Care Act Assessment Overview

Why might it be of interest?

On the hub there are various documents about the Care Act, the Adult Social Care assessment, etc.  There is some crossover of information but each of the documents addresses the topic slightly differently so there may be information in one of these documents that is not in another but may be relevant to your situation.

Most of the documents are not long so it will be quite quick and easy to see if you are reading information you need.

When a disabled young person approaches 18 years of age they may want to have an assessment from Adult Social Care (ASC) to see if they are eligible for social care support.  It doesn’t matter whether they have a care package from the disabled children’s team or Continuing Healthcare (CHC) or not.  The eligibility criteria for adult social care are different and the bar is lower than for children’s social care.

If a yp has complex health needs as well as social care needs they may need to look at whether they would be eligible for Continuing Healthcare (CHC) funded by the NHS.  CHC, for adults, usually takes on the funding of both health and social care needs if an adult is eligible, although a package can be jointly funded.

If a young person is receiving support from children’s continuing care it is likely that they will be referred for an adult checklist by one of the staff currently involved in their package.  If they are not receiving continuing care they might be referred by the social worker who carries out their adult social care assessment if they believe that the young person may meet the criteria.

You don’t really have a choice here – if a social worker or other healthcare professional believes that the young person may be eligible for CHC they will make the referral for a checklist assessment.

The initial step is a CHC checklist and if this indicates that a young person may be eligible then a full assessment should be carried out well before they turn 18.  The checklist and assessment should be started when the young person is around 17½.  If they are not eligible for CHC then ASC will do their assessment.

The rest of this document is about the adult social care assessment under the Care Act.

Referral:  You can contact adult social care directly and request an assessment for your young person if they are not referred by another professional.  LB Richmond have a tracker to record details of young people who may need support from adult social care and they may well be referred to adult social care from that.

ASC may do an initial phone assessment to determine whether they believe the young person will meet criteria and may agree to go ahead with an assessment or not based on this conversation.  If you are turned down you can insist that they carry out an assessment as they have a legal duty to carry out an assessment if there is an appearance of need for care and support.  A diagnosis of learning disabilities and/or autism it is not necessary to be entitled to an assessment.

The first stage is an assessment of your young person’s needs.  Their financial situation and whether they receive support already or not is not relevant at this stage.  Once eligibility has been established, ie the young person does have care needs that meet the criteria, then their financial situation and the support they already have and are likely to continue to have will be taken into account when determining the support package.  Your financial situation is not relevant at any stage.

When to have the assessment:  The assessment should take place well ahead of the young person turning 18 – certainly a few months before as making dates for the assessment and then waiting for the report can all take time.  If your young person has a package from the disabled children’s team your social worker or family support worker should make the referral – but do check!

Where:  the initial assessment will probably take place at the young person’s home and it will take some time – an hour or more.  It may take place over zoom but a phone call on its own probably wouldn’t work well.  How it takes place should be guided by what you think will work best for your young person.

Who:  your young person, obviously!  But also anyone they need – most likely you – to support them during the assessment.  Your young person should be involved as much as they are able and reasonable adjustments should be made to ensure that this is possible.  For example, a communication aid or pictures, in their favourite place in the house, at a good time for them.  However, if they don’t want to engage or can’t engage then you can speak for them.

If there is any doubt that your young person has the capacity to be involved in the assessment then a mental capacity assessment should be carried out – most likely by your social worker with your input but the LA may make alternative arrangements, for example an independent assessor.  This is nothing to be worried about and you will be able to speak to the assessor and have your input.

Eligibility

There is a national framework for assessing needs so the eligibility criteria is the same whichever LA you come under.  To be eligible an individual must meet the following:

1. Needs that arise from or are related to a physical or mental impairment or illness (physical, mental, sensory, learning or cognitive disability or illness, substance misuse or brain injury; ASD falls under this definition but a specific learning difficulty such as ADHD does not)
2. As a result of these needs the individual cannot achieve two or more of the following outcomes:

• managing and maintaining nutrition
• maintaining personal hygiene
• managing toilet needs
• being appropriately clothed
• maintaining a habitable home environment
• being able to make use of the home safely
• developing and maintaining family or other personal relationships
• 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 facilities or services
• carrying out any caring responsibilities the adult has for a child

3. As a consequence of being unable to achieve these outcomes, there is, or is likely to be, a significant impact on the individual’s wellbeing

The hft – How to get the right support from your local authority guide is worth reading.  Chapter 7 talks about the assessment.  You can download a copy here:  https://www.hft.org.uk/resources-and-guidance/disability-rights-and-legal/care-act/.