Care Act Assessment Solicitors

Eligibility for financial support with care

The rules regarding financial assessments for care are complex. The fundamental points are outlined below, but even these are fairly intricate so it is worthwhile enlisting the support of specialist Care Act solicitors who understand all of the nuances.

Different rules depending on whether you are receiving care in a care home or receiving care at home. However, generally speaking, the eligibility criteria are:

• If you have capital and savings in excess of £23,250 then you will fund your care costs in full (unless you qualify for NHS Continuing Healthcare or Section 117 aftercare funding) until those assets fall below that level. You are classed as self funding.
•  If you have capital and savings between £14,250 and £23,250 and you qualify for means tested support from the local council then you will contribute to the cost of your care from your income included in the means test, plus an assumed, or ‘tariff’ income based on your capital between £14,250 and £23,250. The council will pay the remaining cost of your care.
• If you have capital and savings of less than £14.250, you no longer pay a ‘tariff’ income based on your capital, but you must continue paying from income included in the means test. The council pays the remaining cost of your care.
•  Your home will not be included if you receive care and support at home or if you go into a care home on a short-term or temporary basis.
• If you move into a care home permanently, your home will not be included if, for example, your partner still lives there or, in certain circumstances, a relative.
•  If you receive care in a care home then If you are eligible for funding support, your local council must calculate the overall cost of your care and, using the means test, how much you have to contribute to the overall cost from your financial resources. The council must ensure that the overall cost figure it calculates, called the ‘personal budget’, is high enough to meet the cost of at least one suitable care home.
• You will be expected to pay towards the cost from your income included in the financial assessment, for example pensions, however you must be left a Personal Expenses Allowance (PEA). The PEA must be at least £25.65 per week. The council has discretion to increase this amount, depending on your circumstances. See below for more information about the means test.

These rules apply to England only. Separate criteria are used in Wales.

The full criteria for financial assessments for care are more extensive than the above, and are best understood when applied to your individual circumstances. Contact our experts today for support with determining your eligibility.

Applying for care funding

The first stage of applying for care funding is to contact your local council requesting a Care and Needs assessment. Our Care Act assessment lawyers can support you with this right from the outset, helping to prepare a case that satisfies the Care Act eligibility criteria and sets you up with the best chances of a successful outcome.

Once eligibility for care has been established, we also support clients with handling the second phase: the financial assessment. The team has considerable expertise and experience in this area, which enables them to identify whether or not the financial eligibility criteria have been considered correctly in your case and ensure that you receive the full amount of funding you are due.

Read on for a thorough breakdown of the Care Act assessment process – alternatively, get in touch and we can guide you through how it works in practice.

The Care Act assessment process

The Care Act sets out a new legal duty for an adult’s ‘eligible needs’ to be met by the local authority, subject to their financial circumstances. If eligible, The local authority must help the person to make decisions about how they want their needs to be met and prepare a care and support plan.

An assessment is carried out by a social worker to decide whether a person needs care and support to help them live their day-to-day life.

They will consider a number of factors:

• The person’s needs and how they impact on their well being
• What matters to the person
• The person’s other circumstances

The aim is to get a full picture of the person’s needs and goals. It is then determined whether the needs identified are eligible for support.

The Act gives local authorities a duty to carry out a needs assessment in order to determine whether an adult has needs for care and support. The assessment must be provided to all people who appear to need care and support, regardless of their finances or whether the local authority thinks their needs will be eligible

After the assessment, the local authority must determine whether the person is eligible for care and support. The person will have eligible needs if they meet all of the following:

• They have care and support needs as a result of a physical or a mental condition;
• Because of those needs, they cannot achieve two or more of the following:
  • Dressing themselves on a daily basis
  • Maintaining personal relationships
  • Eating property and maintaining nutrition
  • Maintaining personal hygiene
  • Managing toilet needs
  • Being able to use and move about the home safely
  • Maintaining their home
  • Being able to participate in social activities and hobbies
  • Being able to make use of public transport and local services. 
• The person’s wellbeing must also be significantly affected by their inability to achieve two or more of the above tasks.

Where the person has eligible needs, and wants the local authority’s help to meet them, then the authority will discuss the person’s care and support plan with them. In all cases, the local authority must give people advice and information about what support is available in the community to help them. The local authority must provide the adult with a copy of their assessment and their eligibility determination.

Speak to our team if you suspect that this process has not been duly followed in your case.