What is the care assessment process in Wales?
If you need care and support in Wales, your local authority will need to carry out an assessment of your needs. Then they will carry out a financial assessment to decide who will pay for your care. If the local authority fund your care, you will receive a direct payment.
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- Who pays for care home fees in Wales?
- Nursing care in Wales: when does the NHS pay?
- Paying for care in Wales: complaints and FAQs
- Paying for care in Wales - useful organisations
What is a needs assessment?
If it looks like you might need care and support, your local authority has a duty to carry out an assessment of your needs.
This ‘needs assessment’ should find out specifically what you need help with, and consider the things that are important to you. The local authority uses it to decide whether you are eligible for support. If so, you are considered to have ‘eligible care needs’.
The local authority will then talk to you and your carer (if appropriate) to produce a care and support plan. This will normally be done by a social worker or a care co-ordinator (they may be referred to as an assessor). They may organise for other professionals to be involved, for example the person’s doctor or a nurse. This is a joint effort and you will have ideas and preferences about what you want to be in place to support you best.
After that, it will consider whether you are entitled to financial support to meet your needs (see ‘What is a financial assessment?’ on this page).
Can I be refused a need assessment if it looks like I can afford my own care?
The local authority cannot refuse to assess your needs because you appear to have enough money to pay for your own care.
Some people find this assessment useful as it can help you to work out what type of care you need and what options are available. This can help you to decide whether the services you are considering are appropriate.
Assessment for care and support in Wales
Want more information on needs assessment? Read how to request an assessment and what to expect.
What is a financial assessment?
Once your needs have been assessed, your local authority will carry out a financial assessment to help decide who will pay for your care and support.
The financial assessment varies slightly depending on the type of care and support you need. For example, if you are living at home, the assessment will be slightly different to if you are living in a care home.
What might be involved in a financial assessment?
The person doing the financial assessment is likely to ask you (or your carer or relative) to complete some forms about your finances and declare that this information is true. Someone from the local authority may also visit to help you to fill in the forms. You can ask for help to fill these forms out.
The Social Services and Wellbeing (Wales) Act says that, where a local authority has decided to charge for care and support – it must carry out a financial assessment and determine what the person can afford to reasonably pay, except where a flat rate charge is to be applied.
Once the financial assessment is complete, the local authority must provide a written statement.
What happens if I refuse to have a financial assessment?
It can feel like an invasion of privacy when the local authority or its representative is looking over something as personal as your finances. However, it is important to make sure that you are charged the right amount for your care.
Remember, if you refuse to answer the financial questions, you could automatically be charged for care that would otherwise have been free.
Financial assessment forms
Can I transfer my assets to someone else so that they aren't assessed?
If you have an asset that you transfer to someone else to avoid it being used to pay for your care, the local authority can still assess you as if you own the asset. Any attempt not to include an asset in the financial assessment may be seen by the local authority as a deliberate ‘deprivation of assets’.
Examples of this are transferring money into someone else’s bank account, or transferring ownership of a property into someone else’s name.
If my local authority are paying for my care, how will I receive this?
If your care is being funded by the local authority, you can choose to receive this funding in the form of a direct payment.
What is a direct payment?
A direct payment is money that a local authority gives to someone to spend on meeting their own eligible care and support needs.
The money can be spent on a wide range of products and services, and is intended to give you greater choice and control over how your eligible needs are met.
How are direct payments managed?
Your local authority will work out how much money you need to meet your eligible care needs. You will have a financial assessment (see above) which will include assessing what you can afford to pay yourself.
If you do receive a direct payment from the local authority, they will provide regular statements to make it clear how much money is being paid towards meeting your needs.
The local authority cannot refuse to give you a direct payment on the basis that you are unable or unsure about managing one. They must make sure you have the correct level of support that you need to manage your direct payment.
The Social Services and Wellbeing (Wales) Act 2014 allows people to use direct payments to pay for long-term residential care as well as other services.
For more information on direct payments see our 'Personal budgets' page. This mainly deals with the system in place in England, but the information on direct payments is still relevant for Wales.
Are there are types of care and support that I cannot be charged for?
The local authority may charge people for some care and support services, but some types of care and support must be free of charge.
These include, but are not restricted to:
- intermediate care, including reablement (care that can help to restore a person’s independence by providing support or helping them relearn daily living skills) for up to six weeks
- after-care/support provided under the Mental Health Act 1983 section 117 (see ‘Paying for care fees and the Mental Health Act 1983’ below)
- transport to a day service where the transport is provided as part of meeting a person’s needs
- independent professional advocacy where a local authority has arranged it
- any services that an authority has a duty to provide based on other legislation.
Paying for care fees and the Mental Health Act 1983
If you have been in hospital for treatment under section 3 of the Mental Health Act 1983, the local authority and NHS are responsible for providing and paying for any related aftercare.
This aftercare is provided under section 117, (usually pronounced ‘one, one, seven’) of the Act. This can include any care you need in your own home or in a care home. The purpose of this is to try to prevent readmission to hospital.
When completing financial assessment forms, ‘income’ refers to money you receive regularly, for example, benefits or a pension.
‘Capital’ refers to any other assets you have. This includes savings, investments and in some cases (for residential care) the value of your home.
Capital and income will either be:
For example, the value of your home might be fully disregarded in certain circumstances. For more information see ‘Will my property be included in my financial assessment for care home fees?’ on 'Who pays for care home fees in Wales?'.
If you have a partner, the forms may ask about their finances too. However, once it is decided what belongs to you and what belongs to your partner, the assessment should only take into account the finances of the person who needs care, and no one else’s.
If you have joint bank accounts or other assets held jointly, the assessment can only take into account the share belonging to you. It will be assumed that your share is 50% of these joint assets, unless you can show otherwise.
Once the assessment has been completed, the local authority must provide clear, written information about how much you will pay for your care. This should show clearly what has been taken into account, and regular statements from the local authority should follow.
You will always be allowed to keep a certain amount of income known as a ‘minimum income amount’ (MIA). For more information see ‘What is minimum income amount (MIA)?’ on 'Who pays for care home fees in Wales?'.