Eligibility
After an assessment the social care practitioner will use the Care Act national eligibility criteria to determine if you are eligible for support from the council.
The national eligibility criteria tells social care practitioners to consider:
- Needs - The adult’s needs relate to a physical or mental impairment or illness
- Outcomes - As a result of those needs, the adult is unable to achieve two or more specified outcomes
- Wellbeing - As a consequence, there is likely to be a significant impact on their wellbeing.
An adult’s needs are only eligible when they meet all three of these conditions.
1. Needs
The need is because of a physical or mental impairment or illness, this includes:
- Physical
- Mental
- Sensory
- Learning or cognitive disabilities
- Illnesses
- Substance misuse
- Brain injury.
2. Outcomes
As a result of the needs, the adult is unable to achieve two or more of the following:
- Managing and maintaining nutrition
- Maintaining personal hygiene
- Managing toilet needs
- Being appropriately clothed;
- Maintaining a habitable home environment
- Being able to make use of the home safely
- Developing and maintaining family or other personal relationships
- Accessing and engaging in work, training, education or volunteering
- Making use of necessary facilities or services in the local community including public transport and recreational facilities or services
- Carrying out any caring responsibilities the adult has for a child.
The adult is “unable to achieve” an outcome if:
- They are unable to do so without assistance
- Doing so causes significant pain, distress or anxiety
- Doing so is likely to endanger their health or safety or that of others
- Doing so takes significantly longer than would normally be expected.
3. Wellbeing
As a consequence of the adults needs, there is or is likely to be a significant impact on the adult’s wellbeing, including the following:
- Personal dignity (including treatment of the individual with respect)
- Physical and mental health and emotional wellbeing
- Protection from abuse and neglect
- Control by the individual over day-to-day life (including over care and support provided and the way it is provided)
- Participation in work, education, training or recreation
- Social and economic wellbeing
- Domestic, family and personal relationships
- Suitability of living accommodation
- The individual’s contribution to society.
The council must consider whether the adult’s needs impact on the above nine areas of wellbeing and make a judgment whether:
- The adult’s needs impact on an area of wellbeing in a significant way
- The cumulative effect of the impact on several areas of wellbeing mean that they have a significant effect on the adult’s overall wellbeing.
The council should consider the impact of the person’s needs in the context of what is important to him or her. What is important to one person may not be the same for another.
The determination of eligibility must be based solely on the adult’s needs. Any care provided by a carer should not be taken into account. Support available from carers is considered at the support planning stage.
