Living independently at home for as long as possible is what most of us want. Over time it may be that help at home is needed to remain happy and safe.
An important first step to more care and support is to arrange for a care needs assessment. This is sometimes referred to as a social care assessment which is undertaken by every local authority adult social services department.
Here we explain:
- What is a care needs assessment?
- Factors taken into consideration
- What the assessment process involves
- Preparing for the assessment
- Needs and wishes to take into account
- The care plan and personal budget
- Carer’s Assessment
- Financial Assessment
What is a care needs assessment?
Local authorities have a legal duty to carry out a care needs assessment for anyone who needs help with daily tasks to allow them to carry on with their everyday life. This is regardless of finances and eligibility. They also have a responsibility to ensure the integration of care and support with health and health-related services, including housing.
A social worker or care manager from the social services department will carry out the assessment. Under the Care Act the local authority must always consider the person’s well-being when making arrangements and decisions.
What factors are taken into consideration?
Your parent or relative will be assessed on the basis of their general well-being and not just their personal care needs. The local authority must provide for needs that meet these 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 nutrition
- Maintaining personal hygiene
- Managing toilet needs
- Being appropriately clothed
- Being able to make use of their 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 local community facilities or services including public transport
- If there is likely to be a significant impact on their well-being.
The Assessment Process
The local authority is obliged to ensure that the person under assessment can involve their spouse/carer/relative fully in the assessment process. The care needs assessment can take five forms depending on the circumstances of the person needing care.
- It can be carried out face to face.
- The person needing care can complete a supported self-assessment on their own.
- A joint assessment will be carried out by relevant agencies working together. This will reduce the amount of assessments a person will have to undertake.
- 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.
Tips on preparing for a care needs assessment
Here are some tips to help you and your parent prepare for the assessment
- Discuss with your parent 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 for the assessment if you possibly can. You can help avoid the “stiff upper lip” approach that some parents may take, minimising or downplaying their health/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 are medical issues?
The care plan and personal budget
Following the assessment, and if the situation meets the criteria, the local authority must produce a detailed care plan and a personal budget.
They must also provide information on what care is available and how to access these services, even if it will not be provided by them. The care plan will contain:
- A statement of needs.
- How the needs will be met.
- Information on any charges to pay.
- Details of the support carers.
- The date to review the assessment and services received which will take place at least once a year. You are able to ask for a reassessment at any time if circumstances have changed.
What will the care look like?
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. Or moving to sheltered housing or more suitable accommodation such as a residential or nursing care home.
What if the care plan does not meet expectations?
In the first instance speak to the care manager detailing why you believe the plan does not match the needs of your parent. Be specific about what amendments you want to see.
If you need to escalate the issue, complain through the complaints procedure.
Carers’ rights are extended so that anyone who provides unpaid care and feels they might benefit from some support is entitled to a carer’s assessment by the local authority. 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 could be eligible for:
- Respite care for a holiday
- A sitting service, a day centre placement or a befriending service
- Carers 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 even if your parent 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.
Once the services needed 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.
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 The Money Advice Services’ useful advice regarding the asset limits in financial assessments to get a better understanding.
What is included in the 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 the Assessment?
The value of your parent’s home, any personal possessions and the surrender value of life insurance policies/annuities.
In addition, the Assessment excludes a number of benefits and allowances.
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.
- Got a question about care and financial assessments? Go to our forum now!
There is lots of good advice regarding assessments. You might want to look at Your Guide To Care and Support on the NHS website.
For more general information, the Which Guide 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. Check it out here. Listen to our podcast about NHS Continuing Care here
For more advice on Self-Funding Care Fees – visit our Money & Finance section.