Who qualifies for our support?
Page contents
- Summary
- Social care needs assessment
- Eligibility criteria: what these say in full
- If you are eligible
- If you are not eligible
- Help for people who look after someone
- Eligibility criteria for carers (if you look after someone)
- If you don’t agree with your assessment
- More information
Summary
This factsheet explains how we assess your social care needs, and how we decide if you are eligible for support from Adult Social Care.
April 2024 (FS1)
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Social care needs assessment
Anyone can ask us for information and advice, or an assessment of their social care needs. A social care needs assessment is where we look in detail at your needs, strengths and outcomes, to find out if you are eligible for support from us. When we carry out a needs assessment, we will think about things like:
- your care and support needs (for example, if you need help with getting dressed or getting to work)
- your wellbeing (if you feel lonely or isolated)
- your circumstances (if you live alone or if someone supports you)
- the urgency of your support
After we complete an assessment with you of your needs, we use the government's ‘eligibility criteria’ (which is part of the Care Act), to work out if you qualify for support from Adult Social Care. The aim of the criteria is to work out what your care and support needs are and how they impact your wellbeing.
Using the eligibility criteria ensures that the limited resources are used for the people who most need care and support, and that everyone has equal access to them. We can take into account demand, what is already being provided and available resources.
If you are not eligible for support from Adult Social Care, we will still provide information and advice about your options and other support that could help you.
Eligibility criteria: what these say in full
For people with care and support needs
You will be eligible for support from Adult Social Care if all three of these criteria are met:
- you have care and support needs due to a physical or mental impairment or illness, and
- because of those needs, you cannot achieve two or more of the following outcomes:
- manage and maintain your nutrition
- maintain your personal hygiene
- manage your toilet needs
- dress yourself appropriately
- use your home safely
- maintain a habitable home environment
- develop and maintain relationships with your family
- get and maintain work, training, education or volunteering
- make use of important facilities or services in the local community, including public transport and recreational facilities
- carry out any caring responsibilities for a child, and
3. being unable to achieve two or more of the above has (or is likely to have) a significant impact on your wellbeing, which includes:
- personal dignity
- physical and mental health
- physical, mental and emotional wellbeing
- being protected from abuse and neglect
- having control over your day-to-day life
- participating in work, training and recreation
- your social and economic wellbeing
- your domestic, family and personal relationships
- suitable living accommodation
- your individual contribution to society
If you are eligible
After your assessment, if we agree that you have eligible needs, you will be offered support to find ways to meet them. For more information on planning your support, see our factsheet Assessment, support planning and review.
When looking at options for meeting your needs, we will look with you at support you already receive from a partner, family member or friend. This could be to support you to go out in your community or to cook meals.
We’ll also complete a financial assessment with you, to tell you what you will need to pay. Most people pay some or all of the costs of their care. For more information, see our leaflet: What you will need to pay towards the cost of your care and support.
If you are not eligible
If your assessment shows that you are not eligible for help from us, we’ll write to you to explain why and give you other options.
Support might be available in your local community, and this may help prevent or delay development of your needs in the future. We’ll tailor information to your individual situation. You can contact us again at any time to discuss your needs and an assessment if you feel things have changed.
Get more information on community support and services in East Sussex from:
- Health and Social Care Connect, call 0345 60 80 191
- East Sussex 1Space, our online directory of care, support and wellbeing services
- East Sussex Community Information Service (ESCIS) for information on community clubs, societies and events
Help for people who look after someone
If you look after someone, you may be a carer and may be eligible for support. The Care Act also sets national ‘eligibility criteria’ for carers. You can ask us for a carer’s assessment. Even if the person you are caring for does not meet the eligibility criteria, or does not want an assessment, you may still be entitled to an assessment and support in your caring role.
Young carers
If you’re under 18 and helping someone in your family who cannot look after themselves, because they are ill, have a physical or mental impairment, or are dependent on alcohol or drugs, you might be a young carer.
If you want to have an assessment, we will consider the needs of everyone in your family. We will work with Children’s Services to understand your situation and what support you may need. We will also look at what help the person you look after may need.
More information and support for carers is in our leaflet: Do you look after someone?.
Eligibility criteria for carers (if you look after someone)
You will be eligible for support if you meet the following three criteria as a result of providing necessary care for an adult:
-
your physical or mental health is at risk of deteriorating and
-
you are unable to achieve one or more of the following outcomes:
- carrying out any caring responsibilities you have for a child
- providing care to other people that you are responsible for
- maintaining a habitable home environment
- managing and maintaining nutrition
- developing and maintaining family or other personal relationships
- engaging in work, training, education or volunteering
- making use of necessary facilities or services in the local community
- engaging in recreational activities and
3. as a consequence there is (or is likely to be) a significant impact on your wellbeing
A note on what ‘necessary’ care is
To get support from us, you must be providing ‘necessary’ care to someone. If you are providing care and support which the person you look after can do themselves, it may not be considered ‘necessary’. In these cases, we will give information and advice to you (and the person you look after, if appropriate) on how they can use their own resources or community support to meet their needs. This helps delay the need for care and support services for you and the person you look after.
If you don’t agree with your assessment
If you don’t agree with your assessment, talk to your adult social care worker and explain why you think they should reconsider it. You can do this in writing, or by talking to them, providing supporting information where you can. This is called an appeal.
Your social care worker will consider your appeal and will work with you to reach an agreement you are happy with. If their decision does not change and you still don’t agree, your appeal will be referred to their manager for consideration. They will let you know the outcome.
If they stay with the original decision, and you don’t agree, you can make a complaint. You will be given information about how to do this. If you feel you may need someone to help you speak up, you can ask your social care worker about how to get in touch with an independent advocate.
More information
See further leaflets and factsheets
Contact us to get copies of this factsheet, or any of the other leaflets or factsheets mentioned.
Email: Health and Social Care Connect
Phone: 0345 60 80 191
Minicom : 18001 0345 60 80 191
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