Care Needs Assessment and Respite Care: Your Rights

Contact social services at your local council and ask for a needs assessment. You can call them or do it online. GOV.UK has a page for applying through your local council that covers England and Wales.

Someone from the council, such as a social worker or occupational therapist, asks how you are managing everyday tasks like washing, dressing and cooking. The assessment can happen face-to-face, over the phone or online, or by self-assessment.

The assessment must include the outcomes you want to achieve in day-to-day life, and the council must involve you, any carer you have and anyone you ask it to involve.

The statutory guidance says an assessment should be carried out over an appropriate and reasonable timescale, taking into account the urgency of needs and any fluctuation in them, and that the council should tell you an indicative timescale.

If it seems you may need alterations in and around your home, such as grab rails in the bathroom, you might also be referred for a separate assessment of your home for home adaptations. Our Disabled Facilities Grant guide covers one way of paying for them.

Your needs meet the eligibility criteria if all three of these apply.

• ✓Yes: Your needs arise from or are related to a physical or mental impairment or illness
• ✓Yes: You are unable to achieve two or more of the specified outcomes below
• ✓Yes: As a consequence there is, or is likely to be, a significant impact on your well-being

The specified outcomes

• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Being able to make use of your home safely
• Maintaining a habitable home environment
• 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 you have for a child

When you count as unable to achieve an outcome

• ✓Yes: You are unable to achieve it without assistance
• ✓Yes: You are able to achieve it without assistance but doing so causes you significant pain, distress or anxiety
• ✓Yes: You are able to achieve it without assistance but doing so endangers or is likely to endanger your health or safety, or that of others
• ✓Yes: You are able to achieve it without assistance but it takes significantly longer than would normally be expected

If your needs fluctuate, the council must take into account your circumstances over such period as it considers necessary to establish accurately your level of need.

If your needs meet the eligibility criteria, the council must meet them if you are ordinarily resident in its area, or present there with no settled residence, and either there is no charge or one of the financial conditions is met.

If none of your needs meet the criteria, the council must give you written advice and information about what can be done to meet or reduce them and to prevent or delay needs developing in future. The NHS says to ask if you are not given free advice about where to get help in your community.

Your care and support plan is a document prepared by the council which specifies the needs identified, whether they meet the eligibility criteria, the needs the council is going to meet and how, and includes your personal budget. The council must give you a copy.

The NHS says a plan includes the following, and that you should get a copy within a few weeks.

• What is important to you
• What you can do yourself
• What equipment or care you need
• What your friends and family think
• Who to contact if you have questions about your care
• Your personal budget and direct payments

The council must keep plans under review and review yours on a reasonable request by or on your behalf. The NHS says reviews usually happen within the first few months of support starting and then once every year, and that you can call adult social services at any time and ask for a review.

If your plan includes a personal budget and you ask the council to pay some or all of it to you or to someone you nominate, it must make direct payments if all four of these apply, subject to regulations.

• ✓Yes: You have capacity to make the request
• ✓Yes: Regulations do not prohibit direct payments in your case
• ✓Yes: The council is satisfied that you or your nominated person can manage direct payments, with whatever help it thinks you can access
• ✓Yes: The council is satisfied that direct payments are an appropriate way to meet your needs

You will generally be expected to pay toward the cost of social care. If the assessment identifies you need help, you will have a financial assessment (means test) to see if the council will pay towards it. A council must not charge you for the assessment itself.

In England the upper capital limit is currently set at £23,250 and the lower capital limit at £14,250.

The guidance gives an example: a person with £4,000 above the lower capital limit is charged tariff income of £16 per week.

For care outside a care home, the limits of £23,250 and £14,250 are simply minimums, and councils have discretion to set higher capital limits.

Intermediate care, including reablement, must be provided free of charge for up to 6 weeks.

The NHS says some people with long-term complex health needs qualify for free health and social care arranged and funded solely by the NHS, known as NHS Continuing Healthcare.

Respite care means taking a break from caring while the person you care for is looked after by someone else. Councils will only fund it for people they have assessed as needing it, so the carer should have a carer's assessment and the person they look after a care needs assessment.

The options range from a volunteer sitting with the person you look after for a few hours to a short stay in a care home. The main types are:

• Day care centres
• Homecare from a paid carer
• A short stay in a care home
• Getting friends and family to help
• Respite holidays and sitting services

If you or the person you care for qualifies for respite care, the council will do a financial assessment to work out if it will pay towards it. If it qualifies for council-funded respite, you can ask the council to arrange it for you, or do it yourself through a personal budget or direct payment.

If the person you care for has to pay for their own respite care, they might be able to raise money towards it from income from pensions, work, investments or property, savings, or benefits such as Attendance Allowance.

Yes. Where it appears a carer may have needs for support, now or in the future, the council must assess them, whatever the level of those needs and whatever the money of the carer or of the person they care for. A carer's assessment is free and anyone over 18 can ask for one.

A carer is an adult who provides or intends to provide care for another adult, which includes practical or emotional support. Someone providing care under a contract or as voluntary work is not regarded as a carer, unless the council considers the relationship is such that it would be appropriate to regard them as one.

It is separate from the needs assessment the person you care for might have, but you can ask to have them both done at the same time.

Contact adult social services at your local council and ask for a carer's assessment. If you are a parent or carer of a child, contact the children with disabilities department. You can call or do it online, and assessments usually last at least an hour.

The assessment must include whether you are able, and are likely to continue to be able, and willing, and likely to continue to be willing, to provide care. The council must also have regard to whether you work or wish to, and whether you take part in or wish to take part in education, training or recreation.

What the NHS says an assessment might recommend

• Someone to take over caring so you can take a break
• Gym membership and exercise classes to relieve stress
• Help with taxi fares if you do not drive
• Help with gardening and housework
• Training how to lift safely
• Local support groups so you have people to talk to
• Advice about benefits for carers

What to have ready

• Your NHS number, if you have one
• Your GP's name, address and phone number
• Contact details of anyone who is coming to the assessment with you
• The name, address, date of birth and NHS number of the person you care for, if you have it
• Your email address

When a carer's needs meet the eligibility criteria

A carer's needs meet the criteria if all three of these apply.

• ✓Yes: Your needs arise as a consequence of providing necessary care for an adult
• ✓Yes: Your physical or mental health is, or is at risk of, deteriorating, or you are unable to achieve any of the specified outcomes
• ✓Yes: As a consequence there is, or is likely to be, a significant impact on your well-being

The specified outcomes are carrying out caring responsibilities for a child, providing care to other persons, maintaining a habitable home environment, managing and maintaining nutrition, family or other personal relationships, work, training, education or volunteering, making use of necessary facilities or services in the local community including recreational facilities or services, and engaging in recreational activities.

If your needs meet the criteria, the council must meet them if the conditions on charging are met, and it may meet needs for support it is not required to meet. A council must not charge a carer for care and support provided directly to the person they care for under any circumstances.

You might also qualify for benefits for carers that can help with costs, such as Carer's Allowance.

The NHS says your local council has to provide an advocate if you do not have family or friends who can help or support you and you have difficulty understanding and remembering information, communicating your views or understanding the pros and cons of different options. A paid carer cannot act as your advocate.

Contact social care services at your local council and ask about advocacy services, or refer yourself to an independent advocacy organisation. Advocates are independent of social services and the NHS.

If you disagree with the results of your needs assessment or how it was done, you have a right to complain. First complain to your local council. If you are not happy with the way the council handles your complaint, you can take it to the Local Government and Social Care Ombudsman.

The Ombudsman looks at all adult social care complaints, including care that is funded privately without council involvement. It cannot look into your complaint before the organisation has had a chance to put things right, and it cannot normally look into it if more than 12 months have passed since you first knew about the problem.

In Wales, where it appears to a council that an adult may have needs for care and support, it must assess whether they do and what those needs are, regardless of its view of the level of the adult's needs or financial resources. It must involve the adult and, where feasible, any carer.

Where it appears a carer may have needs for support, the council must assess whether they do, or are likely to in future, regardless of the level of the carer's needs or the financial resources of the carer or the person they care for.

If needs do not meet the eligibility criteria, the council must determine whether it is nevertheless necessary to meet them to protect an adult from abuse or neglect or a risk of abuse or neglect. The eligibility criteria are set out in regulations.

You have a right to an assessment of your care needs from your local council's social work or social care department. If care is mainly provided by an unpaid relative or friend, they have the right to be involved in the assessment and to a personalised plan of their own, and are also entitled to an assessment of their own community care needs.

Carers have the right to get a plan from the council that outlines their needs as a carer, called an Adult Carer Support Plan. It is a written record of the following.

• Your caring role
• Your physical, mental and emotional needs
• Whether you are able or willing to continue caring
• What services the council will provide to you
• Whether you are eligible for financial support
• An emergency care plan

The council must consider if you need short breaks when creating your plan. If you are eligible for breaks, the plan will state what you need and how your breaks will be arranged, for example by giving you money to arrange your own.

Self-directed Support gives you four options: a direct payment, an Individual Service Fund, the council arranging support, or a mixture. Each council sets its own rules for who can get this support, and a carer needs a carer's assessment from their council to get it.

A health and social care assessment with the social services department of your local trust is often the first step towards getting the help and support you need. The assessment is called an assessment of need.

If you provide a regular and significant amount of care for someone, you are entitled to a carer's assessment from your Health and Social Care Trust. There is no definition of regular and significant care. Your right to an assessment and to the services and support you may receive is not linked to your income or capital.

To be eligible for direct payments you must already have been assessed as needing help from social services. A carer aged 16 or over may be eligible for direct payments to buy services the Trust agrees they need in their caring role, but cannot use them to buy services for the person they care for.