An adult who believes that they have care and support needs can request a needs assessment directly from the social services department of their local authority, or they can ask to be referred by a third party. There are no set limits on how long local authorities have before they carry out an assessment, but if the situation is urgent, this should be explained to social services. In emergencies, the local authority will have the power to provide services before they carry out an assessment.

The local authority must carry out a needs assessment if the individual concerned appears to be in need of care and support. This should be done regardless of the individual’s finances, their level of need or their immigration status. Apart from providing services before an assessment in an emergency, the local authority cannot make any decisions about what an individual is entitled to without doing a needs assessment.

If a local authority refuses to carry out an assessment, this can be challenged. It is best to ask the local authority to give the reasons for their decision in writing.

Before the assessment, the local authority should provide the person being assessed with information about what to expect from the process, for example a list of the questions that will be covered.

If the person being assessed is not able to engage in the process, for instance if they have learning disabilities or are suffering from dementia, the local authority should seek to involve someone who can advocate on their behalf. If there are no family members or friends who are available or suitable to do this, the local authority must appoint and independent advocate.

A needs assessment will usually be done face to face, but it can be done by phone or online as long as this allows the person being assessed to effectively communicate their needs.

The assessment will normally be carried out by social workers, but may also involve occupational therapists, carers and anyone else with information about the individual’s needs.

The social worker should explore the following:-

• physical needs, eg personal care

• social needs eg maintaining relationships with family/friends

• psychological needs

• emotional needs

• recreational needs and leisure needs

• work, education or learning needs

• health needs

• accommodation needs

• transport needs

• likely future needs

The social worker should also consider what outcomes the person would like to achieve in order to maintain or improve their wellbeing.

Once all of these needs have been identified, the local authority can evaluate whether they are ‘eligible’ ie whether they arise from an individual’s physical/mental conditions and impact on their ability to achieve certain outcomes affecting their wellbeing.

An assessment should be carried out in the place the individual is currently living so that the local authority can look at how they are managing in that environment and whether it is suitable for their needs. However, assessments should be done in hospital before someone is discharged if it is believed that they will need care and support once they leave.

Following the assessment, and taking into consideration all the evidence gathered from the individual concerned and anyone else involved in their care, the local authority will decide whether their needs are eligible and if they are entitled to receive services.

If the local authority decides that the individual is entitled to services, they must come to an agreement about how these services should be arranged in order to meet eligible needs. This will be in the form of a care and support plan and will set out details of the person’s eligible needs, the services the local authority will provide and any charges they will make.

The services provided could take a variety of forms, for example:

• adaptations or equipment in the home eg handrails, hoists

• home care services eg help with washing, dressing, cooking etc

• night sitting

• accommodation eg in a care home

• arranging travel eg to a day centre

If the local authority refuses to provide support, they should provide a report setting out their reasons. Where support is refused because the local authority has decided that the individual’s needs are not eligible, it may be possible to challenge this. It is best to ask for reasons to be given in writing and to get advice as soon as possible.

The Care Act 2014 requires people who have no recourse to public funds to demonstrate that their eligible needs for care and support do not arise solely from destitution or its effects.

There are also special rules about the provision of accommodation to people with no recourse to public funds; it must be shown that an individual’s needs are ‘accommodation related’ and that the provision of other services would be ‘effectively useless’ if accommodation wasn’t provided as well. For example, if a person was unable to wash or cook for themselves and the local authority decided that care should be provided to help with these activities, but the person had nowhere to live, the assistance of the carer would be ‘effectively useless’ without the means to wash or cook which are part of having somewhere to live.

In addition, certain migrants are specifically excluded (by immigration rules) from accessing social care unless the local authority’s failure to provide services would result in a breach of the individual’s human rights. This can be quite difficult to argue and if you are in this situation and would like further advice please contact us or see our resources.