SCOPE OF THIS CHAPTER

All Adults: following assessment of care and support needs.

RELEVANT CHAPTER

Eligibility Framework

This chapter was added in April 2015.

1. Principles

National eligibility criteria set a minimum threshold for adult care and support which local authorities must meet. The eligibility framework provides clarity regarding what level of need is eligible and supports decision making as to whether provision of advice and information, preventative services would delay the development of eligible needs or long term care and support might be needed. The transparency of the criteria should help the person or their carer think more broadly about the support available in their community or through their social networks to meet their needs and support the outcomes they want to achieve.

See also Eligibility Framework

2. Procedure steps

Step Action By Whom
1. On completion of the assessment either by an assessor or as a self-assessment or supported self-assessment the responsible worker must be satisfied that the assessment is an accurate and complete reflection of the person’s needs, outcomes and impact of needs on their wellbeing. Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker
2. To identify whether the person with care and support needs has eligible needs, the responsible worker must consider the completed assessment in the context of the eligibility framework which is in effect a 3 part “test”.
  • Do the person’s needs arise from or are they related to a physical or mental impairment or illness?
  • As a result of their needs is the person unable to achieve two or more of the specified outcomes which are:
    1. Managing and maintaining nutrition;
    2. Maintaining personal hygiene;
    3. Managing toilet needs;
    4. Being appropriately clothed;
    5. Being able to make use of the adult’s home safely;
    6. Maintaining a habitable home environment;
    7. Developing and maintaining family or other personal relationships;
    8. Accessing and engaging in work, training, education or volunteering;
    9. Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services; and
    10. Carrying out any caring responsibilities the adult has for a child.
  • As a consequence of not being able to achieve these outcomes is there (or is there likely to be) a significant impact on the adult’s wellbeing?

The person’s needs are only eligible when all three of these conditions are met.

Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker
3. The eligibility decision should be based on the person’s needs and how these impact on their wellbeing. Any care or support provided by a carer cannot be taken into account until after a decision is made regarding eligible needs when the support plan is being prepared. Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker
4. Once the decision regarding eligibility has been made the worker should provide the person with a copy of the completed assessment documentation which includes a clear record of the decision and outcome of the assessment. Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker