7 tips for planning a Care Needs Assessment

In my previous blog, How To Avoid Negligence Claims – Working With Elderly Clients I outlined ten important questions to ensure practice is sound and person-centred and said that I would explore each one separately. My first considers care needs assessment for older people.

Local authorities must undertake an assessment for any adult with an appearance of need for care and support, regardless of whether or not the local authority thinks they have eligible needs and regardless of their financial situation.

The duty is triggered under Section 9 of The Care Act 2014 for anyone who appears to be in need of support services.

The purpose of an assessment is to identify the person’s needs, how these impact on their well-being and the outcomes that the person wishes to achieve in their everyday life.

Even if the person doesn’t want the Council to support them it is helpful that they have a needs assessment to provide a foundation for care navigation and procurement.

There are two interdependent parts to the assessment and both must be met to qualify for social care funding. These are care and support and financial eligibility

Planning senior care on a whiteboard.
Using a Care Needs Assessment For Planning
  1. The criteria used to assess care and support needs

To be eligible for social care funding a person must be assessed to have a ‘substantial’ or ‘critical’ level of need. As a minimum, they are likely to need support with personal care and daily living on a daily basis.

  1. How financial eligibility is determined

The following rules apply to financial assessments for both residential care and care in the home:

  • People with over £23,250 pounds savings/capital will meet the full cost of their care.
  • People with between £14,250 and £23,250 will make a contribution from their savings/capital as a tariff income of £1 for every £250. A contribution from income will also be assessed.
  • People with savings and capital below £14,250 will not make a contribution from capital but contribution from income will be assessed.

The difference between the assessments is that for residential care, a person’s property is taken into account.

  1. The care assessment

A Care assessment is not always undertaken face-to-face. It is not unusual for an unplanned screening assessment to be carried out directly with an older person over the phone. This can come out of the blue to the older person, especially if they live alone. Older people are proud and often eager to minimise the help they need. Many are hard of hearing. Make sure you ask to be advised if and when a phone assessment will be taking place when making the referral, so you can prepare and support the person.

During the assessment the person should be advised to answer all questions as if it was their ‘worst day’ without any support.

  1. The person must have capacity to make decisions during the assessment

If an individual requiring assessment lacks capacity and there is no registered LPA in place, the Care Act imposes a responsibility to refer the matter to the Court of Protection who can appoint a professional Deputy.

  1. The person has to be offered support to participate if necessary

New rules under the Care Act 2014 allow the person to take the lead in explaining what support they need to make life easier for them.

There is also a duty to provide independent advocacy to represent and support the person, if needed, to facilitate their involvement in assessments.

  1. Unpaid carer’s needs and their need for support are entitled to be assessed

There is a duty for carers to receive an assessment regardless of their needs for support or their financial resources. Also to provide independent advocacy to represent and support them if necessary.

  1. Obtain a written copy of the assessment

The assessment and any other relevant information will be recorded and authorised. Make sure the person obtains a copy as they or their representative have the right to challenge or dispute anything they don’t agree with.

Here are some helpful links

The Care Act 2014 – Assessment and Eligibility

How to get help with social care for adults in West Sussex

Apply for adult care assessment in East Sussex

Apply for adult care assessment in Surrey

My next post will consider Health Assessments

Finding a Care Home For Barbara

We are often asked which the ‘good care homes are?’ in a specific geographical area. We cannot answer this as everyone has unique needs, preferences and expectations. Finding the right care home for someone takes time, expertise and the ability to see things from the person’s perspective.

Relative Matters were asked to assist with a Bob who had become concerned about his Mother, Barbara who had returned home after a hospital stay and it had become evident very quickly that she was not coping. Bob had found a care home willing to take her at short notice, however, soon after she had moved in, Barbara was demanding to go home, her behaviour had become challenging and the home were not coping with her. During this time, Barbara was being assessed for a diagnosis of dementia and the Deprivation of Liberty (DOLs) team had been asked to be involved as the home were concerned that they were holding Barbara against her will.

We responded swiftly and assessed the situation from Barbara’s perspective and it was evident there were some memory and capacity issues. A full holistic assessment of her objective needs, her perceived needs, and her home environment were completed and through this process, it became apparent that she lacked capacity to make an informed decision to return home and was not actually concerned about going home. Barbara simply did not want to be in the home where she was.

Care home being enjoyed by two happy residents
Care home being enjoyed by two happy residents

After liaising with Bob, the DOLs team and the care home, it was agreed that it would be in Barbara’s best interests to move her to a care home that could meet her needs, and through meeting her needs, promote better behaviour patterns that could be managed in a more person centred way. A carefully drawn up profile was developed with Barbara of what she wanted from her next move. Once research had identified a specialist care home that could meet Barbara’s needs and preferences, she was escorted for a visit, so that she was fully involved in the process and then supported with the actual moving process.

The move was a complete success. We had ensured that the new care home was understanding of the behavioural aspects of Barbara’s dementia and were willing to work with her so that her needs could be met in a cohesive environment where she did not feel institutionalised, activities were interesting and she felt valued.

Finding a care home is easy if you use a ‘one size fits all approach’ but just like you and I will inevitably have different needs, preferences and expectations about where we live, older people are no different.

This post has drawn on work undertaken by Liz Tremlett. Liz works as one of Relative Matter’s Occupational Therapy (OT) Consultants. OT’s work with people to identify the difficulties they are experiencing in every day life and to work with the person to find ways to overcome these, in order to promote health and wellbeing.