Eligibility criteria under the Care Act 2014

Adults with care and support needs

When determining eligibility, local authorities must consider the following three conditions.

Condition 1

The adult’s needs for care and support arise from or are related to a physical or mental impairment or illness and are not caused by other circumstantial factors.

This includes if the adult has a condition as a result of physical, mental, sensory, learning or cognitive disabilities or illnesses, substance misuse or brain injury.

Condition 2

As a result of the adult’s needs, the adult is unable to achieve two or more of the outcomes specified in the regulations and outlined in the section ‘Eligibility outcomes for adults with care and support needs’.

Local authorities must also be aware that ‘being unable’ to achieve an outcome includes any circumstances where the adult is:

  • unable to achieve the outcome without assistance. This includes where an adult would be unable to do so even when assistance is provided. It also includes where the adult may need prompting. For example, some adults may be physically able to wash but need reminding of the importance of personal hygiene.
  • able to achieve the outcome without assistance but doing so causes the adult significant pain, distress or anxiety. For example, an older individual with severe arthritis may be able to prepare a meal, but doing so will leave them in severe pain and unable to eat the meal.
  • able to achieve the outcome without assistance, but doing so endangers or is likely to endanger the health or safety of the adult, or of others. This would include, for example, situations where the health or safety of another member of the family, including a child, could be endangered when an adult attempts to complete a task or an activity without relevant support;
  • able to achieve the outcome without assistance but takes significantly longer than would normally be expected. For example, a physically disabled adult is able to dress themselves in the morning, but it takes them a long time to do this, leaves them exhausted and prevents them from achieving other outcomes.

Local authorities must consider the whole range of outcomes contained in the criteria when making the eligibility determination.

There is no hierarchy to the eligibility outcomes – all are equally important.

Condition 3

As a consequence of being unable to achieve these outcomes, there is, or there is likely to be, a significant impact on the adult’s wellbeing.

Local authorities should determine whether:

  • the adult’s needs impact on at least one of the areas of wellbeing in a significant way or
  • the cumulative effect of the impact on a number of the areas of wellbeing means that they have a significant impact on the adult’s overall wellbeing.

Carers with support needs

Carers can be eligible for support in their own right. The threshold is based on the impact their caring role has on their wellbeing.

When determining carer eligibility, local authorities must consider the following three conditions.

Condition 1

The carer's needs for support arise because they are providing necessary care to an adult.

Carers can be eligible for support whether or not the adult for whom they care has eligible needs.

The carer must also be providing 'necessary' care (i.e. activities that the individual requiring support should be able to carry out as part of normal daily life but is unable to do so). If the carer is providing care and support for needs that the adult is capable of meeting themselves, the carer may not be providing 'necessary' care and support. However, necessary care includes care provided to support needs that are not eligible.

Condition 2

As a result of their caring responsibilities, the carer's physical or mental health is either deteriorating or is at risk of doing so or the carer is unable to achieve any of the outcomes as specified in the regulations and as summarised in the section 'Eligibility outcomes for carers with support needs'.

Local authorities must also be aware that 'being unable' to achieve an outcome includes circumstances where the carer:

  • is unable to achieve the outcome without assistance. This includes where the carer would be unable to achieve an outcome even if assistance were provided. For example, a carer might be unable to fulfil their parental responsibilities unless they receive support in their caring role.
  • is able to achieve the outcome without assistance, but doing so causes or is likely to cause significant pain, distress or anxiety. For example, a carer might be able to care for the adult and undertake full-time employment, but if doing both causes the carer significant distress, the carer should not be considered able to engage in employment.
  • is able to achieve the outcome without assistance but doing so is likely to endanger the health or safety of themselves or any adults or children for whom they provide care. For example, a carer might be able to provide care for their family and deliver necessary care for the adult with care and support needs, but, where this endangers the adult – for example, because the adult receiving care would have to be left alone while other responsibilities are met – the carer should not be considered able to meet the outcome of caring for their family.

Local authorities must consider the whole range of outcomes in the eligibility criteria when making the eligibility determination.

There is no hierarchy to the eligibility outcomes – all are equally important.

Condition 3

As a consequence of being unable to achieve these outcomes, there is, or there is likely to be, a significant impact on the carer’s wellbeing.

Local authorities should determine whether:

  • the carer's needs impact on at least one of the areas of wellbeing in a significant way or
  • the cumulative effect of the impact on a number of the areas of wellbeing means that they have a significant impact on the carer’s overall wellbeing.

The term ‘significant’ must be understood to have its everyday meaning, as it is not defined by the Regulations, but see the section ‘What does significant impact mean?’ in this guide for further clarity.

Eligibility determination
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