Care Act training: determination of eligibility

This theme explores what determination of eligibility is, the legal duties from the Regulations, including an explanation of the legal terms and ‘myth busters’.

Training videos

Overview of the legal journey

What do the regulations say?

Meaning of legal terms

Common misunderstandings

Key messages





Specified/eligibility outcomes provided in the regulations:

The regulations and statutory guidance must be used when responding to the second question/criteria for determining eligibility to ensure compliance with the law.

Unable to achieve is a legal term. There are four options that can be used to deem an adult as unable to achieve a specified outcome, and three options for a carer.

“For the purposes of this regulation an adult is to be regarded as being unable to achieve an outcome if the adult—

(a) is unable to achieve it without assistance;

(b) is able to achieve it without assistance but doing so causes the adult significant pain, distress or anxiety;

(c) is able to achieve it without assistance but doing so endangers or is likely to endanger the health or safety of the adult, or of others; or

(d) is able to achieve it without assistance but takes significantly longer than would normally be expected.”

The Care and Support (Eligibility Criteria) Regulations 2014

Significant impact

To comply with the Care Act, these terms must be used as per their legal meaning.

Key misunderstandings

As professionals we need to support our eligibility decisions with evidence. The Act is clear that we need to evidence the decision-making process.

Reflective questions

Find below a set of reflective questions that will help you embed the above key messages in your social care practice.

  1. Do you have enough evidence in the assessment of needs/carer assessment about all of the needs identified for the adult/carer that will enable you to professionally determine eligibility?
  2. Have you had the Regulations exact phrasing in front of you?
  3. Have you identified specific eligible needs? Have you linked each outcome that the carer/adult is unable to achieve with an assessed need?
  4. Have you been ‘carer blind’ in the determination of eligibility for the adult?
  5. Have you responded to the three questions/criteria in sequential order?
  6. Have you recorded the rationale for your responses/decisions?

Further resources