This factsheet describes how the Care Act (2014) and its supporting regulations and guidance set out the process of assessing an adult’s need for care and support.

What happens now?

The purpose of the needs assessment is to identify with the adult their personal outcomes, existing needs and the impact that these needs have on the individual’s wellbeing. The assessment must be carried out by an appropriately trained assessor, for instance a social worker, who will consider several factors defined in Section 9 of the Act, such as:

• The person’s needs and how they impact on their wellbeing – for example, a need for help with getting dressed or support to get to work.
• The outcomes that matter to the person – for example, whether they are lonely and want to make new friends.
• The person’s other circumstances – for example, whether they live alone or whether someone supports them.

It is a critical interaction during which the local authority should support the adult to take a lead in the process of exploring current their circumstances, what is important to them and for them now and what can be anticipated for future needs, utilising the frameworks of strengths-based and person-centred practice. 

An assessment provides the opportunity for the adult to consider ways in which needs can be reduced or delayed and to consider what may be the right support when they require it.

The Act states that the adult is best placed to judge what is important to their wellbeing.  The local authority can support the development of understanding this, but during the assessment it cannot determine how individual wellbeing is impacted by the assessed needs. 

Every adult will not be assessed in the same way and the intervention must be appropriate and proportionate to the presenting needs and individual circumstances. It is important to recognise that an adult’s needs can fluctuate and so the assessment should not be based just on needs that are present at the time of the assessment but take an appropriate and proportionate approach to considering how the adults needs can change.

The adult must have as much choice and control over the nature and level of their involvement as possible. Some adults will want to be more involved than others and some will find being involved easier than others. However, in all cases the local authority must encourage the adult to be as involved as they can be and be flexible in their approach to assessment to facilitate this. It may be necessary to appoint an Independent Advocate if it is identified that the adult would have substantial difficulty being involved in the process without additional support; and there is not an Appropriate Individual that can maximise their involvement in the intervention.

Upon completion of an assessment, the local authority should have a full picture of the adult’s needs, priorities, and personal outcomes; and how the identified needs impact on their individual wellbeing. 

The adult should have been provided with appropriate information and advice to enable them to work towards their priorities and personal outcomes, having been supported to identify their existing or potential set of personal strengths, or that which could be accessed through the support of family, friends, or wider community resources.

An assessment of an adult’s needs can be carried out under the Act as a combined assessment at the same time for a person who is providing unpaid care to the individual, so long as it is deemed appropriate to do so. Both the adult and the carer must agree to this and there must be no conflict between the two.

The information gathered during the assessment will enable the local authority to undertake a determination of eligibility for support, following the guidelines of Section 13 of the Act and the accompanying Care and Support (Eligibility Criteria) Regulations 2015. 

The local authority must provide the adult with a copy of their assessment and their eligibility determination.

This factsheet relates only to adults who need care and support. The Care Act factsheet 4: Legal duties for a carers assessment explains the equivalent provisions for carers.

What happens after charging reform?

The introduction of the cap on care costs (anticipated in 2025) does not make any changes to the way in which an assessment of needs is undertaken. However, if the assessment intervention results in the implementation of a care and support plan, the cap could have implications for an adult.

Section 14 of the Act gives the local authority the power to charge. In most cases local authorities do charge for providing support to an adult and it is of vital importance that the adult is made aware that while the assessment of needs is provided free of charge, for any subsequent provision of care and support a means-tested financial assessment will be used to identify any financial contribution that the adult may need to make.

A financial assessment must be undertaken to determine the level of capital and savings that the adult has. Until the cap on care costs is initiated, if the adult has more than £23,500 in savings and capital, they will be deemed to be a self-funder, see Care Act factsheet 1: Legal duties towards self-funders. In such circumstances the self-funder can request the local authority to arrange care and support on their behalf but may be charged a fee for this service. When the cap on care costs is introduced, the upper capital limit will change from £23,500 to £100,000.

If an adult is below the current upper capital limit of £23,500 but has savings or capital of £14,250 and above, the financial assessment will identify how much the adult should contribute towards the cost of the identified support. When the cap on care costs is introduced, the lower capital limit will change from £14,250 to £20,000.

When the cap on care costs is introduced, the most an adult will be expected to contribute to the support will be £86,000 (under current proposals). Once this threshold has been met, the local authority will be responsible for any costs incurred to meet eligible needs.

The elements of care and support that are considered are those incurred in order to meet the outcomes specified in the Care and Support plan, for example support from a third-party to enable an individual to get washed and dressed.