Care Needs Assessment

Under the Care Act 2014, every adult who appears to need care and support has the right to a free care needs assessment from their local council, regardless of their financial circumstances or how likely they are to receive funded care. The assessment is carried out by a social worker or occupational therapist and looks at how the person's physical or mental condition affects their ability to manage 10 specified outcomes (e.g. personal hygiene, nutrition, maintaining safety). If the assessment concludes that needs are 'eligible' under the national eligibility criteria (Care and Support (Eligibility) Criteria) Regulations 2015, the council must meet them. A carer can also request a separate Carer's Assessment. The council must produce a care plan and, where eligible, follow up with a financial assessment (means test). Refusal to assess, or a failure to meet eligible needs, can be challenged via the local complaints process and the Local Government and Social Care Ombudsman (LGSCO).

What it means in practice. The assessment is about needs, not money, and the two must be kept apart. A council cannot refuse to assess you because it thinks you will have to pay, and it cannot decide what you need by reference to what it would cost. The eligibility test has three parts: the needs must arise from a physical or mental impairment, they must mean you are unable to achieve two or more of the specified outcomes, and as a result there must be a significant impact on your wellbeing. "Unable to achieve" includes being able to do something only with pain, only with help, only very slowly, or in a way that endangers you or others.

A worked example. Bill is 78 and lives alone after a stroke. He can wash, but only by leaning on the basin, and he has fallen twice doing it. He can make a sandwich but no longer cooks a hot meal. He has stopped going out because he cannot manage the step. At assessment he is asked to describe a typical day. Because he cannot safely manage personal hygiene, nutrition, or access to the community, and the impact on his wellbeing is significant, his needs are eligible. The council must then produce a care and support plan setting out how those needs will be met.

Common pitfalls. Playing down your difficulties is the most damaging, and it is instinctive — most people describe their best day to a stranger. Ask someone who knows you to be there, and write down beforehand what goes wrong on a bad day. Do not accept an assessment carried out entirely over the phone if that would not capture the reality. And insist on a written copy of the assessment, the eligibility decision, and the care plan, since you cannot challenge reasoning you have never seen.

How it relates to other terms. The duty comes from the Care Act 2014. Once needs are eligible, charges are worked out through a separate financial assessment, and property-owning residents may be able to use a deferred payment agreement. Where health needs dominate, NHS Continuing Healthcare should be screened first because it is free at the point of use. Support can be taken as a personal budget or direct payment.

What to do next. Request an assessment in writing from adult social care — read our care needs assessment guide for how to word it and prepare. Anyone providing unpaid care should request their own carer's assessment at the same time, and your rights under the Care Act explains what to do if the council refuses or delays.