Social Care for Younger Adults

The Care Act 2014 applies to all adults aged 18 and over in England who appear to have care and support needs. There is no age below which the Care Act does not apply — a 19-year-old with a spinal cord injury is as entitled to a care needs assessment as an 85-year-old with dementia.

The eligibility criteria are the same regardless of age: needs must arise from a physical or mental impairment or illness, the person must be unable to achieve two or more specified outcomes, and there must be a significant impact on wellbeing. The outcomes against which the assessment is measured include things like maintaining personal hygiene, nutrition, maintaining relationships, and engaging in employment or education.

For younger adults, work, education, and social participation are often particularly important outcomes, and the assessment should reflect this. A good social worker will consider not just personal care needs but also support needs relating to employment, further education, relationships, and community participation.

Young people with care needs who are receiving support from children's services face a potentially disruptive transition to adult services at age 18. The Care Act 2014 includes specific provisions to manage this transition more smoothly:

• Transition assessment — The council must carry out a transition assessment for young people likely to have care and support needs as adults, when it would be of "significant benefit" to them — usually from age 16 or earlier if needs are complex;
• Child's carer transition assessment — Parents caring for a young person with complex needs are also entitled to a transition assessment;
• Young carer transition assessment — Young people aged under 18 who are caring for someone else are also entitled to a transition assessment from children's services.

In practice, the transition from children's to adult services is often experienced as a cliff-edge, with services that were available in childhood disappearing or being significantly reduced. Families should engage with the transition process early and make the council aware of the young person's needs and the level of support currently being received.

Younger adults often have different needs and preferences from older adults, and general elderly care services may not be appropriate. Specialist provision for younger adults includes:

• Supported living — Rather than a care home, younger adults may be better supported in their own tenancy with a care package. This provides independence and community inclusion while ensuring support needs are met;
• Personal health budgets and direct payments — Give younger adults control over their care arrangements, enabling them to employ a personal assistant and design their own support;
• Specialist residential and day services — For those with acquired brain injuries, learning disabilities, complex mental health needs, or degenerative conditions, specialist services designed for younger adults are available — though waiting lists can be long;
• Condition-specific support organisations — Charities and organisations specialising in specific conditions (Headway for brain injury, Scope for cerebral palsy, etc.) often provide advocacy, peer support, and practical guidance that general social care services do not offer.