Assessments of Need

I need help and assistance – what can I Do?

As our population increases so does the number of people who require care and assistance.

If you require help with everyday tasks, the local authority has a legal duty to carry out an assessment to ascertain what help and assistance you need. The law states that anyone who needs health or social care because of problems associated with old age, mental illness, learning, physical or sensory difficulties should be able to attain care services and support tailored to their individual needs whether at home or in a residential home.

Care can be simplified into 3 areas.

  1. Obtain a Care Needs assessment to see what care you require.
  2. Find out what your Care fees are going to be
  3. Calculate what you will pay having looked at your capital income and entitlements.

Obtaining a Care Needs Assessment

The Care Act 2014 states that you are entitled to a care needs assessment and for services to be provided directly to you from the local authorities. Such an assessment of your care needs is available whether you are paying privately for your care or whether you are requiring assistance from the state.

As with any assessment, you wellbeing is paramount to the local authority.

The law allows you to explain what care and support you require to make your life easier. This could be care at home, residential accommodation or support. The assessment thereafter takes into consideration your requests and balances these against your wellbeing and risk.

Can I Fail?

Many people are concerned with assessments as they feel it is a test. You cannot pass or fail such an assessment and is designed to find out what specific help you require.

How can I apply ?

  • Apply directly to social services, your GP or health consultant.

What happens at the assessment?

You assessment should be carried out by a suitable specialist such as a NHS employee or someone from the Local Authority such as a nurse or Social worker.

They will discuss with you what needs or help you have with your day to day activities (such as dressing, cooking, cleaning etc…) what you require to help you live safely within your own home (equipment or adaptations) or whether you or your carer require day centres or activities to give you both a break.

If someone (even a family member) is helping you with some tasks (such as cleaning, shopping, cooking) this still qualifies as a need.

Following the assessment?

Following this assessment the Local Authority will decide whether you qualify for care and support. There is a range of criteria that you must fall within to qualify (this information is available on your LA website).

Agreement of your assessment / (Care Plan)

Should you qualify, the Local Authority will advise you as to what services it can provide to you directly or arrange for you and this is known as your Care Plan and can recommend either services to enable you to stay at home or that your needs require residential care.

I did not qualify – what now?

  • Should your needs not be great enough to qualify for a Care Plan. The Local Authority should still provide you with information as to what help and assistance is available locally (through charities or local businesses) to help with your needs.
  • You can apply for a re assessment should you feel your care needs or financial circumstances have changed

Reviewing your Care Plan

You have a legal right to review your care plan at any time should you feel that your care and wellbeing needs or your financial situation has changed.

A review should occur by default the Local Authority review you care plan every year even if nothing has changed.

Furthermore, should you not agree with their decision, you have the right to challenge the decision.

What if I don’t agree with the Care Plan

You may want to challenge the decision reached because you are unhappy with the findings, the way it was carried out or the final outcome.

  • Ask the Local authority to full explain their decision to you in writing as to how they came to their decision.
  • If you still don’t agree with the decision, you can inform the Local Authority that you think the decision is unfair.
  • If you are still unhappy, you should use the Local Authorities Complaint Procedure to progress your claim.
  • You can further seek advice from Citizens Advice, Local Councillor or Local Support groups who may be able to assist.
  • If you are still unhappy, you can ask for an independent Local Authority or Trust to carry out an independent review of your case.
  • As a final option you can take you matter the ombudsman for review.
  • Remember, you can still ask for a reassessment at any time should you feel your care needs or financial circumstances have changed

NHS Continuing Health Care Funding

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.

Again, should you feel that you qualify for the above, your can find out whether you are eligible by attaining an assessment.

Assessment

You can request an assessment to be carried out at your home or care home by a Medical professional, Social worker or Healthcare Worker. The assessment will look at your health and care needs and determine whether you qualify for NHS Continuing Care Funding.

Review of the Assessment

Should you not be happy with the outcome, you can request a review of your assessment by the Local Clinical Commission Group or Health and Social Care Trust.

You can request a full assessment, if their finding were intialy based on an initial screening and you can at this stage provide further evidence.

Should you have been already been in care and paying fees, but feel you now qualify for NHS Funding you can ask for an assessment to be carried out.

What if I Don’t qualify

Should you not qualify for NHS Funding, the Local authority may still be able to help with your care needs.