The care needs assessment
If you’re an adult needing help with everyday tasks, your local authority has a legal duty to carry out a care needs assessment. They decide whether you’re eligible for social care based on your care needs, not your financial circumstances. You can find out about the eligibility criteria for services on your local authority’s website.
If you pass the care needs test, you’ll then have a separate financial assessment to work out how much you’ll have to pay towards the services you need although some may be free. For more detailed information on the financial assessment read this helpful guidance.
Health needs assessment
Your local authority is only responsible for your personal care needs, not your health care needs. Your health care needs are the responsibility of the NHS. You can find out more about applying for continuing NHS care here.
How are decisions made?
The local authority decision about the care you need is made by comparing your needs with a set of nationally agreed criteria which all Local Authorities must use. The assessor must also take into account how these needs affect your general well-being when they decide if you need support.
You will qualify for support with your care from the council if your difficulties have a big impact on your life and wellbeing.
Your needs assessment must show that you answered ‘yes’ to all three of the following questions:
- Is your need for support caused by a physical or mental impairment or illness?
- Are you unable to achieve two or more of the following care outcomes:
- Prepare and eat food without help and get enough to drink;
- Wash yourself and clean your clothes;
- Use a toilet and manage all your toilet needs;
- Dress yourself properly;
- Move around your home safely;
- Keep your home safe and habitable;
- Have enough contact with other people;
- Take part in activities, like volunteering, training or learning;
- Use services such as public transport and local shops;
- Carry out any caring responsibilities you have for a child.
- Could this have a significant impact on your wellbeing?
Care services include:
- Residential care or nursing homes;
- Disability equipment and adaptations to your home;
- Home care help with things like cleaning and shopping;
- Day care for your child if either you or they have a disability;
- Day centres to give you or the person who cares for you a break.
Preparing for the assessment
Independent Age give the following essential tips to get the best out of your assessment:
- Make sure you mention all your needs;
- Don’t be afraid of asking questions if anything is unclear;
- Be honest about your situation;
- Keep a diary so you can tell the assessor about your needs on a bad day as well as a good day;
- Make a list before the assessment so you can remember what you want to say;
- If you think the assessment didn’t go well, contact social services to ask them to look at the assessment again.
Make a written description of your difficulties before the assessment (with help if necessary).
It is essential that you can show a detailed account of all the tasks you find difficult, especially on ‘bad’ days, so you can show evidence and discuss them during the assessment. Keep a record (either yourself if you can or with the help of a trusted relative, friend or helper) of how your daily self care routines and activities go for as long as you can before the assessment starts. You will then have a current clear record of what you can’t manage.
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What should you record?
Use the 10 care outcomes listed above to organise your records (but if that’s too difficult use just the one label for care outcomes).
Say what goes badly with your daily activities each day, being specific about the actual task, the difficulties you encountered and the time you took.
If someone already helps you with any of these activities, this still counts as a need you have, so you should make sure that you record on each occasion whether you carry out these tasks either with or without help. It would be a good idea if whoever gives you help also contributed to your records. Rate the level of difficulty you experience each time.
Record the same tasks over time and each and every time you do it. It may seem repetitive but don’t worry there really is a point to it. This will show if the same activity is easier on one occasion than another or if something has happened to make things harder for you. For example if you’re being assessed on a good day it’s bound to influence the assessor’s thinking unless you have evidence that it’s normally worse. Your records will give the assessor a much better picture of how you fare each day rather than having to explain in a question and answer conversation. You will be armed with evidence from the start of the assessment and needn’t worry about not being able to remember enough or explain your situation well enough.
What happens at the assessment?
You can find lots of useful guidance online about the care needs assessment and what to expect. We recommend you follow the guide on the Independent Age website.
Have support at the assessment itself
It’s a good idea to have a friend, family member or ideally your helper who knows your difficulties first hand with you at the assessment so that they can help you explain how your condition affects you. If there isn’t anyone who could be with you and if you would find it very difficult to understand the assessment or to explain your needs, the local authority must arrange an independent advocate to help you at the assessment. Ask to meet the advocate before the assessment so they understand the evidence you’ve collected on the app and make sure it’s all discussed.
The better your account the more likely the assessment will be successful and tailored to your needs.
Keep a written record of what happens during the assessment in case things go wrong.
In lots of cases the assessment will go smoothly and professionally and the outcome is fair but sadly this is not always the case. Lots of different things can go wrong and lots of applicants have to complain.
Consequently we recommend that, whenever you begin to feel that things might not go well or if things about the assessment start to go wrong, you make a record of your interactions with the local authority and anyone else you come into contact with acting on their behalf. If you make records relating to your experience of how the local authority carry out the assessment this will go a long way to assisting you if you end up having to complain.
Keep correspondence and documents, record calls, save texts and emails. Most importantly keep a record of any interactions which you find unprofessional, uncomfortable, unreasonable, unfair, insulting etc. In fact anything which makes you think things are going wrong and you might have a problem. It’s much better to be prepared.
If the actions of the local authority in the course of their involvement with you have an adverse impact on your wellbeing then this should be taken into account too.
What to do if things go wrong
The local authority complaints procedure
The stages for complaining about your local authority are:
- Try to resolve the problem by negotiating and/or asking the local authority to review a decision you disagree with.
- If that fails you can make a complaint using the local authority complaints procedure.
- If you are still not satisfied with the outcome you can complain to the Local Government and Social Care Ombudsman or consider a legal challenge by way of judicial review. Once it receives your complaint, your local authority must respond to you based on its complaints procedure.
What can you complain about?
You have a right to complain about any aspect of a service being provided by your local authority apart from in a few circumstances listed below. Here are some examples of situations that might lead to a complaint if they cannot be resolved:
- You have been told you are ineligible for a service but you disagree;
- You have been wrongly refused an assessment of your needs;
- There have been excessive delays in dealing with your case, for example a home adaptation;
- The services arranged for you are not satisfactory or adequate;
- The personal budget allocated to pay for your care is insufficient to meet your eligible needs;
- Your assessment has not considered all your needs;
- Your local authority has not followed relevant legislation or regulations;
- You have not been properly informed of your rights and options;
- You have not been told about services such as advocacy or reablement;
- Your potential right to NHS continuing health care has not been explained to you;
- The charging procedures have not been properly administered;
- You have not been informed about funding options such as deferred payments;
- You have been wrongly asked to pay a top-up fee for a service;
- Your service has been cut at a review due to funding pressures;
- You have been treated in a discriminatory way;
- Your human rights or dignity has not been respected; or
- You have received poor quality services.
Limitations on what you can complain about
The complaints regulations state your local authority does not have to deal with:
- Complaints that are resolved to the complainant’s satisfaction by the next working day;
- Complaints that were resolved or investigated under previous complaints regulations;
- Complaints that relate to the Freedom of Information Act 2002, which are dealt with by the Information Commissioner’s Office.
How to make a complaint
There are lots of good online fact sheets and guidance about complaining.
Here are two excellent links to help you.
Other useful resources
- www.moneyadviceservice.org.uk/en/articles/how-a-local-authority-care-needs-assessment-works the money advice service has lots of good advice.
- www.mind.org.uk/information-support/legal-rights/health-and-social-care-rights/needs-assessments Explains your rights to social care, and how this differs from healthcare. Includes information on eligibility, needs assessments, financial assessments, and how local authorities may meet your needs.
- www.scie.org.uk/care-act-2014/assessment-and-eligibility The Social Care Institute for Excellence (SCIE) improves the lives of people of all ages by co-producing, sharing, and supporting the use of the best available knowledge and evidence about what works in social care and social work.
- www.kingsfund.org.uk/topics/adult-social-care The King’s Fund is an independent charitable organisation working to improve health and care in England.
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