Adult and Community Services

Fair Access to Care

Our new eligibility criteria for accessing Adult Services (over 18 years)

What is Fair Access to Care Services?

This is government guidance that helps to make sure that community-care services for all adults over the age of 18 are provided consistently.

At the heart of the government's Fair Access to Care Services guidance is the principle that all councils should use just 1 eligibility threshold for all adults who want social-care support - that is, 'Should people be helped or not?'.

Under fair access to care services, we will use the same eligibility conditions to consider the risks to the independence of all adults, whether they are older people (over 65 years), or younger adults aged 18 or over who have a physical, sight or hearing impairment (disability), mental health issue or learning disability.

The guidance confirms that when setting their eligibility conditions, each council should take account of the resources (funding) locally set aside for adult social care. Because of the financial positions of different councils, the guidance does not make all councils reach similar decisions on eligibility, or provide similar services to people in similar needs.

Why have an eligibility threshold?

We have to balance increasing demands for services with the limited resources which are available to meet the needs of our community. In the past, we have tried to provide some services to more people, but this has meant that we were not fully meeting the needs of those people within the community whose independence is at the greatest risk.

To put this right, we need to make sure that the adults (and their carers) with the highest risk to their independence receive the right level of services. To achieve this, we use eligibility to target our services to those in greatest need, but of course as with any situation where a judgment is made, this will result in some people not receiving any community-care service from us.

Like other local authorities, we should reconsider our eligibility threshold each year. At the moment, we can only consider meeting needs which we decide are either 'critical' or 'substantial'. Whenever the eligibility threshold changes, where adults are assessed for the first time only we will consider meeting their needs which meet the revised conditions.

Adults we already support with services will receive a review and reassessment as usual within 12 months, during which we will match their needs against the revised eligibility conditions.

This may mean that some adults receiving support will find that they will no longer qualify for some care. Of course in these situations, staff will try and support service users to contact other resources or to make private arrangements.

What are critical and substantial risks?

Critical risks

Concern emergency situations where, if support is not provided immediately, there may be serious consequences to your health, safety and independence.

If you have critical risks, we will take protective action, arrange support, and provide services to help you to regain, or to maintain, your ability to live independently.

Example: A woman with some confusion, who is a wheelchair user and who has poor eyesight, finds her home is severely damaged by flooding from broken pipes. This woman is likely to have critical needs around accommodation, washing and accessing meals.

Substantial risks

Concern very serious situations where, if support is not provided quickly, your independence or wellbeing may be threatened. If you are assessed as having substantial risks, we will strengthen any existing support systems, and provide the support that you need to stay as independent as possible.

Example: A woman with no confusion lives alone. She has severe arthritis and walks slowly using a zimmer frame, and has a history of falling. She can slowly manage to get out of bed but cannot wash or dress herself. She can make hot drinks and snacks, but is not able to prepare or heat a meal. This woman is likely to have substantial needs around washing, dressing and having a meal.

Moderate and low needs

Examples of what are usually categorised as moderate or low needs include cleaning the home, polishing and dusting, vacuuming, shopping, collecting benefits, laundry and social contact or other forms of reassurance and general emotional support.

Where the assessed needs are identified as moderate or low, we will not be able to consider providing services to meet them. Instead, where possible, we may provide advice and information, for example, details of other community organisations that may be able to help.

More information about Fair Access to Care Services can be found on the Department of Health's website.

How we assess your needs

We carry out an assessment so you can tell us about your circumstances and discuss your needs. You and anyone you would like to be present will be fully involved in the assessment so the assessor can collect the information needed.

After the assessment, the social worker or care manager will consider whether or not your needs put you at risk, and how serious that risk is. It is helpful to remember that as adults we all take risks every day - driving our cars, crossing the road, coming down the stairs. But, just because someone gets older or develops a disability does not mean that they can no longer take risks.

An assessment will try and identify ways that risks can be reduced but it is not possible to guarantee someone is ever free of risk.

How we decide how to support your needs

Any care we provide tries to meet eligible needs while considering 'best value'. This allows us to choose the cheaper of 2 different ways of meeting eligible need, in the interests of the wider community and tax-paying public. It is also important that we do not create a dependency by providing more care than is appropriate. Services should be focused at increasing people's independence.

Any care is designed to promote people's independence, not to make people reliant on carers or to lose skills or abilities that they have. Often, the aim of a care package is to increase a person's abilities to manage for themselves.

It is quite common for people to receive a package of care for a short time only, until they are able to manage independently, either without a care package or with a small amount of support. Managing our resources so that we can meet the needs of the people who rely on our services is essential in helping us achieve our goal of improving people's lives.

What you can do if you are unhappy with our decision

If you disagree with our decision on whether or not you are eligible for community care services, discuss the matter with the social worker concerned (or his or her manager). You may also ask for advice about who may act as your representative.

If you and we cannot settle the matter in this way, you can make a formal complaint by contacting the Adult and Community Services Complaints Manager.

What are community care services?|

How we assess your needs?|

How fair access will affect you if you are already receiving community care services|

The services you will get if you are eligible for community care services|

The services 'fair access to care' applies to|