Fair access to care services (FACS): prioritising eligibility for care and support

Key points for practitioners

  1. Under Fair Access to Care Services (FACS), individuals and carers seeking or referred for social care support are entitled to an assessment of their circumstances, needs and risks. This must ensure they can maintain as much control as possible of their lives, of the care and support that they receive, and of the opportunities to engage in training, employment, civil society and voluntary activities.
  2. An individual’s financial situation must not pre-empt or influence the assessment of their social care needs. There are three distinct stages: enabling people to understand their needs and consider options for meeting them; informing them about which are assessed as eligible needs; and conducting a financial assessment.
  3. Offer early identification, proactive support and access to prevention and reablement services to remove, minimise or delay individuals’ and carers’ need for care and support. Early intervention can delay or prevent needs from increasing.
  4. Ensure enough good quality information and advice is available, in a variety of accessible formats and media, to enable people to manage their own support as much as they wish. Information, advice and support tailored to the individual’s specific needs may prevent, minimise or delay the need for publicly funded support or care.
  5. Respect carers as equal partners in care. Carers are entitled to an assessment in their own right in relation to their support needs, and government plans to give them the right to support if they are eligible. Remember there may be ‘hidden carers’ in a family, e.g. young carers or other family members who may have support needs of their own.
  6. When an individual is assessed as lacking capacity to make decisions about aspects of their lives, take steps to ensure they are not filtered out inappropriately, their wishes are represented as fully as possible and appropriate action taken when consent cannot be given. This may be done with the assistance of family, a facilitator or an advocate.
  7. Remember each area/domain listed in the FACS criteria must be given equal weight. Personal care is not for example more important than involvement in family life. Needs in different bands of the eligibility criteria may interact with each other to lift a person’s need for care and support to a higher band.
  8. Make sure that individuals and carers are not filtered out too quickly. People may need time and confidence fully to share all relevant aspects of their situation. Further discussion may reveal eligible needs, or scope to support carers so as to prevent or reduce the individual’s need for formal care and support. To participate fully, individuals with restricted communication may need access to a family member, facilitator, interpreter or advocate.
  9. In the assessment process, think about the person’s whole situation. This can include their health, housing, income, education, training and employment; their family situation, whether there are children or young people, or other family members with care and support needs; and risks to their social inclusion and participation. Subject to everyone’s agreement, whole family assessment can enable individuals, carers and others in their family network to reach good conclusions about care and support. The views of family and significant others are crucial if a person lacks capacity to make their own decisions.
  10. Think beyond adult social care services, and consider a wider range of community options, to promote people’s control over their lives. High quality information, advice, and signposting to third sector and community support, empowers individuals and carers to make the right choices, whether or not they are eligible for publicly funded services.
  11. Develop opportunities for joint assessment with NHS and housing partners. Most people receiving a full assessment of eligibility will have complex health as well as care needs, and many experience multiple physical and mental health conditions. Prioritising eligibility for local authority-funded services often needs to be combined with assessments of health care needs, including for NHS continuing care and NHS-funded nursing care.
  12. Keep up to date with the new structures and systems in health and care. Within Health and Wellbeing Strategies and joint funding arrangements, GPs and community-based nurses will be increasingly involved in the commissioning of health and social care support for their patients, and should be included in planning support for individuals. Use of personal budgets and personal health budgets means that support can frequently be designed and delivered in new, innovative and personalised ways to suit individual preferences and lifestyles.

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