Requesting an assessment - changes under the Care Act
The Care Act 2014 means that, from April 2015, your local council has changed the way in which it completes an assessment with a member of the public when deciding whether that person will be eligible for care and support from the council.
Your council's responsibilities for assessments were previously set out in a number of different laws. They tended to focus on what service should be provided, rather than on what the person actually needed or wanted. The Care Act pulled all of the old laws together, and aims to provide a care and support system built around the individual person, and which focuses on what the person wants to achieve.
Before the Care Act each council set its own eligibility criteria based on national guidance. This meant that the amount - and type - of care provided by the council varied depending on where a person lived. The Care Act has changed this.
What is an assessment?
If you think you need some support to manage day-to-day tasks, it can be useful to talk through your situation with someone who can look at the difficulties you are experiencing and who can offer suggestions and advice on support that will help make things easier. This process is called an assessment.
Different organisations can help with assessments. You can apply for an assessment from your local council, or you can approach a private assessment agency. In some cases independent community organisations offer advice and guidance on assessments as well.
An assessment from the council
Under Care Act you have a right to be assessed for free by your local council if you appear to need care and support to complete activities in your day-to-day life. You have this right to be assessed regardless of your financial situation, or whether the council thinks you will then be eligible for support from them.
You can ask your council for an assessment yourself, or be referred by someone you know, or by a professional who is already involved in your care, such as a GP, community nurse, or mental health nurse. If you are being referred by someone else, that person should have discussed and agreed this with you in advance.
The assessment will help the council to then decide if you do need care and support, and whether you are eligible for funding from the council towards the cost of that care and support.
The assessment must be carried out with involvement from you and, where appropriate, someone who looks after you (perhaps a relative or friend). It can also involve someone else nominated by you to help you get your views and wishes heard, or an independent advocate provided by the council.
Depending on where you live the council may offer you the chance to complete a form or questionnaire (known as a 'self-assessment') so that they can understand more about your needs and your living situation.
What to expect at your assessment
The assessment must be carried out by an appropriately trained assessor, for instance a social worker, who will consider a number of factors, such as:
- your needs and how they affect your wellbeing - for instance, a need for help with getting dressed or support to get to work;
- the outcomes that matter to you (meaning the things you want to achieve in your life as a result of receiving support) - for example that you are lonely and want to make new friends; or that you struggle to look after yourself but want to stay clean and be well dressed;
- your other circumstances - for example, whether you live alone or whether someone supports you.
The aim is to get a full picture of you and what needs and goals you may have.
If you have an assessment you can expect that whoever carries it out will:
- clearly explain the assessment process from the start, and what your options are at each stage of the process
- make sure that you take part in the assessment as much as possible and give your own views about what you need and what is important in your life
- offer you an interpreter or an advocate (someone who can speak on your behalf) if you need help to communicate your views
- arrange some temporary support for you whilst your assessment is being completed, if you have a serious or immediate need
- involve other professionals and specialists (such as doctors, nurses and physiotherapists) in your assessment if needed. If they do this they will tell you who they intend to consult and check that you are happy for them to do this
- take into account the needs of people living around you, for example your family or someone who is helping to look after you
- give you a copy of your completed assessment and a statement of needs which will tell you whether you are eligible for support from the council or not
- try to give you information and advice about other services more suitable for your needs if you are not eligible for help.
What happens after the assessment?
Following the assessment, and depending on your situation, you may be asked to undertake a short period of rehabilitation or reablement (usually within your own home). The aim of this is to see if you can regain the ability to do some of those things which you have been finding difficult, before a final decision is made on what support you will need, and whether you will be eligible to receive funding from the council towards the cost of that support.
How your council decides if you are eligible for support
Not everyone who completes an assessment with their local council will then be eligible to receive care and support from the council.
Under the Care Act the way in which the council decides whether you are eligible is set out in regulations that set the national minimum threshold for eligibility, which will be consistent across England.
You will have eligible needs if you meet all of the following criteria:
- 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 a set of outcomes set out in the Care Act - those outcomes include things which you might expect to achieve in your day-to-day life such as dressing, maintaining personal relationships, and working or going to school.
- as a result of not achieving those outcomes, there is a significant impact on your wellbeing.
Your local council has produced a leaflet (see page 1) explaining in more detail how the eligibility criteria are applied in your local area, and how this fits in with your assessment.
What happens next? - planning your support
Following the assessment the support you may receive will depend upon your individual situation. This support may include provision of equipment or other gadgets to keep you safe in your home, help looking after yourself at home, help with going out or being involved in education or employment, or help in attending employment or education.
If you are not eligible for support from the council
Even if you are not eligible to receive support from your council they must give you advice and information about what support is available in the community to help you. They should also offer you advice on ways in which you can remain as independent, active and healthy as possible.
You should be able to find a lot of this information on People First, including in our People Who Can Help directory, and our Events calendar.
If you are eligible for support from the council
If you have been assessed as having eligible needs, and want the council's help to meet them, then your social worker will work with you to draw up a written support plan which gives details of how your needs will be met. This plan will include details of:-
- what support you will receive
- how much that support will cost (this is known as your Personal Budget)
- the outcomes which you are looking to achieve whilst receiving the support.
The support plan will include details of support which is being paid for, support provided by your relatives or friends, and support provided by health or other professionals. It will also include details of ways in which you can remain as independent, active and healthy as possible.
You have the right to ask for some or all of your Personal Budget to then be paid to as a sum of money, known as a Direct Payment, which you can use to arrange and pay for the support yourself. This gives you the chance to take more control in deciding how you will receive your support, and when this support will be provided for you.
Alternatively the council can use your Personal Budget to arrange the support on your behalf. You can find out more on our page Personal Budgets and Direct Payments.
If you are eligible for support from your council you will be asked to complete a financial assessment, to decide whether you are in a position to pay towards the cost of your care.
If your needs change
Your local council will arrange for a social worker to review your support plan from time to time to make sure it still meets your needs, and that you are being supported to meet the outcomes which you have identified.
If anything changes in the meantime (for example if your health worsens, or you have a fall, or you move house) it's a good idea to contact your council as soon as possible so that they can make any adjustments to your support plan and see if there are any ways to help you regain your independence.
What to do if you are refused an assessment
In the unlikely event that you are refused an assessment and you are unhappy with the council's decision, you should first of all write to them formally to request an assessment, state your case, and ask the council to provide written reasons as to why it is not willing to carry out an assessment. Make sure your council is fully aware of your situation, and give any relevant details, for example about any disabilities or health problems.
If you are still not happy with the council's decision, you are entitled to make a formal complaint through their complaints procedure.
Contacting your local council to request an assessment
You can contact your local council to request an assessment as follows:-
Assessments for people with learning disabilities
The information on this page also applies for an adult with a learning disability, but you can find out more about how your council and their health colleagues work with someone with a learning disability on our separate page Assessment and Support For People With Learning Disabilities.
Assessments for people with mental health problems
The information on this page also applies for an adult with a mental health problem, but you can find out more about how your council and their health colleagues work with someone with a mental health problem on our separate page Requesting Mental Health Support.
Private and independent assessments
You may prefer not to approach your local council about an assessment. In particular if you are likely to be asked to pay the full cost for your care by the council following a financial assessment then you may feel that it would be simpler to make your own arrangements.
A number of independent organisations and charities, as well as private individuals, can assist you to carry out an assessment of your care needs, and can offer advice and guidance on the assessment process, and assist you to arrange the best support for you once an assessment is completed. The British Association of Social Workers (BASW) can provide information about private social workers.
Please note that these private and voluntary organisations are not affiliated with your local council and they may charge for their service.
Other information and advice
The Which website offers advice on how social care assessments have changed following the introduction of the Care Act.