In order to get financial help from social services for you home care needs there are two evaluations that social services must undertake.
To take these in reverse order; the second assessment that is carried out is a means test. This determinates whether you are entitled to have your home care provision paid for in full by social services; partially paid for by social services or not paid for at all by social services – in this last case, in other words you have to pay for it yourself. There is, though, an assessment that comes before this.
The first assessment is one of your care needs. This is known as a community care assessment. You may also hear it referred to as a care needs assessment. This article deals with the community care assessment only.
The information that follows applies specifically to adults. It is also aimed at people looking for domiciliary care (home care) although much of what is said applies to people seeking residential care.
Here are eight things you should know about community care assessments from social services.
1. Local authorities have a statutory duty to carry out community care assessments.
Local authorities often have statutory duties placed upon them. What this means is that there exists a law that has been passed by Parliament – a law contained in an Act of Parliament, also known as a statute – that places the local authority under an obligation to do something. When such a duty exists, it is something that a local authority can not fail to do. Such is the case with community care assessments. Local authorities therefore, are under a duty imposed by law to carry out community care assessments.
2. The Duty to carry out community care evaluations is interpreted in such a way that means that in practice it is highly improbable that your local authority can refuse to carry out an assessment of your care needs.
The law imposing the duty says that if it appears that you may need community care services that your local authority may be able to provide then your local authority has a duty to carry out an assessment of your care needs.
Even in circumstances where the local authority believes that you have little chance of qualifying for community care services: it must still conduct the assessment. Even in circumstances where your local authority believes that you will not qualify financially for social services help: it must still conduct the assessment.
If you are disabled your local authority has an additional duty imposed upon it by law to carry out an assessment.
3. If you are a carer who looks after someone (your wife, husband, relative or friend), you are also entitled to have a community care assessment.
If you look after someone, you can request a community care assessment when the person you care for is being assessed. You are entitled to an assessment even if the person you care for decides not to have an assessment of his or her needs undertaken.
4. To get a community care assessment your first step is to make a referral to social services.
You can do this yourself. Alternately, a relative, friend or carer can do this on your behalf. You can also be referred by your GP or another health or social care worker.
5. To get an assessment takes about 28 days from the day of referral.
Although local authorities have a duty to conduct community care assessments, there is no duty placed on them that dictates how quickly they must deal with referrals. There are guidelines; however, and the guidelines state that referrals must be processed within 48 hours and the whole procedure completed within 28 days.
6. Assessments usually take place in your home.
If you are seeking home care this is the best location for an assessment to take place. It is possible for alternative locations, like a GPs' surgery, to be used. If you are a little unsure about explaining your needs to someone, you might like to have someone with you at your assessment. This person will sometimes be referred to as your advocate, that is, someone who speaks on your behalf.
It is also possible for assessments to be done by telephone. This may be fine for simple evaluations but it is not advisable if you have more complex care needs. Telephone evaluations are controversial because they can be used as a means of screening out people before the formal assessment is conducted.
You may also be asked to carry out a self-assessment of your care needs. This may help you focus your mind on what your needs are but in no way should it be used as a substitute for a formal community needs assessment.
7. Your care needs will be assessed as falling into one of four categories.
The community care assessments measures the risk to your independence and well-being if nothing more is done – in other words what is the risk to your independence and well-being if no care is provided.
The four categories are referred to as eligibility criteria and they are called: critical, substantive, moderate and low. These criteria are a measure of how serious your needs are.
In the first, and most serious, category your needs are judged to be critical . If your needs fall into this category then your life may be at risk, and / or you have significant health problems, and / or you are at risk of serious abuse or neglect if nothing else is done.
In the second category your needs are deemed to be fundamental, which means that if nothing more is done you have limited choice and control over your living environment and / or you are at risk of abuse or neglect. You are not able to carry out most of your personal care or domestic tasks.
The third, moderate category, you are not able to carry out several tasks relating to your personal care or domestic tasks. You are not able to maintain a lot of contact with society or take an active part in family life.
In the final, low category, are not able to carry out one or two tasks relating to your personal care or domestic tasks.
Many local authorities will provide financing for care only where your needs fall into one of the first two categories.
If you qualify for funding you are said to have an eligible need or eligible needs. However, even though you have an indispensable need you will still need to qualify on a means test.
8. If you are assessed as not having eligible needs, or you feel the assessment is insufficient, you can appeal.
Ask for the decision in writing. You need to know the reason why you have been assessed as you have and make sure that you are aware of the local authority's complaints procedure.