Who is eligible for support?
In deciding if an adult with care and support needs has eligible needs the council must have first completed a needs assessment.
The council will use the information gathered in the needs assessment to decide.
- Do the adult's needs arise from or are related to a physical or mental impairment or illness they have?
- As a result of the adult's needs, is the adult unable to achieve two or more of the outcomes specified in the eligibility criteria regulations?
- As a consequence is there or is there likely to be a significant impact on the adult's wellbeing?
An adult's needs are only eligible for council support if the answer to all three of these questions is "yes".
All council's in England must work to a national criteria for adult care and support needs. The eligibility threshold is set out in the Care and Support (Eligibility Criteria) regulations 2014. The eligibility regulations then sets out a number of specific outcomes to achieve and these are:
- managing and maintaining nutrition (e.g. does the person have access to food and drink, are they able to prepare and eat convenience meals or other food and drink?)
- maintaining personal hygiene (e.g. can the person wash themselves adequately and launder their clothes?)
- managing toilet needs (e.g. can they use their toilet and keep themselves clean?)
- being appropriately clothed (e.g. can the person dress themselves and be correctly dressed for the weather? )
- being able to use their home safely (e.g. can the person move around indoor safely?)
- maintaining a habitable home environment ( e.g. is the home sufficiently clean and maintained in order to be safe and is there access to amenities such as water, gas and electricity?)
- developing and maintaining family other personal relationships ( e.g. is the person able to keep in touch with others?)
- 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 opportunities
- carrying out any caring responsibilities the adult has for a child
Being unable to achieve two or more of these specified outcomes means the adult cannot achieve them without assistance, or they can achieve them without assistance but doing so would cause significant pain, distress or anxiety, or achieving them would endanger their health or safety or others' health and safety, or achieving them would take significantly longer time than normal.
The council will put in writing all decisions about eligible needs, this will include information about how to complain if the person or their representative believes the decision is wrong.