Care assessments for people with dementia in Wales

Anyone with dementia can get a care assessment. It should identify the person’s needs and what support would meet these needs. It also helps to inform the decision around who pays for care. 

What is a care needs assessment? 

A care assessment for a person with dementia may be called different things by different organisations. This includes a ‘community care assessment’, a ‘care needs assessment’ or a ‘social care assessment’.

Everyone has unique needs, so the type of care and support will be different from person to person. Needs also change over time. Care and support should be tailored to meet the person’s needs now and then adapted or increased in the future. 

Examples of care and support could be: 

• someone visiting their home to help prepare meals 
• help with dressing or washing 
• attending a day centre or other activities in the community. 

The local authority’s social services or adult services department carry out most assessments. The assessor is normally a social worker (who may be referred to as an assessor). This person may ask to involve other professionals, for example, the person’s doctor. 

The criteria for a care assessment

The assessment of need will identify if the person with dementia has one or more ‘eligible care needs’. A person must have an eligible care need for the local authority to consider paying for their care and support. 

There are four criteria (conditions) that apply across Wales. The local authority uses them to decide whether a person is eligible for care and support. These are:

1. The person’s needs are due to their physical or mental health, age or disability (this includes dementia). 

2. The person’s needs mean they are unable to do at least one of the following: 

   • carry out self-care or domestic routines – such as cooking meals or bathing 

   • communicate 

   • protect themselves from abuse or neglect 

   • be involved in work, education, learning or in leisure activities – such as volunteering or going swimming. 

   • maintain or develop family or other personal relationships – such as spending time with friends 

   • maintain and develop social relationships and involvement in the community – such as going to the library or local shops 

   • carry out caring responsibilities to a child. 

3. The person doesn’t have a carer or community support to meet their needs, or they can’t meet them on their own. 

4. The person is unlikely to meet their needs without support from the local authority. 

After the assessment, the local authority may decide that the person with dementia does not have an eligible care need. If you or the person believes they do, you will need to make a complaint.

What to expect with a care needs assessment?

A care assessment will usually involve answering questions as part of a discussion. The assessment is designed to find out the person with dementia’s ‘personal outcomes’. ‘Personal outcomes’ are tasks and activities the person with dementia wants to do daily or weekly. For example, the person may want to cook and eat in their own home and would like support to do this. The assessment considers five key things:

• the person’s circumstances – for example, do they have any mental or physical health conditions (including dementia) and do they live alone? 

• the person’s outcomes – what does the person want to be able to do? For example, go shopping or to see friends 

• any barriers to the person achieving those outcomes – for example, any mobility problems 

• the risks to the person if the outcomes are not achieved – for example, they may feel isolated or depressed if they can’t see friends, or they may become ill if they are unable to buy food 

• the person’s strengths and capabilities – such as being able to manage their money or joining in with social events.

Everyone at the assessment will discuss the answers. However, not all assessments are done face-to-face and may be done through a self-assessment questionnaire.

Self-assessment questionnaire 

Sometimes an assessment is done through a questionnaire that the person with dementia completes themselves. They may need help to fill this out. You or a social worker can help make sure that all their needs are considered, or you can also ask the local authority for support. Some local charities, such as a carers’ centre, may also help with this.

Assessments in Welsh 

You and the person with dementia have a right to have the assessment in Welsh. The local authority must meet this request and this should not delay the assessment.