Important concepts for assessment and determination of eligibility

Referrals are received by a local authority for several reasons, such as to inform the local authority of a concern about somebody in relation to their social needs, to notify of a safeguarding concern, or to request an assessment of needs for care and support, or support for an unpaid carer.

When considering a referral:

• What? It informs the local authority about a concern in relation to an individual or that an individual may need support.
• Who? A referral can be raised by anybody.
• How? A referral can be made in any way.

Each organisation has its own standard template to follow when making a referral.

The form should enable the person making the referral to describe as much as possible including, if known:

1. The individual’s presenting needs and their current circumstances
2. The individual’s personal outcomes (what does ‘good’ look like for them?)
3. Any additional information which will support the local authority in understanding necessary next steps (for example is this an emergency, is there a high level of risk, are other professionals involved which could indicate complexity etc)

The information in the referral should describe the individual’s presenting needs. During the screening, these presenting needs will be explored and, if an assessment takes place, assessed needs will be identified.

Following the assessment, when determining eligibility, it will be identified if the assessed needs are eligible. If there are eligible needs the next step will be the support plan which will identify, products, services and activities appropriate to meet the eligible needs.

If there is any information about outcomes in the referral, these will reflect the individuals’ personal and/or desired outcomes.

An assessment under the Care Act is a crucial intervention that starts when we commence gathering information about the individual. Therefore, the screening of the referral is an important part of the assessment from a legal point of view.

• What? An assessment identifies the individual’s existing needs for care and support, regardless of eligibility, from the points of view of all those involved in the assessment process (assessor, individual, professionals, carer etc.)
• Who? An assessment should be carried out by an appropriately trained assessor
• How? An assessment can be done using different methods/means [UPDATED URL to be put in when page created]

Each local authority will have its own standard template for the recording of information gathered during the assessment.

The form should enable the assessor to describe:

1. The individual’s assessed needs and their current circumstances, from the points of view of all those involved in the assessment process (i.e. assessor, individual, professionals, carer, etc.)
2. The individual’s personal outcomes (what does good look like for them?) around the nine wellbeing areas.
3. The impact that the assessed needs have on their personal outcomes (linking points 1 and 2).

During the screening (which is part of the assessment under the law), presenting needs will be explored to determine if there is an appearance of need for care and support.

If it is identified that there is appearance of needs for care and support, an assessment should be carried out, otherwise, the screening is the perfect opportunity to consider the duties of provision of information and advice, and prevention.

The assessment should then explore the presenting needs, to provide a full and accurate picture of the individual’s assessed needs from the points of view of all those involved in the assessment process (assessor, individual, professionals, carer, etc.).

If there is any information about outcomes gathered during the screening process, these will reflect the individual’s personal outcomes.

During the assessment process, the individual’s desired or personal outcomes around the nine areas of wellbeing should be clearly identified.

Determination of eligibility is an intervention undertaken upon completion of the assessment to establish if the assessed needs meet the national eligibility threshold.

• What? A determination of eligibility identifies which of the assessed needs are eligible and which ones are non-eligible.
• Who? It is the LA who must carry out the determination of eligibility.
• How? The determination of eligibility should be in line with the eligibility regulations.

Each local authority may have a different template for the determination of eligibility and it is likely to be same form as the assessment.

The Care Act does not direct that the recording has to be in two separate forms, but clearly defines that the assessment and the eligibility determination are two separate interventions.

The determination of eligibility will look at the needs identified during the assessment – assessed needs – and determine whether they meet the national eligibility threshold.

The outcome of the determination of eligibility will identify which assessed needs are eligible and which ones are not eligible.

There are three conditions that must be met to determine eligibility.

In condition/question 2 within the determination of eligibility: The outcomes will refer to the eligibility outcomes as described in the eligibility regulations, and will indicate the eligibility outcomes which the individual is unable to achieve due to their assessed needs.

In condition/question 3: Personal outcomes should be clear in the assessment form and referred to as appropriate in identifying how being unable to achieve the eligibility outcomes will have, or is likely to have, significant impact on the individual’s wellbeing.

However, while local authorities have a duty to have regards to personal outcomes and impact on wellbeing, it does not have a duty to meet them.