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If you need help to remain living independently in your own home or would like to move into supported accommodation to help maintain your quality of life, getting a care needs assessment from your local social services is a great first step.
You must meet certain eligibility criteria to qualify for local authority care, which can only be decided on through a needs assessment. The assessment will look at all aspects of your life – both physical and mental health, and general wellbeing – to identify your needs.
Depending on your personal circumstances an assessment might identify a wide range of needs - from recommending adjustments to your home to recommending a carer for help with everyday tasks or that a person move into a care home.
We explain what to expect from a care needs assessment, what questions you may be asked, and how care needs are financed. Plus, we tell you how to apply and prepare for an assessment.
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The care needs assessment is completely free of charge and anyone can apply for one.
The needs assessment will be carried out by someone from your council, such as an occupational therapist or social worker, and can be done face to face, online or over the phone. The assessment itself usually lasts at least an hour.
The practitioner assessing you should agree with you on how to describe your situation. They will then work out your various needs, which should have the following elements:
Through asking these questions, the practitioner can assess your level of care needs and the possible ‘risk’ if you’re not provided with support.
The assessor may contact other health or care professionals who are involved with your care. With your permission, they may also talk to any relatives also involved with your care.
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To apply for a needs assessment, contact your GP or local adult social care department. If you’re not able to do this yourself, a friend or relative can request it on your behalf (and, if relevant, they may want to arrange a carer’s assessment for themselves at the same time).
In some areas you can apply directly through your local authority’s website (although this isn’t always possible). Use the gov.uk website to find your local council and social services.
It’s a good idea to sit down with a friend or relative before the needs assessment to discuss what to say. Think about all aspects of your life, such as personal care, washing, showering, dressing, going to the toilet, preparing meals and shopping. Do you struggle with any of these things? If so, what could help?
It can help to have someone else familiar with your situation present at the assessment, such as a relative, friend or carer. If there isn’t someone suitable who can support you, you have a right to ask for an independent advocate to be appointed. An advocate will help to ensure that the relevant circumstances of your situation are taken into account and your views and preferences are listened to.
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Assessors might not mention certain needs that are important, so be sure to speak up. The more you have prepared for the assessment, the better.
These may not be the exact questions asked, but the following examples will give you an idea of what subjects might be covered:
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Following the assessment, the local authority will decide whether your assessed needs meet their criteria for adult social care. In England, the eligibility criteria are based on three tests:
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The local authority will first consider the following ‘care outcomes’:
They will judge that a person can’t achieve an outcome if they’re unable to achieve it without assistance; without significant pain, stress or anxiety; without endangering themselves or others; or if it would take significantly longer than would normally be expected. If you are unable to achieve two or more of the care outcomes, you will be eligible for care and support.
The care outcomes should be recorded. Local authorities are required to ‘signpost’ you to other ways of meeting any of your presenting needs that fall outside the eligible needs.
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Following your assessment, you'll receive a written care plan (sometimes called a ‘care and support plan’). This should outline your assessed needs and suggest suitable solutions. It will also explain which needs will be met by the local authority.
Here are some examples of what a care plan could cover:
Issue: Mr S is unable to work in the kitchen and cook.
Issue: Ms P lives alone and regularly wanders out of the house, putting her in an unsafe situation.
If you don’t receive a care plan following a needs assessment, then request a copy of it. This is an important document, as you will only be eligible to receive support for needs that have been recognised in the care plan.
It’s important to check the documentation to make sure that the recorded assessment captures all your needs, not just the ones the local authority regard as ‘eligible’. Written details of the assessment should be checked, agreed and signed by both you and the local authority.
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If you’ve been found to need extra support, you will have a separate financial assessment (or means test) to see if the council will contribute to your care costs.
Local authority financial assessments differ depending on whether you are remaining in your own home or moving to a care home. We explain how these work in our guide on care home finance.
Not all support is means tested. People with certain health conditions including dementia may be eligible for a discount on their council tax bill or may be exempt from paying altogether, irrespective of their financial situation. This is something you can ask your council about directly.
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Social care needs assessments are used in a similar way across the whole of the UK, but there are some regional differences.
The needs assessment is called a health and social care assessment and it will be arranged by the social services department of the local Health and Social Care (HSC) Trust. You will normally only undergo a financial assessment if you are moving into a care home.
People who are assessed as needing personal care or nursing care should not be charged for these services. The amount an individual contributes towards the remainder of their care costs, including accommodation, utilities, meals and so on, will be determined following a financial assessment of their income and assets. More information on this is available on the Scottish government’s website.
Care Information Scotland has more information about what to expect from a care needs assessment in Scotland.
In the Scottish Highlands, NHS Highland is responsible for arranging the needs assessment, rather than the local authority.
Regardless of your savings you will never have to pay more than £100 a week towards the cost of personal care support at home, if you have been assessed as needing it. Support services that are not classed as personal care (meals and laundry, for example) may take total charges above £100 per week.
Find more information about needs assessments in Wales on the Carers Wales website.
Local authorities should review care and support plans at least every 12 months, and a basic review should happen six to eight weeks after a new or revised care plan. You can ask for an earlier review if your situation changes before that time. Following a review, your care plan might be updated to reflect any changing needs.
If you think your care needs have changed substantially since the last review (for example, care at home is no longer working well for you and you think a care home would be a more appropriate place to live), you should ask the local authority to carry out a full re-assessment.
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