Care needs assessment: how to apply and prepare

If you need help to remain living independently in your own home or would like to move into supported accommodation to help maintain your quality of life, getting a care needs assessment from your local social services is a great first step.

You must meet certain eligibility criteria to qualify for local authority care, which can only be decided on through a needs assessment. The assessment will look at all aspects of your life – both physical and mental health, and general wellbeing – to identify your needs.

Depending on your personal circumstances an assessment might identify a wide range of needs - from recommending adjustments to your home to recommending a carer for help with everyday tasks or that a person move into a care home. 

We explain what to expect from a care needs assessment, what questions you may be asked, and how care needs are financed. Plus, we tell you how to apply and prepare for an assessment.

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Who is entitled to a needs assessment?

The care needs assessment is completely free of charge and anyone can apply for one. 

What is in a needs assessment?

The needs assessment will be carried out by someone from your council, such as an occupational therapist or social worker, and can be done face to face, online or over the phone. The assessment itself usually lasts at least an hour.

The practitioner assessing you should agree with you on how to describe your situation. They will then work out your various needs, which should have the following elements:

• What are the issues?
• What are the difficulties you face on a daily basis?
• What difference would it make to your life if these issues or difficulties were tackled?
• What is the desired ‘outcome’?
• What services or support could bring these outcomes about?

Through asking these questions, the practitioner can assess your level of care needs and the possible ‘risk’ if you’re not provided with support.

The assessor may contact other health or care professionals who are involved with your care. With your permission, they may also talk to any relatives also involved with your care.

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How to apply for a needs assessment

To apply for a needs assessment, contact your GP or local adult social care department. If you’re not able to do this yourself, a friend or relative can request it on your behalf (and, if relevant, they may want to arrange a carer’s assessment for themselves at the same time).

In some areas you can apply directly through your local authority’s website (although this isn’t always possible). Use the gov.uk website to find your local council and social services.

Preparing for the needs assessment

It’s a good idea to sit down with a friend or relative before the needs assessment to discuss what to say. Think about all aspects of your life, such as personal care, washing, showering, dressing, going to the toilet, preparing meals and shopping. Do you struggle with any of these things? If so, what could help?

1. Make a list of key points and services that might help you live more comfortably at home. What would you ideally like? Don’t assume that the assessor knows or understands your difficulties.
2. All councils must publish details of their eligibility criteria and make it available to local people - look at your local authority criteria, against which you will be measured. Where appropriate, use the same words to describe your needs.
3. If you have good and bad days, be realistic about the help needed on those bad days (even if it’s difficult to admit).
4. You may want to keep a diary for a week or so before the assessment, noting down the things that you can manage on your own, things that you manage with difficulty or things that you can no longer do at all.
5. Also think about the ways in which your needs could be addressed. For example, if home care is needed at a specific time, say so and explain why, or if a care home is needed near a relative in another part of the country, say so and give details of where they live.

It can help to have someone else familiar with your situation present at the assessment, such as a relative, friend or carer. If there isn’t someone suitable who can support you, you have a right to ask for an independent advocate to be appointed. An advocate will help to ensure that the relevant circumstances of your situation are taken into account and your views and preferences are listened to. 

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Care needs assessment questions

Assessors might not mention certain needs that are important, so be sure to speak up. The more you have prepared for the assessment, the better. 

These may not be the exact questions asked, but the following examples will give you an idea of what subjects might be covered:

Questions about health

• What medical problems do you have currently or have had in the past, including ongoing issues such as high blood pressure?
• What medication do you take?
• Do you have any physical health problems, such as difficulties with mobility or problems with incontinence?
• Do you have any sight or hearing problems?
• Do you have any mental health problems, such as depression?
• Do you have problems with memory?
• Have you had any falls?
• Are you able to take care of yourself?
• What is your diet like?
• Do you eat regular meals?
• Do you drink or smoke?
• Do you take regular exercise?
• Do you need any guidance on finances or benefits and allowances, such as the Attendance Allowance or Personal Independence Payments (PIP)?

Questions about day-to-day living

• Are you able to look after your home?
• Is your accommodation suitable for your needs?
• Do you have a carer or someone who looks after you?
• What important relationships do you have and wish to maintain with people around you?
• Can you get to the shops and other facilities and services?
• Are there any hobbies and interests that you wish to maintain?
• Have you been abused, suffered from neglect or had any problems with personal safety? This can be an emotional subject and difficult to discuss, but it’s important to share this information at your assessment.
• Where do you want to live? For example, if you need to be in a care home, do you want this to be in a particular area to maintain relationships with family and friends? This can be classed as a need, so it’s important to ensure it’s covered in the assessment.

Download the needs assessment checklist

What are the 3 components of a needs assessment?

Following the assessment, the local authority will decide whether your assessed needs meet their criteria for adult social care. In England, the eligibility criteria are based on three tests:

1. Do your needs arise from or are they related to a physical or mental impairment or illness?
2. As a result of these needs, are you unable to achieve two or more of the specified ‘care outcomes’ (see below)?
3. As a consequence, is there likely to be a significant impact on your wellbeing?

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How do you qualify for care and support?

The local authority will first consider the following ‘care outcomes’:

• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Being able to make use of the home safely
• Maintaining a habitable home environment
• 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.

They will judge that a person can’t achieve an outcome if they’re unable to achieve it without assistance; without significant pain, stress or anxiety; without endangering themselves or others; or if it would take significantly longer than would normally be expected. If you are unable to achieve two or more of the care outcomes, you will be eligible for care and support.

The care outcomes should be recorded. Local authorities are required to ‘signpost’ you to other ways of meeting any of your presenting needs that fall outside the eligible needs.

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Needs assessment care plan

Following your assessment, you'll receive a written care plan (sometimes called a ‘care and support plan’). This should outline your assessed needs and suggest suitable solutions. It will also explain which needs will be met by the local authority.

Here are some examples of what a care plan could cover: 

Issue: Mr S is unable to work in the kitchen and cook.

• Possible outcomes: ensure Mr S has regular meals that meet his nutritional needs.
• Possible services/support: learn how to cook/prepare meals, or have all meals provided.

Issue: Ms P lives alone and regularly wanders out of the house, putting her in an unsafe situation.

• Possible outcomes: to keep Ms P safe.
• Possible services/support: arrange a carer to supervise at home, provide a personal alarm, or move to a care home.

If you don’t receive a care plan following a needs assessment, then request a copy of it. This is an important document, as you will only be eligible to receive support for needs that have been recognised in the care plan.

It’s important to check the documentation to make sure that the recorded assessment captures all your needs, not just the ones the local authority regard as ‘eligible’. Written details of the assessment should be checked, agreed and signed by both you and the local authority.

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 Financing care after a needs assessment

If you’ve been found to need extra support, you will have a separate financial assessment (or means test) to see if the council will contribute to your care costs.

Local authority financial assessments differ depending on whether you are remaining in your own home or moving to a care home. We explain how these work in our guide on care home finance.

Not all support is means tested. People with certain health conditions including dementia may be eligible for a discount on their council tax bill or may be exempt from paying altogether, irrespective of their financial situation. This is something you can ask your council about directly. 

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Needs assessment in Northern Ireland, Scotland and Wales

Social care needs assessments are used in a similar way across the whole of the UK, but there are some regional differences. 

Northern Ireland

The needs assessment is called a health and social care assessment and it will be arranged by the social services department of the local Health and Social Care (HSC) Trust. You will normally only undergo a financial assessment if you are moving into a care home.

Scotland

People who are assessed as needing personal care or nursing care should not be charged for these services. The amount an individual contributes towards the remainder of their care costs, including accommodation, utilities, meals and so on, will be determined following a financial assessment of their income and assets. More information on this is available on the Scottish government’s website.

Care Information Scotland has more information about what to expect from a care needs assessment in Scotland.

In the Scottish Highlands, NHS Highland is responsible for arranging the needs assessment, rather than the local authority.

Wales

Regardless of your savings you will never have to pay more than £100 a week towards the cost of personal care support at home, if you have been assessed as needing it. Support services that are not classed as personal care (meals and laundry, for example) may take total charges above £100 per week. 

Find more information about needs assessments in Wales on the Carers Wales website. 

Re-assessment of care needs

Local authorities should review care and support plans at least every 12 months, and a basic review should happen six to eight weeks after a new or revised care plan. You can ask for an earlier review if your situation changes before that time. Following a review, your care plan might be updated to reflect any changing needs.

If you think your care needs have changed substantially since the last review (for example, care at home is no longer working well for you and you think a care home would be a more appropriate place to live), you should ask the local authority to carry out a full re-assessment.

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