Social Care Assessment and Eligibility - Eligible Needs
How does the local authority decide whether I have eligible needs?
This section covers:
How do they decide if my need is because of a physical or mental impairment or illness?
There are standard eligibility criteria for all local authorities (LA) in England. You will be eligible if:
- your needs are because of a physical or mental health issue,
- your needs stop you from being able to do two or more specific things (these are described in the table below), and
- there is a significant impact on your wellbeing because you can’t do specific things(see here).
The LA might need to talk to your family members or other people that support you to find out about your needs.
The LA has to assess you to see if your needs are because of a physical, mental, sensory, cognitive disability or illness, substance misuse or brain injury. You can be eligible for social care needs if you don’t have a diagnosis.
How do they decide if my needs stop me from doing two or more specific things?
The LA will assess you to see if you can do ten things. These are called ‘eligibility outcomes’. The table below explains what these are, what they mean and has some questions to get you thinking about how they might relate to mental illness.
||Does this apply to me? Things to consider
|a) managing and maintaining nutrition
||If you have access to food and drink to maintain nutrition and if you can prepare and consume food and drink.
Does your illness or the medication you take mean you do not eat and drink regularly?
Do you forget to eat or drink?
Do you need someone to remind you to eat or drink?
Can you go shopping for food on your own?
Can you make yourself something to eat?
|b) maintaining personal hygiene
||Can you wash yourself and your clothes?
Do you wash yourself at least twice a week?
Do you need someone to remind you to wash yourself?
Do you have a washing machine?
Can you do your own laundry?
Do you remember to wash your clothes?
How many times do you wear your clothes before you wash them?
|c) managing your toilet needs
||Do you have a toilet and do you know how to use it?
Do you need any help to use the toilet?
Does your medication cause incontinence?
Do you ever soil yourself?
|d) being appropriately clothed
||Can you dress yourself and do you wear the right clothes for the weather?
Do you need anyone to help you get dressed?
Do you wear warm clothes in the winter?
Do you remember to wear a jacket when it’s cold or raining?
Are your clothes and shoes in good condition? Are there any rips, tears or holes in them?
|e) being able to make use of the home safely
||Can you get around your house and use the kitchen and bathroom? Can you get in and out of your house easily?
|f) maintaining a habitable home environment
||Is your home sufficiently clean and safe? Do you have water, electricity and gas?
Can you keep your house free from clutter and mess?
Do you find it difficult to do chores?
Do you find you have a lot of stuff which makes it hard to get around your house?
Do you find it hard to throw things away?
|g) developing and maintaining family or personal relationships
||Are you isolated or lonely because your mental health stops you from keeping personal relationships you have or making new ones?
Do you feel isolated? Do you feel you need more contact with people?
Does your mental health make it hard to meet people?
Do you get on with people you meet?
Who do you go to if you need help or support?
|h) accessing and engaging in work, training or volunteering
||Do you have the opportunity to apply yourself and contribute to society through work, training, education or volunteering if you want to? Do you need support to do these things?
Do you know where you would go if you wanted education, training or volunteering?
Do you think your mental health stops you from doing any education, training or volunteering?
Do you feel you are part of your community?
Would you need someone to go with you if you wanted to go on a course?
Do you need help with learning or remembering information?
|i) making use of the necessary facilities or services in the local community including public transport and recreational facilities or services
||Can you get around safely using public transport? Do you need support to get around?
Can you use public transport?
Do you need help getting to appointments?
Can you make new journeys on your own?
Do you know where you can go to do hobbies or activities?
Do you need someone to bring you to these places?
Do you feel able to use the gym or leisure centre?
|j) carrying out any caring responsibilities the adult has for the child
||Do you have any caring or parenting responsibilities?
Do side effects of your medication mean you can’t get up in time to help your children get ready in the morning?
Do you feel your mental health makes it difficult for you to look after your children?
How do they decide if there is a significant impact on my wellbeing because I can’t do specific things?
The LA will assess each of these outcomes to see if:
- you need help to do it,
- you can do it without help but it causes you a lot of pain, distress or anxiety,
- you can do it without help but it puts you or other people at risk of harm to health or safety, or
- you can do it without help but it takes a lot longer than it would take other people.
If your needs usually change during the week, month or year the LA need to assess this. They will consider how you can do things at different points over the last year. This is so they can make sure you get support when you need it.
How does the LA assess the impact on my wellbeing?
If you meet two or more of the eligible outcomes from the table above the LA will ask you about the impact this has on your wellbeing. Wellbeing means:
- being treated with respect and having self-respect,
- good physical and mental health,
- being safe from abuse or neglect,
- being in control of your day to day life and being independent,
- being involved in work, training or volunteering if you want it,
- not being isolated and having enough money to live,
- a good home life and relationships,
- having somewhere to live, and
- being part of society.
Significant impact can mean the following things.
- You may have one need but it impacts on one area a lot.
- You have a few needs but they are quite low but impact many areas.
- You may have one need but this is likely to change and impact on other outcomes.
What happens after my assessment?
After your assessment, the LA will decide if you have eligible needs. If you have eligible needs they will give you a copy of their decision. They should also provide a copy to your advocate or carer.
You will have a meeting where they will:
- ask you what needs you have that you want them to support you with,
- decide how they will meet your needs,
- do a financial assessment, and
- make sure you meet the ordinary residence requirement.
The professional who assessed you has to show how they have made the decision and what evidence they used to do this. They need to show how they have linked the three parts, your desired outcomes, the eligibility outcomes and the impact on your wellbeing.
If you have eligible needs you will go on to the support and care planning stage.
What if the local authority decides I don’t have eligible needs?
If the LA decides that you don’t have eligible needs they should explain how they decided this. You can ask for a written record of how they made the decision.
If you don’t agree with the LA’s decision you could challenge this. An advocate may be able to help you challenge a decision.
They should give you information and advice about:
- your needs,
- what services you can use to reduce your needs, and
- what you need to prevent or delay your needs being eligible in the future.
You can find more information about ‘Social Care – Care and Support Planning’ here.
Need practical advice & info? We can help.
Contact our Advice team about mental health & related issues
0300 5000 927 Monday - Friday 9.30am - 4pm, not including bank holidays