Assessments – Asking for Help

Types of Assessment

Assessing needs, yourself

Keeping a diary even if it just for a couple of weeks can help both in completing application forms for a disability benefit and in preparing for a care needs and/or a carers assessment.

When it is part of your daily routine and particularly when your ‘loved one’ has good and bad days, it can be easy to forget to mention important care needs, and to underestimate the time tasks take.  Recording things day by day can help you present a complete picture for an assessment and it is also an opportunity to record thoughts and feelings too, which is important.

Some people may decide or be required to pay privately for their care support. Once you can be specific about the level of support and the times of day it is required, it will be easier to identify the care option which will best meet that need.

Keeping a care diary;

  • Be specific about the help that is needed and the time/days of the week it is required.
  • Make a note of the help required during the day and night, commenting on how long activities take and challenges including any anxieties.
  • Record and comment on physical needs, emotional needs and social needs.
  • Record activities that are enjoyable and work well, not just the difficulties.
  • Include comments on things that you would like to do in the future.
  • Note any times you missed out on a social event or hobby or cancelled an appointment due to care needs.
  • Note down how you are feeling as the carer; physically, emotionally and socially. State how your own health and wellbeing are impacted by the caring role.
  • Note how the caring role impacts on others people who are close to you too.

Local authority assessments

Assessments of adults with care needs and their adult carers are governed by the regulations in the Care Act 2014. They are completed by a social worker and/or a trusted assessor working with the local authority social services.  The first point of contact for adult social services in Southend is the Access team 01702 215008.

  • Care Needs Assessment – assesses the needs of an adult over 18 years old who is ill, disabled or elderly. It can identify the support required to protect health and wellbeing.
  • Carer’s Assessment for carer’s over 18 years old who are looking after another adult over 18 years old who is disabled, ill or elderly. It identifies the impact caring has on the carers own health and wellbeing and considers the support you need to continue in the caring role.
  • Combined Assessment – the care needs and carers assessments are carried out at the same time. Both the cared for and carer should still be given the opportunity to speak privately to the social worker completing the assessment.
  • Joint Assessment – more than one service or organisation is involved in the assessment. The aim is to prevent a person having several assessments taking place one after another. A care needs assessment for example may be carried out at the same time as an occupational therapy assessment or together with an assessment by the housing team.
  • Child Needs Assessment (CNA) in transition Care Act 2014 an assessment for children who are in receipt of care and support and are approaching 18 years old. More details are in the section on Caring for Children with Disabilities.
  • Child Carer’s Assessment (CAA) in transition Care Act 2014 assessment for adult carers of disabled children who are approaching 18. More details are in the section on Caring for Children with Disabilities.

Assessments for Children

  • Assessments for Children with Disabilities and their Carers are completed by the Children with Disabilities team governed by regulations in the Children’s Act 1989 and the Children and Families Act 2014. More details are in the section on Caring for Children with Disabilities.
  • Assessments for Young Carers are referred to the Early Help, Family Support and Youth Offending Service. The regulations are the Children’s Act 1989 and the Children and Families Act 2014. More details are in the Young Carers and Young Adult Carers section of this guide.

Carer’s Assessment

carer’s assessment is for carers over 18 years’ old who are looking after another adult over 18 who has a mental or physical disability or illness, an addiction or is elderly. The regulations for a carer’s assessment are in the Care Act 2014. It identifies the impact caring has on the carer’s health and wellbeing.

Carers in Southend are referred to register with the Southend Carers Hub, which offers a wide range of support services free of charge.  Any eligible support needs which cannot be met by the Southend Carers Hub are referred to Southend Borough Council Adult Social Care.  All Combined and Joint Assessments are completed by adult social care.

The assessment should be proportionate and appropriate; an assessment does not always require a face to face meeting; sometimes a person can assess their own needs or an assessment can be completed over the phone.

The assessment will consider if you have eligible needs and the support required to alleviate or prevent a negative impact on your own health and wellbeing.

The carer is eligible for support if the following statements are true;

  • Your needs arise because you are providing necessary care
  • Your caring role has an effect on you.
  • There is currently, or there is likely to be, a significant impact on your wellbeing.

If there are eligible needs further aspects considered are;

  • Whether you are willing and able to continue in the caring role
  • Any aspects of the caring role which are, or at risk of, causing physical, mental or emotional stress.
  • Any additional responsibilities you have alongside your caring role including home, family, personal relationships, employment, education, training and volunteering.
  • Whether you are able to look after your own needs adequately including your home environment, nutrition and your own health concerns
  • Your needs regarding social, leisure, cultural and spiritual activities
  • What you hope to achieve and your future aspirations

Advice and information will be given to all carers who ask for a carer’s assessment.

A support plan describes the action and services which will be put in place to meet eligible needs.

Support may come from services or grants from a community organisation for example if there is a need to relieve stress a yoga or meditation class may be offered, or free counselling sessions.

Help to break isolation and socialise may be supported by offering alternative care for your loved one. Support to help you into paid work or training may be provision of regular respite (alternative care for your loved one) and/or a carers personal budget to access a college or online course.

A carer’s assessment does not involve a financial assessment however services provided to the person you care for will involve a financial assessment of their income and savings.

For example if the carers support plan includes providing a regular weekly break from their caring role or a one-off longer break for a family holiday, the person you care for may be required to contribute towards the cost of alternative care whether that is homecare, day centre or temporary stay in a care home.

Carers Personal Budget also called Carers Direct Payment

The support plan may include a ‘one-off’ payment to the carer called a carers budget or direct payment. It is awarded to pay for a service or item identified as being necessary to support you in your caring role e.g. transport, driving lessons, mobile phone, white goods such as a washing machine.  More details are in the section on Benefits and Grants.

Care Needs Assessment

Often it can be necessary and helpful to have support from a professional care provider.  Being specific about the care needs will help in the selection of the right type of professional help.

The Care Act 2014 states that anyone who appears to have a need for care or support can have a needs assessment, regardless of the ‘level’ of those needs or the person’s financial resources.

A Care Needs Assessment is completed by adult social care team. As a carer you are entitled to be involved in the assessment if the person you look after wishes.

The assessment should also be proportionate and appropriate; it does not always require a face to face meeting; sometimes a person can, assess their own needs or an assessment can be completed over the phone.

The areas considered during the care needs assessment are;

  1. Whether a person requires support, due to a physical or mental condition.
  2. Whether, due to support and care needs, a person is unable to achieve two or more of the following;
    • eat properly and maintain proper nutrition
    • maintain personal hygiene
    • manage toilet needs
    • dress appropriately
    • able to use and move about the home safely
    • maintain their home in a fit and proper state
    • maintain and develop relationships with family and friends
    • take part in any work, education, training or volunteering they may wish to
    • be able to participate in social activities, hobbies and make use of public transport and local services
    • look after any children they have responsibilities for
  1. The impact on the person’s wellbeing; for example their personal dignity, their ability to take part in social activities and relationships with others, their personal safety and their protection from neglect or abuse.

After the Assessment

If the person you care for does not have eligible needs then specific advice and information should be given to reduce their needs and prevent or delay the care needs increasing.

If the person has eligible needs, a support plan will be produced. The care and support plan must include:

    • details of the needs identified in the assessment
    • which needs meet the eligibility criteria
    • which needs the local council is going to meet, and how
    • the outcomes that the person you care for wants to achieve
    • the personal budget available (the amount of money that the local council has worked out it will cost to arrange the necessary care and support for them)
    • information about direct payments
    • information and advice on what can be done to reduce their needs, and to prevent or delay the development of needs in the future

Any needs to be met within the community; for example by a charity or volunteer organisation, must be realistic.  There should be a check that the service has the current capacity to give the support required.

Moving and Continuity of Care

If the person receiving care moves areas from one local authority to another, regulations in the Care Act 2014 Sections 37-38 describe how the move should be managed to make sure there is no gap in the care and support provided.

The person receiving care or their carer should;

  • Let both local authorities know in advance of the date you will be moving.
  • Request a care needs assessment from the local authority in the area they are moving to.

The local authorities need to cooperate to make sure the procedures work smoothly;

  • The local authority you are moving to should provide you with any information you need and they will carry out an assessment.
  • The two local authorities should share all information necessary to prevent a gap in provision.
  • The local authority you are leaving must make the arrangements needed for the day of your move.
  • If the local authority you move to does not put their own care and support plan in place before the move they must continue to provide the care stated on the support plan you currently have.
  • If the local authority you move to makes a different decision about your eligible needs they must explain their decision.

NHS Continuing Healthcare

NHS Continuing Healthcare Assessment is for adults, when the primary care needs are ‘health needs’.  This assessment will determine whether the NHS will have responsibility for providing and funding the care.

Most people with long term care needs will not be eligible for full NHS Continuing Healthcare; it depends on your assessed needs, and not on any particular diagnosis or condition.

There is an initial checklist and where appropriate the full Continuing Healthcare Assessment is completed.   The NHS Continuing Healthcare Assessment may be carried out as part of the hospital discharge process. In the community, your GP or social worker can advise and organise for the assessment to be carried out. 

The checklist and further information can be downloaded from the government website;

NHS Continuing Healthcare Checklist

If you are not eligible for NHS Continuing Healthcare and you need care from a registered nurse in a nursing home you might receive NHS funded nursing care.  This is a non-means tested contribution towards your nursing costs and is paid directly to the nursing home.

Government Information Leaflet – NHS Continuing Healthcare and NHS funded Nursing Care

Case study

Janet had a Carers Assessment the following needs were identified; the need for a physical rest from the caring role, support to prevent isolation and support to manage stress and low mood.

Southend Carer Hub provided the following support free of charge;

  • Advice and information for herself and for a review of her son’s care package.
  • Carers Peer Support groups gave an opportunity to meet other carers and make new friends.
  • Waves group –a small stress management group for carers.
  • One to one counselling.
  • Referral for a carer’s holiday. Janet went to the Isle of Wight, the self catering accommodation was provided free of charge from Carefree https://carefreespace.org/  Care for her son was provided by other members of the family. 
  • A social worker reviewed her son’s care package and the level of support increased.