Council care and assessments: questions answered

Question 1

Do I have to pay for a care needs assessment?

Accepted Answer

No. A care needs assessment from your local council is free in England, and you are entitled to one regardless of how much money you have. Your finances only matter later, in a separate financial assessment that decides whether you contribute towards the cost of any care the council arranges. Self-funders can still ask for an assessment to get advice and a clear record of their needs.

Question 2

How do I ask the council for a care needs assessment?

Accepted Answer

You contact the adult social care department of the council where the person usually lives, by phone, online form or email. You can ask for yourself, or a relative, GP or hospital can refer someone with their consent. Say clearly that you are requesting a needs assessment under the Care Act 2014. If the person lacks capacity to agree, the council can still assess them in their best interests.

Question 3

What are the national eligibility criteria for council care in England?

Accepted Answer

You meet the national eligibility criteria if three conditions all apply: your needs come from a physical or mental impairment or illness; because of those needs you cannot achieve two or more of ten specified outcomes, such as washing, eating or keeping your home safe; and as a result there is, or is likely to be, a significant impact on your wellbeing. The same threshold applies in every council in England.

Question 4

What are the ten outcomes councils look at when deciding eligibility for care?

Accepted Answer

The ten outcomes are: managing nutrition; maintaining personal hygiene; managing toilet needs; being appropriately clothed; using the home safely; keeping the home habitable; maintaining family or other relationships; accessing work, training, education or volunteering; using community facilities and services, including public transport; and carrying out caring responsibilities for a child. Being unable to achieve two or more, with a significant impact on wellbeing, is part of the eligibility test.

Question 5

What does 'unable to achieve' an outcome mean in a care assessment?

Accepted Answer

Being 'unable to achieve' an outcome covers more than being physically unable. Under the eligibility regulations you are treated as unable if you can only do it with help, if doing it causes significant pain, distress or anxiety, if it endangers your or others' health and safety, or if it takes significantly longer than would normally be expected. Councils must consider all four situations when assessing.

Question 6

Does a council look at my good days or bad days in a needs assessment?

Accepted Answer

A council must consider how your needs vary over time, not just how you seem on the day of the visit. Care Act guidance says assessments should take account of fluctuating needs, looking at your circumstances over a suitable period. Keeping a diary of bad days, falls, night-time problems and help given by family gives the assessor evidence of what a typical week really looks like.

Question 7

How long does a council care needs assessment take?

Accepted Answer

There is no fixed legal deadline for a care needs assessment in England. Care Act guidance says it should be carried out within an appropriate and reasonable timescale, depending on urgency. Many councils aim for a few weeks, but waiting lists vary widely. If needs are urgent the council can arrange care before the assessment is finished, and unreasonable delays can be complained about.

Question 8

Can the council provide care while I wait for an assessment?

Accepted Answer

Yes. A council in England can meet urgent needs before it has completed a needs assessment or decided eligibility, under section 19(3) of the Care Act 2014. If someone is at risk, for example unable to manage at home after a fall, ask for emergency or interim support while the full assessment is arranged. The council may still charge later, after a financial assessment.

Question 9

Who can be present at my care needs assessment?

Accepted Answer

You can have a relative, friend or carer with you at your care needs assessment, and the council should involve anyone you want involved. If you would have substantial difficulty taking part and have nobody suitable to support you, the council must arrange an independent advocate. Assessments can be face to face, by phone or online, but you can ask for an in-person visit if that suits your needs better.

Question 10

What is an independent advocate in a care assessment?

Accepted Answer

An independent advocate is a trained person who helps you understand and take part in your care assessment, care planning and reviews. Councils in England must provide one if you would have substantial difficulty being involved and there is no appropriate family member or friend to support you. The advocate helps you express your views and can challenge decisions on your behalf.

Question 11

What happens after a care needs assessment?

Accepted Answer

After the assessment the council must give you a written record and tell you whether you have eligible needs. If you do, it works out a care and support plan with you, sets a personal budget showing the cost of meeting those needs, and carries out a financial assessment to decide what you pay. If you are not eligible, it must explain why and give advice on preventing needs from getting worse.

Question 12

What is a care and support plan?

Accepted Answer

A care and support plan is the written document a council prepares when you have eligible needs. It sets out your needs, the outcomes you want, how those needs will be met, your personal budget and any direct payments. You should be involved in writing it and are entitled to a copy. It also records which needs the council will meet and which are met by family or other support.

Question 13

What is a personal budget in adult social care?

Accepted Answer

A personal budget is the amount of money the council works out it would cost to meet your eligible care needs. It must be enough to meet those needs and is included in your care and support plan. It is made up of what you pay after the financial assessment plus what the council pays. You can take it as a direct payment, council-arranged services or a mix.

Question 14

Can I use direct payments to pay a family member to care for me?

Accepted Answer

Usually you cannot use direct payments to pay a close relative who lives in the same household, unless the council agrees it is necessary, for example where nobody else can meet your needs or for cultural reasons. You can normally pay a relative who lives elsewhere, but they become your employee or must be self-employed. Paying a relative for managing the direct payment itself has separate rules.

Question 15

Can direct payments be used to pay for a care home?

Accepted Answer

Generally no. In England direct payments cannot normally be used to pay for a long-term care home placement. They can be used for short stays, such as respite, up to a limit of four consecutive weeks in any 12-month period, with stays less than four weeks apart added together. Direct payments are mainly intended for care at home and community support.

Question 16

What responsibilities come with employing a personal assistant through direct payments?

Accepted Answer

If you use direct payments to employ a personal assistant, you become their employer. That means paying at least the National Minimum Wage, holiday pay, sick pay where due, running payroll and pension auto-enrolment, providing employer's liability insurance and checking right to work. Many councils fund a support service or payroll provider to help. Using a regulated agency instead avoids most employer duties.

Question 17

How often does the council review a care plan?

Accepted Answer

Care Act guidance says a care and support plan should be reviewed at least every 12 months, with a first light-touch review usually within six to eight weeks of the plan starting. You can ask for a review at any time if your needs or circumstances change, and the council must consider that request. A review can lead to more, less or different support.

Question 18

Can the council reduce my care package at a review?

Accepted Answer

Yes, but only if a proper review or reassessment shows your eligible needs have changed or can be met another way. A council cannot cut care simply to save money without reassessing, and the revised plan must still meet all eligible needs. It must explain its reasons and involve you. If you think the cut leaves needs unmet, use the council's complaints procedure.

Question 19

Can the council refuse to help if my family could care for me?

Accepted Answer

The council must assess your needs without regard to any help family provide, then consider whether a carer is willing and able to continue. It cannot assume family will provide care. If your carer wants to stop or reduce what they do, those needs must be met another way if eligible. Carers have their own right to an assessment.

Question 20

How do I challenge a council care assessment decision?

Accepted Answer

First raise the problem with the social worker or team manager and ask for written reasons. If that fails, make a formal complaint under the council's adult social care complaints procedure. If you are still unhappy once it has responded, or after about 12 weeks, you can go to the Local Government and Social Care Ombudsman, which is free. Judicial review is a last resort for unlawful decisions.

Question 21

What does the Local Government and Social Care Ombudsman do?

Accepted Answer

The Local Government and Social Care Ombudsman investigates complaints about councils' adult social care and about privately arranged or self-funded care providers in England. It is free and independent. You normally need to complain to the council or provider first. It can recommend apologies, reassessments, refunds or payments, and complaints should usually be brought within 12 months of becoming aware of the problem.

Question 22

Can a carer's assessment be done at the same time as the person's needs assessment?

Accepted Answer

Yes. A council can carry out a combined assessment of the person needing care and their carer if both agree. This can save time and help both plans fit together. The carer can still ask for a separate, private assessment if they would prefer to talk without the cared-for person present, for example about strain or wanting to reduce how much care they give.

Question 23

Who decides whether council care is provided at home or in a care home?

Accepted Answer

The council and the person decide together through the care and support plan, with the person's wishes given significant weight. Councils must meet eligible needs but can consider cost when choosing between suitable options. If someone lacks capacity to decide, a best-interests decision is made under the Mental Capacity Act, consulting family and any attorney or deputy.

Question 24

What happens to my council care if I move to another council area?

Accepted Answer

Continuity of care rules apply. If you tell your current and new councils in advance, the new council must assess you before or soon after you move and, until it has done so, meet the needs in your existing care plan. If it then provides a different package, it must explain why in writing. This applies to moves within England.

Question 25

Which council pays if someone moves into a care home in another area?

Accepted Answer

If the council arranges the care home placement, the person usually stays the responsibility of the original council, even if the home is in another area. This is the 'ordinary residence' rule for council-arranged accommodation. If a self-funder moves to a care home elsewhere and later needs council help, they may become ordinarily resident in the new area instead.

Question 26

Is the six weeks of free care after hospital discharge real?

Accepted Answer

Yes. In England intermediate care and reablement, which help you regain independence after hospital or illness, must be provided free for up to six weeks. It is not free general home care: it is short-term, goal-focused support. If you still need help after it ends, the council assesses you for ongoing care, which may then be charged for after a financial assessment.

Question 27

Can the council charge for equipment and minor adaptations?

Accepted Answer

No, for small items. In England councils must provide community equipment and minor adaptations costing £1,000 or less free of charge when you have been assessed as needing them, such as grab rails, raised toilet seats or key safes. Larger adaptations like a stairlift or level-access shower are usually funded through a means-tested Disabled Facilities Grant of up to £30,000.

Question 28

What if the council says I am not eligible for care?

Accepted Answer

If the council decides you are not eligible, it must give you its decision and reasons in writing, plus advice on what could help prevent or delay future needs, such as community services or equipment. You can ask for a review, provide extra evidence or make a formal complaint. If your needs increase later, you can ask for a fresh assessment at any time.

Question 29

Does the council have to meet needs that my care plan says are eligible?

Accepted Answer

Yes. Once a council decides you have eligible needs and you are ordinarily resident in its area, it has a legal duty under the Care Act 2014 to meet those needs, subject to the financial assessment. It cannot refuse because of a waiting list or budget pressures, although it may choose the cheaper of suitable options. Unmet eligible needs are grounds for a complaint.

Question 30

Is there a waiting list for council care in England?

Accepted Answer

Many councils in England have waiting lists for assessments, reviews and the start of care packages, and the length varies a lot by area. The Care Act 2014 does not set a maximum wait, but councils must act within a reasonable time and must prioritise urgent risk. If you are waiting and your situation worsens, tell the council immediately and ask for interim support.

Question 31

Does a care needs assessment apply to people under 65?

Accepted Answer

Yes. The Care Act 2014 needs assessment applies to any adult aged 18 or over in England who appears to need care and support, including working-age adults with learning disabilities, physical disabilities, mental health conditions or long-term illness. Young people approaching 18 can have a transition assessment. The eligibility test is the same at every age; the financial assessment uses age-based allowances.

Question 32

Is care free if it is needed after being detained under the Mental Health Act?

Accepted Answer

Yes. If someone has been detained under certain sections of the Mental Health Act, such as section 3, the after-care services they need under section 117 must be provided free by the council and NHS. This can include a care home placement linked to their mental health needs. Section 117 after-care continues until both bodies formally decide it is no longer needed.

Question 33

Can the council insist I accept a care home instead of care at home?

Accepted Answer

A council cannot force someone with mental capacity to move into a care home. If you can decide for yourself, you can refuse, though the council may offer a care package it considers able to meet your needs safely within your personal budget. If you lack capacity, a best-interests decision is made, and depriving you of liberty requires a legal authorisation such as DoLS.

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