An assessment is the process where an expert works with you to review how you want to live your life and identify any care and support services which could enable that. The assessment will look at your health and ability, and your current living and support arrangements. You should be fully involved in your assessment and able to state your preferences and choices. Your carer, relatives and other professionals such as a sheltered housing warden or GP may, with your agreement, also be involved.

The type of assessment you receive will depend on your needs. For example, if you only need meals on wheels you may be assessed for this in a simple interview or over the telephone. If you have more complex needs; for example, if you require several different types of support, you may need a longer, more complex assessment.

It is important that all your needs are considered whatever type of assessment you have.  If your assessment is conducted by social services and you do not feel that your assessment was adequate, you can ask for a reassessment or make a complaint.

Charging for services

Social services or care/support providers can charge for care services that you receive as a result of the assessment. But other people, such as your partner or somebody you live with, can’t be charged for services that you receive.

Local authorities have some discretion over how they charge for support at home, but must take account of guidance issued by government. The guidance says that charges for home care services must be reasonable.

If you have difficulty paying the charge, you can ask the local authority to reduce it. The local authority cannot withdraw services if you refuse to pay the charges, but action can be taken to collect any money that you owe.

The care plan

After an assessment, a care plan will be produced. This should outline your needs and the type of support that will be provided. It should specify who will provide the support. In some areas social services and the health authority may be working closely together.  This may mean that your both sets of needs are recorded on your care plan. Government guidance states that you should normally be given a copy of your care plan.  If you are not given a copy you can ask for one.

Remember that some authorities operate direct payment schemes that calculate how much your care arrangements will cost, but then give you more direct control over how they are actually spent. Make sure to ask your local authority about direct payments if you are interested in this option.

Refused an assessment?

If you are refused an assessment by a local authority (social services) this may be because they do not think you are in need of any services. This may be because the person you spoke to did not ask you appropriate questions and was not fully aware of your needs. If this happens, you should write a letter that explains your circumstances in more detail. It may help to get your carer or GP to send in more information or an advice agency may write on your behalf. It may be helpful to obtain a copy of the social services criteria for assessment.

If you are still unhappy, you could consider making a complaint.

What happens at an assessment

Most types of assessment will be carried out in your own home. In some cases, your assessment may be carried out in hospital, in a GP's surgery, a residential/nursing care providers premises or in the social services office. You can have someone with you during the assessment if you wish, such as a relative or an advocate. This may be particularly important if you have communication problems or have difficulty expressing yourself. It may help to have written a list of things you want to talk about or notes about the difficulties you face. The person carrying out the assessment will ask you a number of questions about your needs and ask you about your wishes. If a partner or a friend is caring for you, they should also be involved in the assessment. Both of you should have the opportunity to discuss any worries you may have.

If you have a carer he or she can also ask for their own assessment under the Carers’ Act. Remember that the assessment is a chance for you to have your say. It is important to explain how you feel so that your views are included in your care plan. For example, if you want to move into a residential or nursing home or you want to live in a different part of the country, it is important to explain this during the assessment.

If your needs are complex you may need more than one visit.  The assessors may also contact other people involved in your care such as a care or support worker, district nurse, GP or medical specialist. This is called a multi-disciplinary assessment.

Getting an assessment

If you feel you need some extra help you should contact your local social services department or care/support providers and request an assessment of your needs. Other people – for example, a relative, carer or friend – can contact them and request an assessment on your behalf.

You can also ask someone else to organise an assessment for you such as your GP, district nurse, a voluntary worker or advice worker.

Social services departments have to assess anyone who appears to be in need of a community care service. The social services department cannot refuse to assess you because you have too much income or capital.

When you contact the assessor you may be asked some basic questions such as your age, the state of your health and the difficulties you are having. If it is the local authority and they think you may be in need of a service they must give you a care assessment. The local authority does not have to assess someone who says they have no difficulties in their day-to-day life.

Social service departments will publish criteria as to who will be entitled to an assessment. Their criteria will give examples of different needs and the level of assessment they may carry out.

Social services cannot refuse to assess you for financial reasons.  For example, they cannot refuse to assess you because you have told them you have savings or a high income. They should not ask you about your finances before they have carried out a full assessment of your needs.

Challenging decisions

If you are not happy with your assessment, have been refused an assessment, have experienced delays, or are concerned about the quality of services you receive via social services, you can complain using the local authority complaints procedure.

Receiving services

Social services must provide the services that have been agreed upon in your care plan. Social services cannot withdraw services you are getting without carrying out a reassessment of your needs.

Some of the services you receive as a result of your assessment may be provided by a private or voluntary agency employed by the local authority.

Carers

 
Local authorities are required by law to look at the needs of carers. If you have a carer they should request an assessment. A carer’s assessment will usually be carried out at the same time as your own assessment. A carer's assessment may result in extra services for you or in services for your carer. If the services are for your carer they may have to pay for them.

Reviews

 
If your needs change or you do not feel that your first assessment took all your needs into account, you can ask for a review. You should contact the person who carried out the first assessment to ask for a review. If they will not review your assessment you can request a new assessment or make a complaint.

Social services may arrange to hold regular reviews of your situation and they should inform you of these reviews so that you can be involved.

How to find out about services

Your local authority has to produce information about services that are available in your area. This information should include leaflets and more detailed documents called Community Care Plans or Long Term Care Charters. This information should also be available from your local social services department, or from other information points such as the council’s information desk, your local library or, of course Bettercaring.

Community care services

Many older people need some help to stay independent at home.  The social services department at your local authority (social work departments in Scotland or health and social services boards in Northern Ireland) are responsible for arranging services for people who are old and in need, or who have disabilities. These services are called community care services. Services may be provided directly by the social services department or arranged through other organisations, e.g. private agencies or local voluntary groups. Housing departments and health authorities may also provide services connected to community care.

Refusing services and other problems

Government guidance advises social services that they must meet your assessed needs, but they may consider their budget when deciding how to meet your needs. This means that they may offer you the cheapest option. For example, if you need 24-hour care, the local authority may decide your needs can be met most economically in a residential care home rather than by arranging services in your own home. If you do not want to go into a care home, the local authority cannot usually force you.

But if you stay in your own home you may not receive enough help for you to live comfortably and safely. You may be able to get a review of your assessment and you can argue that you need to remain in you own home. If the local authority will not increase the level of your support at home you may have to sign an agreement to acknowledge that some of your needs are not being met. The local authority should not refuse to provide you with any services at all, but you may have to negotiate with social services and agree that unpaid carers will meet some of your needs or that additional private support will be paid for by you.

You may be offered services that you do not want; for example, you may not want to go to a day centre or have support staff visiting you at home. Discuss your problem with the person at social services who manages your care and try to get your needs reassessed and the services changed. You can refuse services, and social services cannot normally force you to receive help.

Delays in assessments

If you have a very urgent need, perhaps you are about to be discharged from hospital or your existing care arrangement has broken down, an emergency assessment can be arranged.  Alternatively, emergency services can be arranged until a full assessment is carried out.

There is no time limit for how quickly an assessment should be carried out and how long your wait will depend on the urgency of your situation. Many local authorities will have set their own targets for time limits. These should be included in the local authority’s customer charter or long-term care charter that is available from the social services department. If the local authority fails to meet its own targets you can complain.