How to get a care asessment?

If you have care and support needs and find it difficult to look after yourself, your local authority may be able to advise you and provide you with some help.

The best way to get help from your local authority is to ask for a care and support needs assessment. You can do this by contacting the local authority adult social services department.

When you get assessed by the local authority, as a minimum you may be given information and signposting to other services, and ways that you might find funding to pay for them. However, if your needs meet the national eligibility criteria, your local authority will have to meet these needs. 

The local authority will involve you throughout the assessment to identify what your needs are and how these impact on your wellbeing. They will also discuss with you how you wish to live your life and whether there are certain aims you would like to achieve but you are unable to do so because of your care and support needs.

The assessment will start to consider how your care needs might be met. This could include identifying how preventative services like simple aids (such as devices to open jars and tins more easily), adaptations to your home (such as handrails) or information about support available in the community might meet your need.  It will also identify if you have a higher level of need where you may need help in your own home or care in a care home.

The assessment should be carried out in a way that ensures your involvement and that takes the right amount of time to capture all of your needs.

If you have a friend or family member looking after you as an unpaid carer, they can have a carer’s assessment to see if they need support to carry on their caring role.

The local authority must give you a copy of your needs assessment or carer’s assessment.

What are the national eligibility criteria for care and support?

The eligibility threshold for adults with care and support needs is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing.

Local authorities must consider whether the person’s needs: 

• arise from or are related to a physical or mental impairment or illness
• make them unable to achieve two or more specified outcomes
• as a result of being unable to meet these outcomes, there is likely to be a significant impact on the adult’s wellbeing

An adult’s needs are only eligible where they meet all three of these conditions.

The specified outcomes measured include:

• managing and maintaining nutrition, such as being able to prepare and eat food and drink
• maintaining personal hygiene, such as being able to wash themselves and their clothes
• managing toilet needs
• being able to dress appropriately, for example during cold weather
• being able to move around the home safely, including accessing the home from outside
• keeping the home sufficiently clean and safe
• being able to develop and maintain family or other personal relationships, in order to avoid loneliness or isolation
• accessing and engaging in work, training, education or volunteering, including physical access
• being able to safely use necessary facilities or services in the local community including public transport and recreational facilities or services
• carrying out any caring responsibilities, such as for a child

Local authorities do not have responsibility for providing NHS services such as patient transport, but they should consider needs for support when the adult is attending healthcare appointments.

Local authorities' duty to carry out a needs assessment

Local authorities have a duty to assess a person who appears to need care and support. They may need care and support because of serious illness, physical disability, learning disability, mental health problems or frailty because of old age.

The local authority is obliged to carry out a needs assessment when they become aware that someone may be in need of care and support.

This may mean that an assessment is offered even if it has not been specifically requested. Alternatively, you can contact your local social services department and ask them to arrange a needs assessment.

Normally, an assessment is carried out before a service can be provided by the social services department of a local authority. If you need care urgently, the local authority may be able to meet these needs without carrying out the assessment.

Local authorities' duty to carry out a carer’s assessment

Local authorities have a duty to carry out a carer’s assessment where a carer appears to need support.

The carer’s assessment will consider the carer’s need for support and whether they can continue to care without help.
The assessment can be offered even if the carer has not asked for one.

Needs assessments and local authority funding

Once a local authority has established that a person has needs that meet the national eligibility criteria, it has to make sure that these needs are met. The first step will be to draw up a care and support plan, or in the case of a carer with eligible needs, a support plan.

If you have eligible needs, the local authority will check that you normally live in their area. Social care is not free and you may have to contribute towards the cost of meeting your needs. Local authorities will do an assessment to see if you have to contribute and how much that would be.

The local authority should not refuse to meet eligible needs on the grounds of cost, although if there is more than one option, it is allowed to choose what it believes is the most cost effective one.

If your needs do not meet the national eligibility criteria, the local authority still has to give you information and advice on what support might be available in the community to support you.

Alternatively, you may want to consider funding your own care and support to help with the needs identified as a result of the assessment.

If you disagree with your needs assessment or the care and support plan, there are ways that decisions can be challenged or you can make a complaint.

What to expect from live-in care for your parent

For most of our parents the thought of leaving their own home for a life in care can be nightmarish. Moving into a care home is often seen as one of life’s grim realities and this association can mean our parents avoid thinking about care possibilities until it’s too late.

What is live-in care?

If one or both of your parents need full-time care they can have a carer to come live with them so that all their care needs and other wants - in terms of meals and cleaning - are catered for. Their carer is there all day, every day to make sure that your parent is happy and safe. The actual care given and level of care is as individual as your parent.

How will my parent’s needs be met?

First and foremost are your parent’s needs. Your chosen care agency will get to know your parent and work to fulfill all their wants and needs. They’ll assess what kind of care your parent requires as well as the kind of help they want with daily tasks and activities.

The agency will learn your parent’s likes and dislikes, note the medications they’re taking and understand the kind of person your parent is and the type of company they enjoy. They’ll take the time to find out about your parent’s preferred schedule, the hobbies they enjoy, the pets they keep and the family members that visit on a regular basis.

All this information is usually derived from several conversations via phone or in person with you and your parent to make sure that any possible risk factors are minimised and that both parties are happy all care and domestic tasks have been recorded.

How are carers selected?

Most care agencies operate in much the same way when it comes to selecting carers. First and foremost, carers are recruited and trained. Training can differ from agency to agency, but a good agency will provide an in-depth course that complies with CQC requirements. This is where your own research will come into its own. At St Jude's training consists of a  residential training course as well as police checks and lengthy interviews with managerial staff.

Once this process has been completed a suitable carer for your parent can be selected by your family’s care advisor who will check their compatibility as well as their qualifications for dealing with your parent’s care needs.

Who will manage my parent’s carer?

In most cases you and your parent will manage their carer. Personalised care means that your parent can make all the decisions in terms of when they get up, what they would like to eat and drink (within reason!) and when they want to pop to the shops etc.

If your parent can’t make these decisions the carer will rely on you or the care agency to provide care instructions so that your parent can be cared for properly and in the way they want to be. Most agencies will give you and your parent the option of deciding who will manage their live-in care.

When will my parent meet their carer?

This is when your chosen care agency becomes somewhat of a “dating” agency. Your care advisor will have already assessed your parent’s personality as well as their needs which means matching them with a carer they get on with should be a straightforward process.

Your parent will be introduced to their first carer. They may hit it off straight away or your parent may dislike them – sometimes you never can tell. Your care agency should do everything in their power to make a successful match.

What if they don’t get on?

If you parent doesn’t get on with the first carer they’re introduced to the care agency will remove them and ensure your parent never has to see that carer again. Most agencies encourage constant communication between you and your parent, their carer and the agency themselves to ensure everything is going smoothly. If you suspect things are going wrong it’s always best to notify the agency right away so that any issues can be dealt with quickly, before anything becomes serious.

What if something goes wrong?

Simply put, things shouldn’t go wrong. The checks that are carried out by all good agencies should stop things going wrong. But sometimes they do. All good agencies will have a clear safeguarding procedure, to deal swiftly with any allegation of abuse or wrongdoing, which you should be able to see at any point.

What happens if the carer moves on?

We know that no one carer can stay with your parent forever. Your parent’s carer will have other clients and will need a holiday from time to time! Most agencies will build up a team of carers for your parent so that they have 3 or 4 people they know and like, who come and care for them weeks at a time.

 

Preparing for the future

Live-in care is just one of many options that allow for your parent to stay in their own home for longer or indeed for the rest of their life. The need for care often comes suddenly and without sufficient care plans in place your parent may end up in a place they’d rather not be. Discussing the choices and doing the research into care together can take the fear out of the process and determine what your parent does and doesn’t want for their future.

How to fund your long-term care – a beginner’s guide

There are many options for funding long-term care and they can often be complicated to understand. So if you or a loved one need to pay for care at home or in a care home, it’s important to know the facts.

• How much will you need to pay for long-term care?

• NHS continuing healthcare

• Local authority funding for long-term care

• Self-funding your long-term care

• Claim the benefits you’re entitled to

How much will you need to pay for long-term care?

Top tip

People often have to make quick and difficult decisions about their own or a loved one’s care needs. Thinking about the options in advance will help in the long run.

This all depends on your health and mobility, what level of help and support you need and the value of your savings, assets and income.

You could end up paying for all of it, some of it or nothing at all.

NHS continuing healthcare

If you have a disability or complex medical problem, you might qualify for free NHS continuing healthcare (CHC) if you’re an adult, or free NHS continuing care (CC) if you’re under 18. Not many people know about it, so it’s important to find out if you’re eligible and get an assessment.

This is a package of healthcare that’s arranged and funded by the NHS. It is provided for you at home, or in a hospital, nursing home or hospice.

You’re more likely to qualify if you have mostly healthcare needs rather than social care needs. In other words you need a nurse rather than a carer.

If you live in Northern Ireland, Continuing Health Care is provided by your local Health and Social Care Trust.

Are you eligible for NHS Continuing Care funding?

Local authority funding for long-term care

Your local council (or Health and Social Care Trust in Northern Ireland) may be able to help you with the costs of residential care.

If you prefer, they can help you stay in your own home by providing support for carers, equipment and specialist services.

Exactly how much funding you receive will depend on:

• your individual needs (based on a care needs assessment)

• how much you can afford to pay towards the costs of care yourself (based on a financial assessment)

Local authority funding for care costs – do you qualify?

How a local authority care-needs assessment works

Means tests for help with care costs – how they work

Your local authority or trust can arrange care services for you or you can choose to receive direct payments and organise things yourself.

Direct payments explained

Self-funding your long-term care

Self-funding?

The biggest fear about funding long-term care is that you’ll be forced to sell your home. Fortunately, there are other options available.

Depending on your circumstances you may not qualify for funding from the NHS or your local authority.

Even if you do, the amount you receive may not be enough to completely cover your care costs. If this happens you’ll need to think about how you’re going to top up any contributions or pay for it all yourself.

Self-funding your long-term care – your options

Claim the benefits you’re entitled to

Even if you have to pay for care you may still be entitled to claim some benefits.

These two benefits aren’t means tested, so you could get them if your health needs are great enough and you have income and savings:

• Attendance Allowance

• Personal Independence Payment (which is replacing Disability Living Allowance)

There are other benefits that you may also be able to claim depending on your circumstances.