This resource supports care practitioners and answers their questions about assessment and determination of eligibility under the Care Act. It also provides practical guidance over what they should do when applying the letter and spirit of this law.
For brevity and simplicity, throughout this resource the term ‘assessment under the Care Act’ is used to refer to either a Care Act assessment of:
Do the needs arise from a physical or mental impairment or illness?
Do these needs mean that the adult is unable to achieve two or more of the listed outcomes?
Is there consequently a significant impact on the adult’s wellbeing?
Does the adult have access to food and drink to maintain nutrition and are they able to prepare and consume the food and drink?
If the adult is eating a restricted or unhealthy diet (e.g. only eats toast):
Is the adult able to wash themselves and launder their clothes?
If the adult cannot buy cleaning products, or cognitively understand how to operate a washing machine, their clothes and linen may not be properly clean.
Is the adult able to access and use the toilet and manage their own toilet needs?
If the toilet is no longer accessible due to mobility problems or if the adult takes too long to get to the toilet, they may not be managing their toilet needs.
If the adult is unable to maintain their night-time continence, they may not be managing their toilet needs in a way that promotes their dignity.
Is the adult able to dress themselves and be appropriately dressed, for example, in relation to the weather or the activities they are undertaking, which could include work/volunteering?
The adult may be able to dress themselves in casual clothes unaided but may not be able to dress themselves in more formal work clothes e.g. put on a tie, zip up a dress or clean their shoes, and so would not be appropriately dressed for their circumstances.
If they are severely visually impaired, for example, they may be able to dress themselves but not know if clothes are appropriate or clean.
Note: This may also affect another outcome in relation to accessing work or volunteering.
Is the adult able to move around the home safely, including climbing steps, using kitchen facilities and accessing the bathroom/toilet?
This also includes their immediate environment e.g. steps to the home.
If the adult cannot reach certain rooms, they may not be using the home safely or may be unreasonably confined e.g. having to spend all day in bed.
If the adult cannot get in or out of the front door (e.g. because they cannot manage the steps), they are unlikely to be using the home safely or have proper access to it.
If the adult is unable to use home appliances properly and safely (e.g. cooker, heater), they may not be meeting this outcome.
Is the adult’s home sufficiently clean and maintained to be safe, including having essential amenities?
Does the adult require support to sustain the home or maintain amenities such as water, electricity and gas or pay their rent or mortgage?
If the adult is unable to pay their rent or utility bills (e.g. due to mental or physical incapacity), they will not be able to sustain their home.
It may not be a habitable home environment if:
Is the adult lonely or isolated?
Do their needs prevent them from maintaining or developing relationships with family and friends?
The adult’s physical or psychological state may prevent them from making or maintaining relationships e.g. mental ill-health, autism.
If the adult is unable to communicate easily and regularly – e.g. they may not have, or be able to use, a phone or computer, they may be unable to leave their home safely, they may be unable to communicate successfully or interact with others – this may prevent them from maintaining or developing relationships with family, friends and others.
Does the adult have the opportunity and/or wish to apply themselves and contribute to society through work, training, education or volunteering?
This includes physical access to any facility and support with participation in the relevant activity.
If the adult is unable to leave their home safely, or communicate successfully, or interact with others, they may not be able to access work, training, education or volunteering.
If the adult is unable to access information about opportunities available to them, they are unlikely to be able to engage in activities.
Is the adult able to get around in the community safely and able to use facilities such as public transport, shops and recreational facilities?
This includes the need for support when attending health care appointments.
If the adult is unable to walk, or to use public transport unattended or to organise alternative transport (e.g. someone giving them a lift), or does not have money for a taxi, they may not be able to access services locally.
As well as formal appointments e.g. health care appointments, this could include informal appointments e.g. being able to go to the library or to meet a friend in a cafe or pub.
Does the adult have any parenting or other caring responsibilities e.g. as a parent, step-parent or grandparent?
If the individual is not able to take care of others, or feels overwhelmed because of their condition, they may not be able to carry out their caring responsibilities for a child.
Do the needs arise because the carer is providing necessary care and support?
Is the carer’s physical or mental health affected or at risk of deteriorating, or is the carer unable to achieve any of the listed outcomes?
Is there consequently a significant impact on the carer’s wellbeing?
Does the carer have any parenting responsibilities for a child in addition to their caring role for the adult, e.g. as a parent, step-parent or grandparent?
If the carer role takes most or all of their time or energy, the carer may not be able to carry out caring responsibilities for a child e.g. responsibilities as a grandparent caring for a child while their parent goes to work.
Does the carer have any caring responsibilities to other adults, e.g. for a parent, as well as the adult with care and support needs?
If the carer role takes most or all of their time or energy, the carer may not be able to carry out caring responsibilities for other people in their lives.
If the carer and the adult with care and support needs share a home, and the adult’s condition means that they have high expectations about the home maintenance that the carer ‘struggles’ to meet, the carer may be not meeting this outcome.
Does the carer have time to do essential shopping and to prepare meals for themselves and their family?
If the carer lacks the time or opportunity to shop for or cook appropriate meals, they and their family may eat a restricted or unhealthy diet.
If the carer is not eating or avoiding eating certain foods to maintain a health condition, they may not be maintaining nutrition for themselves.
Does the carer’s role prevent them from maintaining or developing relationships with family and friends?
If the carer has no time or energy left after fulfilling their caring role, e.g. when looking after an adult child with care and support needs, they may not be able to maintain existing or develop other relationships.
Is the carer able to continue in their job, contribute to society, apply themselves in education and volunteer to support civil society or have the opportunity to get a job, if they are not in employment?
Does the carer have opportunities to make use of local community services and facilities e.g. library, cinema, gym or swimming pool?
Does the carer have leisure time, e.g. some free time to read or engage in a hobby?
If the carer has no free time for themselves – or no energy left when they do have some free time – they may not be able to engage in activities to maintain their own interests or hobbies e.g. walking or other forms of exercise, being a member of a club or choir, or taking part in pastimes at home such as knitting or reading a favourite book or magazine.