What is a care needs assessment? 

Nobody likes to think about getting old or ill or becoming disabled. However, if your care needs increase, this can put a huge strain on yourself and your close family and friends. But with some careful planning, you can get vital help and support in the form of a local authority needs assessment to meet your needs also known as a social care needs assessment.

What is a social care needs assessment?

If you feel you may be eligible for state-funded care, you should ask your local council to carry out a care needs assessment.

To determine what type and level of care you need, you are entitled to have a local authority care needs assessment.

This short video talks you through the process of what is meant by a care needs assessment.

Am I entitled to a care needs assessment?

If you are finding it difficult to look after yourself, you may need care and support.

It may be because of a serious illness, physical disability, learning disability, mental health problems or frailty resulting from old age.

Everyone has a right to a local authority needs assessment even if they will end up paying for their own care. A local authority needs assessment may be offered, even if you have not asked for one.

If you are having a care needs assessment, you can have a loved one or person you trust with you. If you have dementia and worry you will forget things, you can prepare for the assessment by getting a person you trust to write down what you want to talk about. You could be eligible for help that could include a move to a care home or adaptations to your own home (for example a stair lift).

As a self-funder, it is especially useful to have an assessment of your needs. This is because in the future, there could be a chance that your financial resources might reduce to the level where you would be seeking funding from the council.

(It would, in these circumstances, be unwise to choose a care home that does not match your assessed needs. This is because you would need to find a third party to top up your care fees if they were higher than the local authority pays).

How much does a local authority care needs assessment cost?

Your care needs assessment is free. Your local authority is legally required to pay for your care needs assessment. 

How do I get a local authority needs assessment in England?

In line with the Care Act, local authorities in England have an obligation to assess everyone.
Your local authority has to give you an assessment if you appear to need care and support, regardless of your income or savings or whether the council thinks you will qualify.

In England and Wales you can apply for a social care care needs assessment through your local council.

You can phone to request a social care needs assessment yourself. An application for a care needs assessment can be made directly to your local social services department. Alternatively, it can be made through your GP or health consultant. A carer, friend or relative can also ask for an assessment for you.

The assessment will identify your care needs – specifically what kind of care you require and how much support you need. A social worker, occupational therapist, nurse or someone else working on the local authority’s behalf will carry out the assessment.

What questions are asked in a care needs assessment?

The questions you will be asked as part of a local authority needs assessment are designed to identify your exact care requirements.

Your care needs assessor will discuss with you how you live, any personal care preferences and what you find difficult on a daily basis. They will ask how you wish to live your life. They will ask you whether there are certain aims you would like to achieve but are unable to do so because of your care needs.

Eligibility criteria for a care needs assessment in England

To meet national eligibility criteria for care in England, you are assessed on whether your needs meet three conditions:

• Your needs arise from or are linked to a physical or mental impairment or illness
• Your needs make you unable to do two or more criteria (specified in the list) below
• Whether there is likely to be a significant impact on your wellbeing, because you cannot meet the criteria

The list of national eligibility criteria is:

• Managing and maintaining nutrition e.g. are you able to prepare food and drink?
• Maintain personal hygiene, e.g. can you wash yourself?
• Managing toilet needs
• Dressing appropriately e.g. do you need help to dress?
• Moving around the home safely
• Keeping the home clean and safe
• Developing and maintaining family or other personal relationships
• Accessing and engaging in work, training, education or volunteering
• Safely using facilities or services in the local community
• Carrying out any caring responsibilities e.g. for a child

Give as much detail as you can about the daily tasks you struggle with. Leaving things out might reduce the care recommended for you.

The assessment will identify what level of need you have and could suggest which type of care is appropriate for you. The local authority may identify measures such as simple aids, e.g. to open tins easily or adaptations to your home.

How do I get a care needs assessment in Wales?

When it comes to local authority care needs assessments in Wales, the Social Services and Wellbeing (Wales) Act 2014 introduced a national threshold for eligibility, split into four levels – Critical, Substantial, Moderate and Low.

If you wish to meet the eligibility criteria, your needs must be caused by either physical or mental ill-health, age, disability, dependence on alcohol or drugs, or other similar circumstances. 

The need must also relate to one or more of the following areas:

• Your ability to carry out self-care or domestic routines
• Your ability to communicate
• Your protection from abuse or neglect
• Your involvement in work, education, learning or in leisure activities
• Your maintenance or development of family or other significant personal relationships
• Your development and maintenance of social relationships and involvement in the community
• Your fulfilment of caring responsibilities for a child

How do I get a care needs assessment in Scotland?  

If you are in Scotland, you can contact your local authority’s social care department to ask for an assessment of your care needs.

When it comes to the Scottish Highlands, NHS Highland is responsible for arranging the needs assessment, rather than the local authority.

In Scotland, the eligibility criteria looks at the level of risk (critical, high, moderate or low) to an individual’s independent living or health and well-being. Scotland’s level of risk relates to:

• Neglect or physical or mental health, e.g. health problems which indicate risk to oneself or others or risk to independence.
• Personal care/domestic routines/home environment e.g. ability to do aspects of personal care which may harm oneself or others or risk independence.
• Participation in community life, e.g. ability to sustain involvement in work, education, learning, family/ social connections, risking independence.

How do I get a care needs assessment in Northern Ireland?

In Northern Ireland, the assessment is called a health and social care assessment. It will be arranged by the social services department of the local Health and Social Care (HSC) Trust

Contact your local Health and Social Care (HSC) Trust.

The HSC Trust will decide if you are eligible by comparing your needs with criteria set by the Department of Health, Social Services and Public Safety. This reflects the level of risk to your independence if your needs are not met.

Northern Ireland looks at critical, moderate, substantial or low risk related to: 

• Your level of health problems
• Your control over immediate environment 
• The potential for your abuse or neglect 
• Your ability to carry out personal care or domestic routines 
• Your involvement in work, education or learning 
• Your ability to sustain social support systems/ relationships 
• Your risk from remaining in a hospital bed

What if I cannot participate fully in an assessment?   

You may have difficulty making decisions about your care and support. If you lack the ability, known as ‘mental capacity’, to make decisions, you may need someone else to make decisions on your behalf.

If you are not able to participate fully in decisions about your care and have no one to help you, your local authority is responsible for arranging an advocate for you to represent you.

How can I prepare for a local authority needs assessment? 

Think about the kind of specific help you need. Think about your cultural, religious, emotional and social needs too.

Anyone involved in your care can be invited to attend your assessment. You can ask a family member, friend or an independent advocate to come along to the meeting and represent you.

How long does a care needs assessment take? 

There are no set timescales for carrying out an assessment. It should happen within a reasonable time and consider the urgency of the situation.

It normally takes 4-6 weeks for your claim to be assessed. Once your assessment has been done, you should get the results within a week.  

The care needs assessment interview lasts a least an hour and will be either face-to-face, over the phone or online.

How often does a care needs assessment take place?

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.

Once a person starts receiving care, they will have a new care needs assessment regularly to make sure that their care plan is up to date and the information held is still accurate.

You should request a new assessment if your needs or circumstances change.

What happens after my care needs assessment?

The local authority (or HSC Trust if in Northern Ireland), will use the information you’ve given them to work out what care and support you may be eligible for and the best way for you to get it. 

You must be provided with a copy of your needs assessment.

If you have needs that meet the needs assessment eligibility criteria, your local authority must ensure your needs are met.

Your local authority will talk to you (and carer/independent advocate, if needed) to produce a care and support plan. This care plan highlights how your needs will be met.

The local authority will create your care and support plan that outlines the help you can receive. The plan will set out the services which are to be provided.

You should be provided with a copy of the care and support plan.

How is my care plan created?

Your care plan is created from the results of your needs assessment and any medical information.

The final plan will include information about you, a plan or schedule to deliver the care you need and any relevant notes.  

The local authority will then consider whether the person is eligible for financial support to meet their care needs.

After your care needs assessment, you may have a financial assessment.

The local authority (or HSC Trust if in Northern Ireland), will carry out a financial assessment which is a means test based on national guidelines and calculate how much you have to pay towards your care home fees.

If you, for example, have been assessed as requiring a care home place, you will need a financial assessment.

A financial assessment determines if you are entitled to financial assistance towards care home fees from your local authority. 

If you are told you are not eligible for care, you should receive a letter explaining why. You should also be told about other organisations or charities that may be able to help you.

What if you don’t agree with the care needs assessment?

If, for example, you want to move into a care home but the council recommends that you stay in your home with a care package, you can ask for a review of your care needs. This is to ensure the care needs assessment has considered all the difficulties you are experiencing at home.

Another person can represent you to ensure your difficulties (e.g. frequent falls, memory loss) are recorded.

If you disagree with the decision made about your social care after a review, you can make an official complaint. You can complain to to your local authority in England, Wales and Scotland or your local HSC Trust in Northern Ireland.

What if I made a complaint and am not happy with the local authority’s response?

If you are unhappy with the response received, you can make a complaint to your local ombudsman.

England – Local Government and Social Care Ombudsman.

Wales – Public Services Ombudsman for Wales.

Scotland – Scottish Public Services Ombudsman.

Northern Ireland – Ombudsman in Northern Ireland.

How to fund your care and find a care home

You can read these articles to find out how to fund your care or find the right care home for you and your needs.