Chapter One – An assessment from your Council
If you think you need some support to manage, it can be useful to talk through your situation with a qualified person. They can look at the difficulties you are experiencing and offer suggestions and advice on things that will help to make things easier. This process is called an assessment.
It doesn’t matter what age you are or what you think your issues are – everyone is entitled to ask for an assessment, Whether you have physical problems, issues with your mental health well-being, or just coping day-to-day.
Different organisations can help with assessments. You can apply for an assessment from your local Council, or you can approach a private assessment agency.
If you’ve been in a hospital
You may also have an assessment if you have had an incident affecting your health or been admitted to a hospital, and are ready to go home. In these situations, you may have a period of ‘reablement’ for up to six weeks at home to get you feeling better, and then you will be assessed as a matter, of course, to see if you require further help.
Everyone’s needs and the ways they affect their well-being are different. Identifying your needs and the things you want to achieve will help the council to decide if they can help.
You can ask your Council for an initial assessment if you feel you need support to do normal day-to-day activities. This is your legal right.
The initial assessment will be a conversation with you and a social worker from the Council to understand what problems you are having. If it looks like you need a little extra help with things, they with then complete a fuller assessment with you and discuss in more detail:
• Your needs and how they affect your well-being – for instance, you might need help getting dressed or support to get to work.
• Things you want to do in your life – for example, to make new friends, or to stay clean and well-dressed.
• Any other relevant factors affecting your well-being.
You can, of course, ask a relative, friend or someone else you trust to be present with you. Both the initial assessment and the full assessment are free of charge.
Requesting an assessment
You can ask your Council yourself, or someone else who knows you can request an assessment for you – a friend, relative or professional who is already involved in your care, such as your GP. If someone else asks on your behalf, they should have discussed and agreed this with you in advance.
If you look after someone
If you care for someone, perhaps a relative or close friend, you can also ask for an initial assessment to see if you are eligible for help in your caring role, This is independent of whether the person you look after has also had an assessment.
How your Council decides if you are eligible for support
Not everyone who is assessed will then be eligible to receive support from the Council. Your Council uses national regulations to determine whether you are eligible. These regulations are set out in the Care Act 2014. If you’d like to find out more about the Care Act and how it says Councils should determine eligibility, We have further information on our Employment Support Service page. The GOV.UK also has information or you can ask the Council for more information – they can give this in written form for you to keep.
If you are not eligible for support from the Council
If the Council determines that you do not qualify for help from them, they will nonetheless offer you full information and advice about other ways of getting support, with contact details of other agencies or individuals who may be able to help you.
If you are eligible for support from the Council
Your Personal Budget and Support Plan
If you have been assessed as qualifying for help, your social worker will discuss with you how this help can best be given to you, so you have as much choice as you want over what happens.
As part of the process of the assessment, the amount of help that you have been identified as needing is converted into an hourly rate and then added up as one total figure – this is called your Personal Budget. Your personal budget is the total cost of the care you need and is available to you to spend on your care.
Note that even if you are eligible for support from the council, your financial situation will be assessed to determine if you should contribute to the cost of that support. This will be fully explained to you by your social worker.
Your social worker will talk through your support needs and preferences with you, and help you consider the options available to you, taking into account how much you have in your personal budget, helping you identify specific services that match your requirements, and then once they have talked these ideas with you, they will complete and agree with you a Support Plan.
The Support Plan will have full details of your conversation and describe:
• What your current situation is, including things you need help with
• What support you have agreed you will receive to meet your needs
• What you want to achieve whilst receiving support
• A breakdown of how your Personal Budget is being spent
If you also receive help from relatives, friends or from health professionals, or anyone else, this will be shown on the support plan.
it will also include details and tips on ways in which you can remain as independent, active and healthy as possible. Your social worker will talk with you about resources in your area you may not be aware of, and which you might be able to take advantage of – perhaps community events or activities, or services provided by charities.
Chapter Two – Setting up and managing your care
You can arrange and manage your care yourself
This is a good option if you would like to complete choice and control over who your carers are – you make all the decisions. If you choose this option, bear in mind that you will have to handle arrangements for setting up and managing the care yourself (although there are organisations that can help you do so, or you can nominate a trusted person – a relative for intense – to do this for you if you wish). This option is called a Direct payment.
You can ask an independent organisation to arrange and manage your care for you
This is a good idea if you would like choice and control over who your carers are but don’t want the bother of setting up and running your care, day-to-day. Organisations who do this are usually charities or other organisation who are officially registered to do so and will have lots of experience to sort out the best care for you. This option is called an Individual Service Fund.
You can ask the Council to arrange and manage your care
This is a good option if you don’t want to bother of doing any of the legal and financial arrangements yourself – the Council will handle all aspects of your care for you. however, you will have less choice over who your carers are – the Council will choose them for you. This option is called Council Arranged Services.
Your social worker will fully discuss with your how these arrangements work and which one you would like to do – you can have a combination of these arrangements if this suits you best.
With Direct Payments, the Council will give you your Personal Budget as money, and you choose the care which suits you best. This gives you maximum choice. You can choose an agency of your choice, or hire someone privately to provide your care. The carers and support organisations you choose should meet your needs as agreed in your support plan. There are a number of things you cannot spend your Direct Payment on.
Money is paid into a separate account which must be used for your Direct Payment. You then pay the agency or private carer from the account. You can also have a ‘pre-paid’ payment card to manage your account.
Whilst this option gives you the greatest choice and flexibility over who your carer is, you should be aware that you have to take responsibility for setting up and running the care yourself. You are responsible for choosing care that meets your needs, in particular:
• Choosing and arranging your support
• Making the necessary payments to your care provider
• Keeping track of what’s left in your budget
• Showing the council on a regular basis how you are spending your money.
Hiring Someone Privately
A considerable advantage of having a Direct Payment is that you can hire a private individual to care for you, known as a personal assistant (PA). This may be someone you know, or it may be someone you feel you will be able to relate to well, perhaps because they speak your language, or understand your culture or family history.
Whilst it is a very flexible way of choosing your care, it is also an option for which there are some legal and management considerations – the person is entitled to a contract, a fair wage, holiday pay, sick pay and a pension for instance.
If this sounds like a lot of bother, there are ‘payroll’ companies who can help you with this aspect of hiring a PA. They will charge a small fee, but they will help you with practical advice and support with employing the person of your choice, though they won’t do it all for you.
Nominating a Trusted individual to manage your Direct Payment
You may really like the option of a Direct Payment so that you can choose the agency or private carer of your choice, but feel you don’t wish to handle the financial and legal management yourself; in which case you can ‘nominate’ a person – a relative or trusted friend perhaps – to do this for you.
If you feel you don’t have the ability to make the appropriate choices and decisions about your care because, for instance, of forgetfulness, you can appoint an ‘authorised person’ to manage your Direct Payment for you.
Direct Payments for Carers
If you look after someone, you are entitled to have an assessment to see if you are eligible for support from the Council to help you in your caring role.
Should you be eligible for help, you may receive your Personal Budget in the form of a Direct Payment as described above. This is completely independent of whether the person you care for receives support from the Council and has a Personal Budget.
Having a Direct Payment is a good way of having complete control and choice over your care, but it can mean that you will be responsible for the ‘paperwork’.
You can find out more about Direct Payments for carers on our Direct Payments page. There is also a lot of information and practical help about hiring a personal assistant on the Skills For Care website.
With an Individual Service Fund (ISF), the Council gives your personal Budget to an independent agency. You choose who this agency is (but they must be registered with the Care Quality Commission).
The agency will work with you to design and manage the support you want, based on what was agreed in your support plan, and the agency then sets it up. The Council pays your Personal Budget to the agency and they create a fund to look after the money for you. You don’t have to handle any of the financial or legal aspects.
The agency has to make sure that you’re happy with your care and is responsible for the support you receive that it meets your needs. If it’s not working, you can change the arrangement in agreement with your social worker.
Having an ISF is a good way of making sure you have choice and flexibility over what your care is, without the bother of having to handle the financial and legal management of your care.
With Council Arranged Services, the Council takes responsibility for organizing your care and manages your Personal Budget for you. You don’t need to worry about any of the financial and legal obligations. However, you won’t have very much control over who provides your support.
Of course, the Council will work with you to make sure your care meets your needs and you are happy with it, but it will use providers with whom it has contracts to provide care in your area.
It’s a good option if you are happy for the Council to take care of everything and you do not mind who the agency or carers are that come to see you – of course, the Council will monitor that care to make sure it appropriately meets your needs.
Chapter Three – Reviewing your care
Most people want to be as independent as possible, and if they can, regain skills and abilities. There may be other ways in which your circumstances change over time. Once your care has been set up, your Council will review your care annually to make sure that it is still meeting your needs appropriately; if it isn’t, they will talk to you about changing the level of care you receive.
The Council has a legal duty to do this at least annually, and you have a responsibility also to take part in the process, even if you think everything is working well. The review in some cases may take place earlier.
The Council will let you know in good time when the review will be. It will ideally take place in your home
The review discussion will typically involve:
• The reviewer (from the Council’s social services department)
• if you wish, a family member, trusted friend or someone you have chosen to speak on your behalf (an ‘advocate’)
• A representative from the agency(s) that provide your care
• If you have chosen to have your Personal Budget managed by a ‘nominated’ or ‘authorised’ person, that individual will be asked to attend, or if you have chosen to have it managed as an Independent Service Fund, someone from the organisations will be invited to attend
Not all of these people may be present, it depends on the type of care you receive.
As part of the discussion, the reviewer will ask you about how well you are coping and any problems, issues or concerns you have, as well as asking you what you think is working well.
The other people at the review will also be asked to add their comments.
As a result of the discussion, three things may happen:
• Your care is meeting your needs and does not need to be changed
The reviewer will create a new support plan in agreement with you indicating that there is no change in the amount of care, and let you know the date of the next review.
• Your care is not meeting your needs because there are aspects of your needs which have changed, and are not addressed. The type of care you receive could change to better suit your needs (for instance a regular outing to a lunch club might help if you have not had this before), the provider of your care could change (if your current provider is not providing the level of care you need), or the amount of care you receive may increase. there might be a combination of these things.
The reviewer will create a new support plan in agreement with you and as a result, your Personal Budget will be recalculated to take into account the different amount of help you require. Depending on how you have agreed to receive your Personal Budget, your care will change accordingly. The new plan will show the date of the next review.
• Your care is now more than you actually need because your ability to manage independently has improved.
In this case, in discussion with you, the level or type of care you will change to better suit your improved ability to cope and be independent.
The reviewer will create a new support plan in agreement with you and as a result, your Personal Budget will be recalculated to into account the decreased amount of help you require. Depending on how you have agreed to receive your Personal Budget, your care will change accordingly. The new plan will show the date of the review.