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19 Community care

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1. Introduction

2. Who decides what sort of care I need?

The first step to getting help is to contact your local council’s social services department and tell them about your situation.

Your council must assess you to find out what sort of help and support you need if you need social care support services due to:

  • your age;
  • an illness, including problems caused by alcohol or drug misuse; or
  • a disability.

The law defines people with a disability as people who are:

  • blind, deaf or dumb;
  • seriously or permanently handicapped by an illness, injury or congenital deformity, or suffering from a mental disorder as defined under the Mental Health Act; or
  • partially sighted or hard of hearing.

You can also ask for an assessment for someone else if they need help (for example, a relative or neighbour).

Social services should aim to complete your assessment within 28 days of you asking for it, although complicated cases often take longer.  

What does an assessment look at?

If your assessment shows that you need certain services, your council must usually provide them. or give you a ‘direct payment’ to cover the cost of obtaining them (see ‘Direct payments’ for more about this). These services include:

  • practical help at home;
  • equipment to help with a disability;
  • help with adapting your home;
  • getting meals at home or somewhere else;
  • being given (or given help to get) a phone or any special equipment you need to use one;
  • help to take part in educational and recreational activities at home and outside (for instance, a place at a day centre), including help with getting to and from those facilities; and
  • holidays.

Your assessment should also cover any health services you may need. If you live in an area where a care trust has been set up to deliver both health and social care services, it will carry out your assessment. If you’re concerned only about help to do with your health, contact your GP. Your doctor can get in touch with other people who provide healthcare when needed, to work out what you need. Different areas have different rules about what you can get. You may be able to get, for example, visits from community health providers at home (such as a district nurse, health visitor, physiotherapist or chiropodist).

Do I have to be on low income to be assessed?

You should be able to have an assessment, no matter how much money you have. If the council refuses to assess you because it thinks you could afford to buy care for yourself, you should get expert advice (see ‘Further help’).

Can I get help if I look after someone?

If someone regularly relies on you for care, you have the legal right to ask for an assessment. This type of assessment will be carried out by social services, and is meant to support carers by making sure that:

  • the person being cared for gets the right support and services;
  • the carer has a choice over the type of caring tasks they do
  • the carer’s work, education, training and leisure needs are considered.

You must be made aware of your right as a carer to an assessment of your needs. The NHS and councils are also encouraged to work together to give better support to carers.

If you care for someone and you need support or advice, contact Carers UK or visit the government website (see ‘Further help’).

How is the assessment done?

Each council has its own way of working out what help you may be able to get. You can find out about your council’s policy in its long-term care charter. You should be able to get this from the social services department. You may also find it in your GP’s surgery, Citizens Advice Bureau or library.

You (and anyone who cares for you) should be fully involved in the assessment, and you should get the chance to say what you feel you need. If you need an interpreter to help you, the council should provide one. The aim of an assessment is to:

  • find out what sort of support you need;
  • decide about the services that might help; and
  • look at your finances, including whether you may be able to claim any benefits.

You may be asked questions about:

  • the tasks you can and can’t do;
  • the tasks you find difficult some of the time;
  • whether you have to follow a special diet; and
  • whether you have special needs (because of your religious or ethnic group, for example).

Who does the assessment?

The assessment will often be done in your home, but it could also be done at a social services centre or even in your GP’s surgery. The person assessing you will normally be from social services, though they may be from the NHS. Other people may take part, too. For example, an occupational therapist may give advice on making your home easier for you to live in (such as fitting stair or grab rails, bath seats or special taps).

The local housing authority may also be asked for its views on certain issues, such as whether you need to move to sheltered housing.

The person who assesses you should keep notes of:

  • what is said;
  • the things they have found you need; and
  • whether there is anything you and they disagree about.

You should normally get a written record of the assessment, which may be in the form of a care plan (see ‘What is a care plan?’). If you are not going to get help, you should get a statement saying why.

You usually have a right to see any other personal information that social services departments hold about you. You can ask them to change anything you think is wrong.

What happens after my assessment?

Part of the assessment process is to decide what help you qualify for. Once that has been decided, a care plan should be drawn up for you.

Councils are allowed to ‘ration’ their services by limiting who can get them. They often do this by deciding that only those people who need a service most can have it. Government guidance says that in deciding who can get care, councils should take into account the extent to which people are at risk. Your council has to help you only if you qualify under its policy. For example, you may need help with household cleaning but you won’t qualify if the council says it will usually only give that kind of help to people who also need help with washing and dressing themselves.

If you find yourself in this position, you can challenge the decision (see ‘What if I have difficulty getting the care I need?’). And even if you’re not eligible for help, your council should still give you information or advice.

What is a care plan?

A care plan is a record that should set out your needs, what services you will get, any charges to be made and a date when the plan will be reviewed. The council may give you some services itself. It may also arrange for you to get some services from other organisations, such as voluntary groups or private care agencies. If you have a carer, your plan should also show what help your carer has agreed to give you.

The council should look at your care plan from time to time, normally within three months of the help being provided and then at least once a year after that. But if your circumstances change at any point, you can ask to be assessed again. And if the council wants to take away or reduce what you get, it must reassess you first. It cannot take away services just because it is short of money, and it cannot take them away if that would leave you at ‘severe physical risk’.

Once your care plan has been drawn up, you should start getting that care within a reasonable time. Social services may put you on a waiting list (as long as it is not unreasonably long), but in this case they should make arrangements to make sure you do not suffer while you are waiting for the services you’ve been promised. If you consider the waiting list too long, you can challenge the decision (see ‘What if I have a difficulty getting the care I need?’).

The council should normally try to produce a care plan that helps disabled people to be as independent as possible. However, this support should be provided as cost-effectively as possible. So, for example, the council may want to move you into a care home because it believes this would better meet your needs and because it would cost much less than giving you the care you need in your own home.

You have the right to say you don’t want to move into a care home. But if you choose to stay in your own home, you may not get all the help you need. For example, if the council would have to pay £140 a week towards the cost of a place in a care home, it might argue that it should give you care at home only worth that much, even if that wouldn’t be enough for your needs. If you are unhappy with what the council has decided for you, you can challenge its decision (see ‘What if I have difficulty getting the care I need?’).

Your assessment may say that you need short-term ‘intermediate care’ at home or in a care home. This may include both health and social services. Intermediate care is a care that can be provided only for a limited time (usually no more than six weeks) so that you don’t have to go into hospital or to stay there when you don’t really need to.

3. Who pays if I get care in my home?

4. How much will I have to pay?

5. What if I am coming out of hospital?

6. What happens if I need to move into a care home?

7. What if I need nursing care?

8. Will I have to sell my home?

9. What benefits may I claim?

10. What choice of home do I have?

11. What if I want to move to a care home that costs more than the council will pay?

12. What if my move into a home is temporary?

13. What rights do I have when I am in a care home?

14. What if I have difficulty getting the care I need?

15. Further Help

16. About this leaflet

This leaflet is published by the Legal Services Commission (LSC).  It was written in association with Sue Bloomfield, a freelance consumer affairs writer.

The leaflets are regularly updated but the law may have changed since they were printed so the information in them may be incorrect or out of date.

Leaflet Version: May 2019

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