Westminster CC v SL  UKSC 27
ISSUES: The main issues in the case were (a) the meaning of “care and attention” in s 21 of the National Assistance Act 1948, particularly as it applied to people with needs arising from mental health issues, and (b) whether, to be eligible for accommodation under s 21, the individual’s need for care and attention had to be related in some way to the accommodation to be provided: does s 21 only lead to accommodation for those whose care needs are “accommodation related”?
BRIEF FACTS: SL was a gay Iranian man who had applied for asylum. He suffered from mental health difficulties, had attempted suicide, and had recently been cared for within the psychiatric unit of a hospital. On leaving hospital he received assistance from the local community mental health team (CMHT).
His most recent assessments found him to be independent of all self-care needs. The social worker stated that he did not need “looking after” and that it would be counter effective, but decided that he would continue to be assisted in arranging activities and monitoring his mental state. This involved weekly meetings with a “care coordinator” who was a local authority-employed social worker. At these meetings the social worker provided advice and encouragement and monitored SL’s condition and progress. The meetings were at the social worker’s office and not at SL’s home. The local authority decided he was not in need of care and attention.
UKBA was willing to accommodate SL. Westminster CC was not willing to make a similar offer. In light of his needs arising from his mental health problems, SL’s lawyers considered that he fell within s 21(1) of the 1948 Act.
HELD: The Supreme Court framed the issues before it as whether the local authority was reasonably entitled to take the view it did that SL was not in need of care and attention and, if he was, whether it was available otherwise than by the provision of accommodation under s 21.
On the first issue of the meaning of “care and attention” the Court stated that the term “care and attention” takes some colour from its association with the duty to provide accommodation, that it is not confined to the care and attention that can only be delivered in specialist residential accommodation, and “the fact that accommodation must be provided for those who are deemed to need care and attention strongly indicates that something well beyond mere monitoring of an individual’s condition is required”.
The Court rejected Westminster’s argument that “care and attention” was limited only to personal care, or services of a close and intimate nature. The Court also rejected SL’s reliance on Lady Hale’s formulation in M v Slough that “care and attention” involved “doing something” for the person cared for “which he cannot or should not be expected to do for himself”.
On the second issue, the Court held that the care and attention required was available otherwise than by the provision of accommodation under s 21, stating at para 45 that “The services provided by the council were in no sense accommodationrelated. They were entirely independent of his actual accommodation, however provided, or his need for it. They could have been provided in the same place and in the same way, whether or not he had accommodation of any particular type, or at all”. And at para 48 that “The need has to be for care and attention which is not available otherwise than through the provision of such accommodation … the care and attention obviously has to be accommodation-related. This means that it has at least to be care and attention of a sort which is normally provided in the home (whether ordinary or specialised) or will be effectively useless if the Claimant has no home”. The Court rejected the “practicable and efficacious” test adopted by the Court of Appeal. Analysis of this case is provided at page 3.