and attention which could not be provided in their own homes.
“…we are required, by the NASS case, to accept that people who need care and attention which could be provided in their own homes, if they had them, can fall within section 21(1)(a). But that does not answer the question in this case.”
“First, the person must be in need of care and attention; secondly, the need must arise by reason of age, illness, disability or ‘other circumstances’ and, thirdly, the care and attention which is needed must not be available otherwise than by the provision of accommodation under section 21.”
“personal care of this sort but did need to be watched over to make sure that they did not do harm to themselves or others by what they did or failed to do.”
“‘care and attention” must mean something more than ‘accommodation’. Section 21(1)(a) is not a general power to provide housing. That is dealt with by other legislation entirely, with its own criteria for eligibility.
“…care and attention” in this context is “looking after". Looking after means doing something for the person being cared for which he cannot or should not be expected to do for himself: it might be household tasks which an old person can no longer perform or can only perform with great difficulty; it might be protection from risks which a mentally disabled person cannot perceive; it might be personal care, such as feeding, washing or toileting. This is not an exhaustive list. The provision of medical care is expressly excluded.”
“There has to be some sensible flexibility here. Section 21(1)(a) requires that the person “are in need of care and attention” so that the primary focus must be on present rather than future needs. But if there is a present need for some sort of care, then obviously the authorities must be empowered to intervene before it becomes a great deal worse.”
“A person must need looking after beyond merely the provision of a home and the wherewithal to survive -- beyond, therefore, the needs able to be met by NASS for suitable accommodation and subsistence. The looking after required does not have to be for either nursing or personal care. It must, however, be of such a character as would be required even were the person wealthy.”
“It is immaterial that this care and attention could be provided in the person’s own home if he had one (as he would have if he were wealthy). All that is required is that the care and attention needed must not be available to him otherwise than by the provision of section 21 accommodation.”
“that the words “care and attention” in section 21 (1)(a) ‘must be given their full weight. Their natural and ordinary meaning in this context is ‘looking after': this can obviously include feeding the starving, as with the destitute asylum-seekers in [Ex parte M]’.”
“M is not ‘in need of care and attention’ simply because he is without accommodation. However, in addition to being without accommodation, he is HIV-positive (and may have AIDS), he consequently must take medication which is provided to him by the NHS, he requires the use of a refrigerator in which to keep the medication; and he needs access to a medical practitioner four or five times a year. However, his illness does not otherwise affect him, and he can look after himself. The absence of somewhere to live, coupled with the requirement for medication, refrigerator use and access to a doctor, even taken together, cannot, in my view, be said to amount to a need for care and attention, as a matter of ordinary language. M simply does not need looking after.”