Assessment for care and support in England

4. Support for carers: carers' assessments

Anyone who cares for a person with dementia is also entitled to an assessment of their needs as a carer. This is called a carer's assessment. The aim is to work out exactly what the carer's needs are, and the level and type of support required to meet these needs.

If the carer fulfils certain eligibility criteria, the local authority will pay for these needs to be met. Again, even if a carer is self-funding (paying for their own care), a carer's assessment can help to work out what care and support they might need, and the local authority should not refuse to carry out a carer's assessment because they think the carer will not be eligible for funded support.

Often a carer's assessment is done at the same time as a care needs assessment for the person with dementia. This can be helpful, as the support needs for a carer might be best met by services that are actually provided to the person they care for. For example, replacement (respite) care or short breaks may be provided to the person with dementia and this enables the carer to have a break (and the person with dementia to have a break from their carer). Carers are entitled to a carer's assessment even if the person with dementia refuses an assessment, or does not want care or support.

Accessing a carer's assessment

A carer can request a carer's assessment directly from their local authority's social services department. There are other ways this may be arranged:

  • as part of a care needs assessment for the person they care for
  • a referral from a health or social care professional
  • a referral from a relative.

If someone makes the referral for a carer, they must seek the carer's consent. For a carer's assessment to be carried out, the carer must agree to it.

What to expect

What to expect from a carer's assessment may depend upon how it has been arranged. For example, if it is carried out at the same time as a care needs assessment, it is likely to be in the home of the person getting the care needs assessment - the two assessments will be linked. Alternatively, the carer's assessment may be separate from the care needs assessment of the person with dementia, or the person with dementia may not be having an assessment themselves. In this case the assessment should take place somewhere that is convenient for the carer, for example in their own home. They should be given the list of assessment questions in advance; this can help carers to prepare.

The assessment will usually be carried out by a social worker. It may involve other health professionals, such as a GP if appropriate, but the social worker will arrange this if it is needed. It usually involves a series of questions. The carer will have the opportunity to outline the care and support they provide, and also what help and support they themselves would like. This information may be gathered through a self-assessment form.

Preparing for a carer's assessment: tips for carers

If you are caring for a person with dementia and you are preparing for a carer's assessment, there are a number of things you can do to help you prepare:

  • Look over the assessment questions, which you should be given in advance, and think about or write down your answers.
  • Write a list of the care and support that you provide to the person, including when, where and for how long. Include any time that you might spend checking that things are ok or being 'on call' in case of problems or because you are worried.
  • Keep a diary for a few weeks detailing all the tasks that you do to support the person - include things that are involved in this, such as making several bus journeys across town or having to do a daily shop. Make a note of how your caring role may be difficult at times - possibly making you feel depressed or tearful.
  • Take note of the things that you are unable to do as a result of caring, for example cleaning your home, childcare responsibilities, work or education, or even maintaining social activities.
  • Think about and list what support would help you in your role. This may be care for the person you care for so you can have a break, or it could be some specific help for you, such as training or having some equipment, eg a tumble dryer, or items such as driving lessons so you would no longer need to use public transport.
  • Think about what support you may need in the future as the person's condition progresses.

During a carer's assessment: tips for carers

  • Be open and honest. This may be difficult, but for the assessment to work the person carrying out the assessment needs to understand your situation.
  • If necessary, ask to speak to the assessor without the person you care for being present.
  • Tell the assessor what outcome you would like from the assessment, for example you would like to know that the person you care for is clean and comfortable when you are not there.

Eligible care needs

Local authorities will only provide care and support to carers who meet certain eligibility and financial criteria. They can only consider this once the assessment has been concluded. 

An eligible care need is the level of need that a carer must have for the local authority to be responsible for that care, and therefore fund it. As with needs assessments, there are now national eligibility criteria that show the level of support required for a carer to be eligible. These are summarised in the box opposite.

If a carer is told that they are not eligible as they do not meet these criteria, but they feel that they do, they will need to put in a complaint (see 'Complaints' below). They should outline why they believe their needs do meet the criteria.