Eligibility outcomes under the Care Act 2014

Adults with care and support needs

The eligibility decision-making process for adults with care and support needs involves the consideration of the following three criteria:

Eligibility decision making process

  • Managing and maintaining nutrition Open

    What to consider

    Does the adult have access to food and drink to maintain nutrition and are they able to prepare and consume the food and drink?

    Examples of circumstances affecting the ability to achieve the outcome

    If the adult is eating a restricted or unhealthy diet (e.g. only eats toast):

    • they may have difficulty in getting to the shops to buy food
    • they may be able to prepare food but have swallowing problems.
  • Maintaining personal hygiene Open

    What to consider

    Is the adult able to wash themselves and launder their clothes?

    Examples of circumstances affecting the ability to achieve the outcome

    • If the adult cannot reach to wash themselves all over, this is not hygienic.
    • If the adult does not have access to a washing machine and their mobility is poor, clothes and linen may not be properly clean.

    If the adult cannot buy cleaning products, or cognitively understand how to operate a washing machine, their clothes and linen may not be properly clean.

  • Managing toilet needs Open

    What to consider

    Is the adult able to access and use the toilet and manage their own toilet needs?

    Examples of circumstances affecting the ability to achieve the outcome

    If the toilet is no longer accessible due to mobility problems or if the adult takes too long to get to the toilet, they may not be managing their toilet needs.

    If the adult is unable to maintain their night-time continence, they may not be managing their toilet needs in a way that promotes their dignity.

  • Being appropriately clothed Open

    What to consider

    Is the adult able to dress themselves and be appropriately dressed, for example, in relation to the weather or the activities they are undertaking, which could include work/volunteering?

    Examples of circumstances affecting the ability to achieve the outcome

    • If the adult cannot put on or fasten their clothes, they are unlikely to be appropriately dressed.
    • If the adult cannot acquire new clothes when needed, they may not be appropriately dressed e.g. for the change in seasons.

    The adult may be able to dress themselves in casual clothes unaided but may not be able to dress themselves in more formal work clothes e.g. put on a tie, zip up a dress or clean their shoes, and so would not be appropriately dressed for their circumstances.

    If they are severely visually impaired, for example, they may be able to dress themselves but not know if clothes are appropriate or clean.

    Note: This may also affect another outcome in relation to accessing work or volunteering.

  • Being able to make use of the adult's home safely Open

    What to consider

    Is the adult able to move around the home safely, including climbing steps, using kitchen facilities and accessing the bathroom/toilet?

    This also includes their immediate environment e.g. steps to the home.

    Examples of circumstances affecting the ability to achieve the outcome

    If the adult cannot reach certain rooms, they may not be using the home safely or may be unreasonably confined e.g. having to spend all day in bed.

    If the adult cannot get in or out of the front door (e.g. because they cannot manage the steps), they are unlikely to be using the home safely or have proper access to it.

    If the adult is unable to use home appliances properly and safely (e.g. cooker, heater), they may not be meeting this outcome.

  • Maintaining a habitable home environment Open

    What to consider

    Is the adult’s home sufficiently clean and maintained to be safe, including having essential amenities?

    Does the adult require support to sustain the home or maintain amenities such as water, electricity and gas or pay their rent or mortgage?

    Examples of circumstances affecting the ability to achieve the outcome

    If the adult is unable to pay their rent or utility bills (e.g. due to mental or physical incapacity), they will not be able to sustain their home.

    It may not be a habitable home environment if:

    • the home is damp or in very poor repair
    • the adult is unable to clean their kitchen, leading to infestation
    • the adult is hoarding excessively (note: hoarding per se does not determine eligibility; however, the impact of excessive hoarding on the individual’s ability to achieve their outcomes, and thereby on their wellbeing, will affect eligibility).
  • Developing and maintaining family or other personal relationship Open

    What to consider

    Is the adult lonely or isolated?

    Do their needs prevent them from maintaining or developing relationships with family and friends?

    Examples of circumstances affecting the ability to achieve the outcome

    The adult’s physical or psychological state may prevent them from making or maintaining relationships e.g. mental ill-health, autism.

    If the adult is unable to communicate easily and regularly – e.g. they may not have, or be able to use, a phone or computer, they may be unable to leave their home safely, they may be unable to communicate successfully or interact with others – this may prevent them from maintaining or developing relationships with family, friends and others.

  • Accessing and engaging in work, training, education or volunteering Open

    What to consider

    Does the adult have the opportunity and/or wish to apply themselves and contribute to society through work, training, education or volunteering?

    This includes physical access to any facility and support with participation in the relevant activity.

    Examples of circumstances affecting the ability to achieve the outcome

    If the adult is unable to leave their home safely, or communicate successfully, or interact with others, they may not be able to access work, training, education or volunteering.

    If the adult is unable to access information about opportunities available to them, they are unlikely to be able to engage in activities.

  • Making use of necessary facilities or services in the local community, including public transport, and recreational facilities or services Open

    What to consider

    Is the adult able to get around in the community safely and able to use facilities such as public transport, shops and recreational facilities?

    This includes the need for support when attending health care appointments.

    Examples of circumstances affecting the ability to achieve the outcome

    If the adult is unable to walk, or to use public transport unattended or to organise alternative transport (e.g. someone giving them a lift), or does not have money for a taxi, they may not be able to access services locally.

    As well as formal appointments e.g. health care appointments, this could include informal appointments e.g. being able to go to the library or to meet a friend in a cafe or pub.

  • Carrying out any caring responsibilities the adult has for a child Open

    What to consider

    Does the adult have any parenting or other caring responsibilities e.g. as a parent, step-parent or grandparent?

    Examples of circumstances affecting the ability to achieve the outcome

    If the individual is not able to take care of others, or feels overwhelmed because of their condition, they may not be able to carry out their caring responsibilities for a child.

Carers with support needs

The eligibility decision-making process for carers with support needs involves the consideration of the following three criteria:

eligibility decision making process for carers with care and support needs

  • Carrying out any caring responsibilities the carer has for a child Open

    What to consider

    Does the carer have any parenting responsibilities for a child in addition to their caring role for the adult, e.g. as a parent, step-parent or grandparent?

    Examples of circumstances affecting the ability to achieve the outcome

    If the carer role takes most or all of their time or energy, the carer may not be able to carry out caring responsibilities for a child e.g. responsibilities as a grandparent caring for a child while their parent goes to work.

  • Providing care to other persons for whom the carer provides care Open

    What to consider

    Does the carer have any caring responsibilities to other adults, e.g. for a parent, as well as the adult with care and support needs?

    Examples of circumstances affecting the ability to achieve the outcome

    If the carer role takes most or all of their time or energy, the carer may not be able to carry out caring responsibilities for other people in their lives.

  • Maintaining a habitable home environment in the carer’s home, whether or not this is also the home of the adult needing care Open

    What to consider

    • Is the carer's home a safe and appropriate environment to live in?
    • Does it present a significant risk to the carer’s wellbeing?
    • A habitable home should be safe and have essential amenities such as water, electricity and gas.

    Examples of circumstances affecting the ability to achieve the outcome

    • If the carer’s role means that they are unable to pay their bills, or do not have time to deal with the maintenance of their home e.g. if there is a damp problem, they may not be maintaining a habitable home.
    • If the carer is caring for somebody in their own home, and there is not enough space in the home, it may not be a habitable environment.
    If the carer and the adult with care and support needs share a home, and the adult’s condition means that they have high expectations about the home maintenance that the carer ‘struggles’ to meet, the carer may be not meeting this outcome.
  • Managing and maintaining nutrition Open

    What to consider

    Does the carer have time to do essential shopping and to prepare meals for themselves and their family?

    Examples of circumstances affecting the ability to achieve the outcome

    If the carer lacks the time or opportunity to shop for or cook appropriate meals, they and their family may eat a restricted or unhealthy diet.

    If the carer is not eating or avoiding eating certain foods to maintain a health condition, they may not be maintaining nutrition for themselves.

  • Developing and maintaining family or other personal relationships Open

    What to consider

    Does the carer’s role prevent them from maintaining or developing relationships with family and friends?

    Examples of circumstances affecting the ability to achieve the outcome

    • If the carer is unable to keep in touch with their family and friends, they may not be able to maintain or develop friendships and other relationships.
    • This could occur due to the attention and time commitment of their caring role, meaning that they are unavailable at times when family members or friends are free e.g. in the evenings and at weekends; or because they do not have a phone or computer and/or are tied to the house due to their caring role.
    If the carer has no time or energy left after fulfilling their caring role, e.g. when looking after an adult child with care and support needs, they may not be able to maintain existing or develop other relationships.
  • Engaging in work, training, education or volunteering Open

    What to consider

    Is the carer able to continue in their job, contribute to society, apply themselves in education and volunteer to support civil society or have the opportunity to get a job, if they are not in employment?

    Examples of circumstances affecting the ability to achieve the outcome

    • If the carer has no time or energy left after fulfilling their caring role, they may not be able to engage in work, training, education or volunteering.
    • If the carer has to take too many days off work or has to use all of their holiday entitlement to fulfil their caring role, they may not be able to find or maintain suitable employment or commit to a regular volunteering role.
  • Making use of necessary facilities or services in the local community, including recreational facilities or services Open

    What to consider

    Does the carer have opportunities to make use of local community services and facilities e.g. library, cinema, gym or swimming pool?

    Examples of circumstances affecting the ability to achieve the outcome

    • If the carer has no time or energy left after fulfilling their caring role, they may not be able to make use of necessary facilities or services.
    • If an adult with care and support needs disapproves of their carer making use of the facilities or services in the local community, or prevents them from doing so, this may have an impact on the carer’s desired outcomes/wellbeing.
  • Engaging in recreational activities Open

    What to consider

    Does the carer have leisure time, e.g. some free time to read or engage in a hobby?

    Examples of circumstances affecting the ability to achieve the outcome

    If the carer has no free time for themselves – or no energy left when they do have some free time – they may not be able to engage in activities to maintain their own interests or hobbies e.g. walking or other forms of exercise, being a member of a club or choir, or taking part in pastimes at home such as knitting or reading a favourite book or magazine.

Eligibility determination
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