In deciding if an adult with care and support needs has eligible needs the council will meet with you and have a conversation to learn more about you and consider what options are open to you.
Where possible we will work to help you access support in your community which addresses these needs but if there are any unmet needs we need to consider your eligibility for support under the Care Act. This is often referred to as an 'assessment' but we've made the process more about the person and we like to avoid words and jargon which may confuse or cause unnecessary alarm.
The council will use the information gathered to decide.
- do the adult's needs arise from or are related to a physical or mental impairment or illness they have?
- as a result of the adult's needs, is the adult unable to achieve two or more of the outcomes specified in the eligibility criteria regulations?
- as a consequence is there or is there likely to be a significant impact on the adult's wellbeing?
An adult's needs are only eligible for council support if the answer to all three of these questions is "yes".
All council's in England must work to a national criteria for adult care and support needs and the eligibility threshold is set out in the Care and Support (Eligibility Criteria) regulations 2014. This identifies a number of specific outcomes:
- managing and maintaining nutrition for example does the person have access to food and drink, are they able to prepare and eat convenience meals or other food and drink?
- maintaining personal hygiene for example can the person wash themselves adequately and launder their clothes?
- managing toilet needs for example can they use their toilet and keep themselves clean?
- being appropriately clothed for example can the person dress themselves and be correctly dressed for the weather?
- being able to use their home safely for example can the person move around indoor safely?
- maintaining a habitable home environment for example is the home sufficiently clean and maintained in order to be safe and is there access to amenities such as water, gas and electricity?
- developing and maintaining family and other personal relationships for example is the person able to keep in touch with others?
- accessing and engaging in work, training, education or volunteering
- making use of necessary facilities or services in the local community including public transport and recreational opportunities
- carrying out any caring responsibilities the adult has for a child
Someone is eligible if they cannot manage two or more of these outcomes without assistance, or they can achieve them without assistance but doing so would cause significant pain, distress or anxiety, endanger their health or safety or others' health and safety, or achieving them would take significantly longer time than normal.
After meeting with you, the council will write to you to confirm it's view of whether you are eligible and what steps follow, this will include information about how to complain if the person or their representative believes the decision is wrong.