Care assessment process in Northern Ireland

What is a health and social care assessment? 

If it looks like you might need care and support, your HSC trust has a duty to carry out an assessment of your care and support needs. This ‘health and social care assessment’ (assessment of need) should find out specifically what you need help with, and consider the things that are important to you. 

The trust may also carry out a financial assessment as part of this process (see below). However, the trust cannot refuse to assess your needs because you appear to have enough money to pay for your own care, and many people find this assessment helpful (see Care home fees). 

The trust uses the assessment to decide whether you are eligible for support. They will consider the risk to you as a result of your care needs, putting it into one of four categories – low, moderate, substantial or critical.

A trust must provide care to people who have been assessed as being at either substantial or critical risk. If you have moderate or low risk, the trust is not legally required to provide you with care or support, but they may choose to. Instead, they should refer you to voluntary sector organisations where support may be available. 

Financial assessments 

Your HSC trust may carry out a financial assessment to help decide who will pay for your care and support. The trust may carry out a financial assessment if a person requires social care services in their own home, or a placement in a nursing home or residential care home. Depending on the outcome of the financial assessment, the trust may not make a contribution towards all the services you need. 

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 trust may also visit to help you to fill in the forms, or to ask you some questions about your finances. 

It can feel like an invasion of privacy when the HSC trust 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. It’s worth noting that, if you refuse to answer the financial questions, you could be charged for care that would otherwise have been free. 

If you have questions about the financial assessment, ask the person carrying out the interview. Alternatively, the finance department of the HSC trust will be able to help with the process. 

The financial assessment form 

When completing financial assessment forms, ‘income’ refers to any 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. You will always be allowed to keep a certain amount of income known as a Personal expenses allowance (PEA) (see Care home fees).

Capital and income will either be: 

• fully included in the assessment 
• partially taken into account 
• ignored completely (fully disregarded). 

For example, the value of your home might be fully disregarded in certain circumstances. For more information see Care home fees.

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 HSC trust 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 trust should follow. 

Deprivation of assets 

If you have an asset that you transfer to someone else to avoid it being used to pay for your care, the trust can assess you as if you still own the asset. Any attempt not to include an asset in the financial assessment may be seen by the trust 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.

Direct payments 

If your care is being funded by the HSC trust, you can choose to receive this funding in the form of a direct payment. A direct payment is an amount of money the HSC trust gives to someone to spend on meeting their own eligible care and support needs. This is intended to give you greater choice and control over how your eligible needs are met. 

Direct payments can cover care costs or one-off items such as paying for a computer to help you to stay in touch with people who are important to you, but these must be things that you have been assessed as needing. The money will be paid into your bank account, and you will then need to keep a record of how the money has been spent. 

If someone has been able to consent to receiving direct payments but is not able to manage them because they lose the ability (known as ‘mental capacity’) to do so, then the trust may continue to make direct payments. This is only if an ‘authorised person’ is prepared to manage the payments instead. 

An authorised person must be prepared to manage the money and the care package on a day-to-day basis on behalf of the person and in their best interests. They must also have the legal authority to do so – for example, if they are the person’s attorney under an Enduring power of attorney.