Fair access to care services (FACS): prioritising eligibility for care and support
Assessment - Personalisation and the assessment process: implications for practice
The purpose of a community care assessment is to identify and evaluate an individual’s presenting needs and how these needs impose barriers to that person’s independence and/or wellbeing. Information derived from an individual’s assessment should be used to inform decisions on eligibility.(‘Response to the first contact and assessment’, DH, 2010, para 78)
Simon’s story – good assessment the foundation of stability and quality of life
Simon, aged 39, lives in the community. He needs considerable support because of his learning difficulties and health problems. Assessments of Simon’s needs produced a combination of family care with support from a third sector organisation. Over the years his support has been reassessed to meet his changing needs. Careful assessment has enabled Simon to have a good quality of life, to remain integral to his family and to follow his interests in gardening, ecology and arts for the past 15 years.
The section of the 2010 DH Guidance headed ‘Response to the first contact and assessment’ outlines good practice when undertaking assessments. The guidance makes it clear that assessing the needs of groups with particular conditions (e.g. deaf-blind people) must be undertaken by staff with the necessary specialist expertise in that area. Staff should:
- work in partnership with individuals and their carers at all stages of the assessment process, beginning with the assumption that people are best placed to judge their own wellbeing, and should be provided with the information and support necessary to participate as fully as possible in decisions relating to their welfare
- explain how the assessment process for care and support works, advise on the likely timescale and tell people and carers how they can track progress in the meantime
- ensure that knowledge about the individual’s and carer’s health conditions, health care needs and NHS support informs the assessment process
- apply the principles of personalisation to:
- maximise individuals’ and carers’ choices and control over their lives, and prioritise the outcomes they value
- recognise individuals’ and carers’ expert contributions to assessment
- explore solutions that lie within the individual’s own network or via local community resources
- signpost to or provide information and advice on support from universal services, other agencies and community resources.
- Draw on the results of self-assessment to inform the assessment process.
- Carry out capacity assessments where necessary, and Best Interests decision making if individuals are assessed as lacking the mental capacity to make a particular decision themselves.
- Ensure that the scope of the assessment process is proportionate to the person’s need and fit for purpose.
- Collect sufficient evidence to make a sound judgement about eligibility within the FACS bandings and criteria, agree outcomes, support the individual to identify and manage risks, and address any safeguarding issues.
The Care Bill includes provision to establish national eligibility criteria for adult care and support. This is to be achieved through regulations to be made under a power in Clause 13. These will set a minimum threshold for people’s care and support needs which must be met by local authorities in all areas. Local authorities will not be able to restrict eligibility beyond this threshold, but if they wish to do so they can meet other needs which are below the national threshold. The government proposes to set the national threshold at a level equivalent to ‘substantial’ in the current system. This is the level currently operated by the vast majority of local authorities.