Assessment for care and support in England

2. Support for people with dementia: the care needs assessment

A local authority (also known as local council) has a duty to assess the care needs of a person with dementia. The assessment will determine what care needs they have, and whether the local authority will contribute towards meeting them. Any person has a right to this assessment, even if they will end up paying for their own care.

The process is called a ‘care needs assessment’. The aim is to work out exactly what the person’s needs are, and the level and type of care and support required to meet these needs. It will also help the local authority to decide whether or not someone is eligible for care and support funded by the council. Even if the person is not eligible, the care needs assessment may still be useful, as it might provide valuable information on the kind of care and support that is required, and which can be accessed through other options. A local authority cannot refuse to carry out an assessment because they think the person will not be eligible for funded care and support.

For more information about paying for care see ‘Financial assessments’ below, or factsheet 532, Paying for care and support in England.

Getting a care needs assessment

There are a number of ways someone can get an assessment. The person needing the assessment can request it themselves via their local authority’s social services department (this may be called different things in different areas, such as Adult services). To find out how to contact your local authority, see Other useful organisations. Alternatively, contact details should be on a Council tax bill or available at the GP surgery or local library. There are other people who can arrange the assessment on behalf of the person:

The person’s GP, consultant or another health or social care professional can make a referral to the local authority.

A carer or relative can contact the local authority asking for an assessment.

If the person is in hospital, a hospital social worker can make the referral.

If the assessment is requested on behalf of someone, the person making the referral must get the individual’s consent before contacting the local authority. Some people with dementia may lack the ability (mental capacity) to give this consent. For more information on this see factsheet 460, Mental Capacity Act 2005.

What to expect

A care needs assessment will usually involve a series of questions, often in the form of a discussion, which the person should be given in advance. They are designed to find out:

  • the person’s present arrangements for living and care
  • the person’s health and disabilities, and what they can and cannot do
  • the person’s concerns and thoughts, and how they would like to be supported
  • the concerns and thoughts of any carers.

Not all assessments are done face to face. It may be done through a self-assessment form: a questionnaire for the person to complete themselves. (This may also be done before a face-to-face assessment.) People with dementia can be assisted, for example by a social worker at home, when filling in self-assessment questionnaires, to ensure that all their needs are considered. Some local charities may also help with this.

Some local authorities may carry out phone assessments, but this is only appropriate when the person’s needs are not complex, or where the person is already known to the local authority and the assessment is a result of a change in needs. As people with dementia often have more complex needs, telephone assessments are generally not appropriate, and should not be used as the only method of assessing care needs.

Where the assessment takes place

A face-to-face assessment usually takes place in the person’s home. This gives a clearer picture of the care and support they need. If the assessment is arranged elsewhere, it should be somewhere convenient for the person and their carer.

Who carries out the assessment?

The local authority adult services department will carry out most assessments. This will normally be by a social worker. They may organise for other professionals to be involved if this is needed, for example the person’s doctor or a nurse.