If you’re concerned that your elderly parent or relative is no longer coping well at home due to physical health or mental health issues, then a first step is to arrange for a care needs assessment by the local authority. An assessment is free and will determine what help or care is needed.
In this guide we explain more about what a care needs assessment is, what it entails and how to prepare for one – and what happens next.
What is a care needs assessment?
Local authorities have a responsibility to carry out a care needs assessment for anyone who may need more help at home with with daily tasks – such as washing, shopping, or cooking – because of a physical or mental impairment. The assessment will take place regardless of personal financial circumstances and eligibility. If the care assessment concludes that your parent or relative needs more help or care, then a financial assessment will be carried out to assess if the local authority will help fund the care or not.
You can contact social services via the local authority website, which may include an initial online assessment of need. Then, a social worker or care manager from the social services department will carry out the assessment.
Since the pandemic, local authorities have struggled to keep up with demand for care assessments. You may have to wait for weeks or months for one to be undertaken.
Our advice is to book an appointment as soon as you can.
What factors are taken into consideration?
Your parent or relative will be assessed on the basis of their general wellbeing and not just their personal care needs. The local authority must provide for needs that meet three conditions:
- If the needs arise from a physical or mental impairment or illness.
- If your parent is unable to achieve two or more of these specified “care outcomes” without assistance and without danger:
- Managing and maintaining healthy eating and general nutrition.
- Maintaining personal hygiene – washing and dressing.
- Ability to go to the toilet unaided and manage every day continence.
- Being appropriately clothed for the time of year.
- Being able to live safely in their home.
- Maintaining a habitable home environment.
- Developing and maintaining family or other personal relationships.
- Ability to make use of local community facilities or services including public transport.
- If there is likely to be a significant impact on their overall wellbeing.
Some of this may feel a bit subjective so it is very important to prepare well for the assessment.
The assessment process
Your parent or relative can involve you and their spouse and/or carer fully in the assessment process. The care needs assessment can occur in different ways depending on the circumstances of the person needing care:
- Face to face in the home with relatives and/or carers in support.
- The person needing care can complete their own self-assessment.
- A joint assessment will be carried out by relevant agencies working together. This may happen when someone is being discharged from hospital and care providers become involved.
- If the needs are straightforward or the requirements are already known by the local authority, then the assessment can be carried out over the phone or completed online.
- A combined assessment can take place when the care needs assessment combines with a carer’s assessment for a spouse, partner or family carer.
Tips on preparing for a care needs assessment
It is very important to give as much information as possible for the assessment. In particular, the impact health issues – mobility, personal care, other ailments – have on the ability to live independently every day. Here are some tips to help you and your parent prepare for the assessment:
- With your parent, discuss what they want to talk about during the assessment.
- Make a list of the activities which your parent is finding difficult to do unassisted.
- Keep a diary so you cover how your parent is managing on good and bad days.
- Be prepared to give lots of information about your parent. Assume the assessor does not have this level of information.
- If your parent is hard of hearing or has difficulty communicating, let social services know prior to the assessment so they can prepare.
Our advice is to be with your parent or relative for the assessment if you possibly can. You can help avoid the “stiff upper lip” approach that some may take, minimising or downplaying their health and/or care issues for the needs assessment. And you can ensure that it covers all your parent’s health and social care needs.
Needs and wishes to take into account during the care needs assessment
All of your parent’s needs and wishes are recorded as part of the assessment, regardless of whether these are met by the local authority according to the eligibility criteria. This will include:
- How do they see themselves? What problems do they consider they have?
- What are their expectations?
- Where and how do they want to live?
- What are their interests?
- Are they able to look after their own home and shop for food?
- Are there any safety issues?
- Do they suffer from memory problems or depression?
- Are they hard of hearing or have problems with their sight?
- Can they look after themselves? How is their mobility?
- Do they look after their health? Do they smoke, drink or are they overweight?
- Are there medical issues?
The care plan and personal budget
Following the assessment, and if the situation meets the criteria, the local authority will produce a detailed care plan which will contain:
- A statement of needs.
- Information on costs and any charges that need to be paid for.
- How the needs should be met, whether that’s home care, extra support during the week, or a move to residential care, for example.
- Details of available support and carers.
- The date to review the assessment and services received which will take place at least once a year. You can ask for a reassessment at any time if circumstances have changed.
- A financial assessment will be carried out to determine how the recommended care and support plan will be funded, whether in full by the local authority, or funded by your parent either in full or in part. In England, if you have more than £23,250 in cash and assets, then the local authority will not fund care. If someone has between £14,500 – £23,250 then they will make some contribution.
A financial assessment will be carried out to determine how the recommended care and support plan will be funded, whether in full by the local authority, or funded by your parent either in full or in part. In England, if you have more than £23,250 in cash and assets, then the local authority will not fund care. If someone has between £14,500 – £23,250 then they will make some contribution.
If the local authority is going to pay for the care, then they will create a personal budget which will be given to your parent to pay for their care and support.
In addition, the local authority will provide information on what services are available locally and how to access them – whether or not they are providing for or funding them.
What will the care plan include?
This will all depend on the outcome of the care needs assessment.
The local authority might recommend services such as disability equipment or home adaptations. It may also recommend that domiciliary or day care is provided a certain number of times a day or week to provide personal care or other support.
A care plan might also recommend moving to sheltered housing or more suitable accommodation such as a residential or nursing care home.
Financial assessment
Once the services required are agreed, the council will need to carry out a financial assessment to determine how much your parent or relative will need to contribute to pay for their own care.
All local authorities provide information on their charges when your parent’s care need assessment is carried out.
Following this financial assessment they will provide further details on how any charges arise and how to pay them.
A financial assessment will determine how the recommended care and support plan will be funded, whether in full by the local authority, or funded by your parent either in full or in part, taking into consideration their savings and assets, as detailed above.
Thresholds for eligibility in the UK
Current thresholds for eligibility in England are £14,250 in capital for maximum support. Contributions towards care at home will be made for anyone with capital up to £23,250.
Anyone with more than £23,250 is not eligible for means-tested support.
In Northern Ireland, personal care is free to those aged over 65 who their local authority have assessed. The same applies in Scotland for personal care.
For more information on the situation in Scotland visit the Care Information Scotland “Where to Start” page. In Wales, savings above £23,750 mean they will have to pay all of the fees for their care at home or £50,000 (care in a care home)
Read useful advice from The Money Advice Services regarding the asset limits in financial assessments to get a better understanding.
What is included in a financial assessment?
All income (property, investments, pensions and benefits); bank and building society accounts, National Savings and Premium Bonds; stocks and shares; shares in family businesses; regular savings including ISAs.
What isn't included in a financial assessment?
The value of your parent’s home, any personal possessions and the surrender value of life insurance policies or annuities.
In addition, the assessment excludes a number of benefits and allowances.
More often than not, assessments will assume you’re receiving all the benefits you’re entitled to, even if you aren’t already claiming them. There could be some you’re missing out on, such as reductions on your council tax bill.
Live-in carers are eligible for reductions on their bill if they look after someone with a disability who isn’t their partner, spouse, or child under 18, for an average of at least 35 hours a week.
The person cared for must be receiving one of the following benefits:
- Attendance allowance.
- Middle or higher rate of the care component of disability living allowance.
- Standard or enhanced rate of the daily living component of personal independence payment.
- An increase in constant attendance allowance.
- An increase in disablement pension.
- Armed forces independence payment (any amount).
People referred to as ‘severely mentally impaired’ (SMI) are also eligible for discounts to their council tax bill. The term includes people with dementia, Parkinson’s, or severe learning difficulties. Those who meet both of the following criteria will not be counted for Council Tax:
They have a certificate from a registered medical practitioner confirming the condition.
They are entitled to one of a number of benefits, including but not limited to:
- The middle or the higher rate of the care component of Disability Living Allowance (or Child Disability Payment in Scotland)
- The daily living component of Personal Independence Payment at any rate (or Adult Disability Payment in Scotland)
- Attendance Allowance at any rate
- Constant Attendance Allowance or Pension Age Disability Payment (in Scotland)
You can apply via your local council’s website. There is also more information available on GOV.UK.
If your parent is not eligible, you will still receive information and advice about what care and support is available to help you locally. This could be help from community groups or voluntary organisations.
Carer's assessment
If you or a parent or relative are providing unpaid care you are eligible for a carer’s assessment. You should request this:
If your physical or mental health is at risk of deteriorating.
If you are unable to achieve any of a list of specified outcomes (including things like maintaining family relationships or engaging in recreational activities) which is impacting on your wellbeing.
You or your parent’s spouse or partner could be eligible for:
- Respite care for a holiday.
- A sitting service, a day centre placement or a befriending service to provide time out or away for the carer.
- Carer’s training, which might include lifting techniques for example.
- Computer and training courses to aid starting or returning to paid work.
- Taxi fares to help with travel.
- Gardening and housework help.
A carer’s assessment can be carried out for you or your other parent even if the spouse of concern does not wish to have a care needs assessment.
If more than one person is caring for your parent, all those with carer’s responsibilities are entitled to an assessment.
What if the care plan does not meet expectations?
In the first instance speak to the social worker and/or care manager, detailing why you believe the plan does not match the needs of your parent. Be specific about what amendments you would like to see.
If you need to escalate the issue, there is a complaints process.
More information
- There is lots of good advice regarding assessments. You might want to look at a guide to care and support on the NHS website.
- For more general information, the Which? has excellent information about the care and needs assessment.
- If you are worried about funding, there is NHS funding available in various forms. This might not be dependent on your parents finances. Listen to our podcast about NHS continuing care here.
- For more advice on self-funding care fees – visit our finance section.
Join our Facebook Group Caring for Elderly Parents UK and ask others that have gone through the same process.
