Adult care eligibility - who can get care and support?
What is the assessment process?
An assessment is how a local authority decides whether you need care and support to help you live your day-to-day life.
The assessment must be carried out by an appropriately trained assessor, for instance a social worker or occupational therapist, who will consider a number of factors, such as:
- Your needs and how they impact on your wellbeing – for instance, a need for help with getting dressed or support to get to work
- The outcomes that matter to you – for example, whether you are lonely and want to make new friends
- Your other circumstances – for example, whether you live alone or whether someone supports you
The aim is to get a full picture you and what needs and goals you may have.
To start the assessment process, please complete a self-assessment. This will indicate whether you are likely to need a full assessment, and can be referred to us to follow up with one.
After carrying out the assessment, we will consider whether any of the needs identified are eligible for support. Because not all care needs are met by the State, we use an eligibility framework to decide which needs are eligible to be met by public care and support.
How does the authority determine who has eligible needs?
After the assessment, the local authority must determine whether you are eligible for care and support. The Care Act sets out the national minimum threshold for eligibility, which is the same across England.
Determining eligible needs is important to work out whether to the local authority must meet your needs for care and support. You will have eligible needs if they meet all of the following:
- You have care and support needs as a result of a physical or mental condition
- Because of those needs, you cannot achieve two or more of the outcomes specified
- As a result, there is a significant impact on your wellbeing
Outcomes for adults with care and support needs are as follows:
- Managing and maintaining nutrition
- Maintaining personal hygiene
- Managing toilet needs
- Being appropriately clothed
- Being able to make use of the adult’s home safely
- Maintaining a habitable home environment
- Developing and maintaining family or other personal relationships
- Accessing and engaging in work, training, education or volunteering
- Making use of necessary facilities or services in the local community, including public transport, and recreational facilities or services
- Carrying out any caring responsibilities the adult has for a child.
Where you have eligible needs, and want the local authority’s help to meet them, then the authority will discuss your care and support plan with you. In all cases, the local authority must give people advice and information about what support is available in the community to help them.
Support during your assessment
You are able to have a friend or family member with you at the assessment if you want to. The Care Act states that the council must arrange for you to have an independent advocate with you at the assessment if:
- You don't have anyone else (like a friend or family member) to support you
- You have 'substantial' difficulty doing any of the following:
- Communicating what you want to say
- Understanding the information given to you, or remembering it
- Weighing up the information you are given in order to make decisions about your support
An independent advocate is a trained professional who can help you to get your voice heard at the assessment and make sure that the end result reflects your wishes and rights.
What to do if you disagree with a decision about the level or type of care you receive
If you have been assessed or reviewed against the above categories but feel dissatisfied with the decision that has been made, you have the right to appeal against that decision. This may be because you are not satisfied with the level or type of support, or because it has been decided that you do not meet the criteria and will not receive any support.
If you are unhappy with the assessment you should contact the Adult Contact team on 023 8083 3003 below and arrange for a reassessment.
If you continue to be unhappy after the reassessment then please contact our Customer Relations Team who will be pleased to help you further.