Eligibility outcomes for adults with care and support needs under the Care Act 2014
The eligibility decision-making process for adults with care and support needs involves the consideration of the following three criteria:
Eligibility outcome
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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 access, prepare and consume 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.
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Maintaining personal hygiene Open
What to consider
What is the adult’s ability 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.
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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 from a dignity-of-life point of view.
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Being appropriately clothed Open
What to consider
Is the adult able to dress themselves and be appropriately dressed, that is, 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.
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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 includes their immediate environment e.g. access and 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 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.
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Maintaining a habitable home environment Open
What to consider
Is the adult’s home sufficiently clean and maintained to be safe, including 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).
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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.
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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.
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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.
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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.