Paying for care in Wales

5. Needs assessment

The local authority has a duty to carry out an assessment of a person’s care and support needs. These are needs in relation to the based on outcomes they want to achieve and the things that are important to them. This is sometimes known as a ‘needs assessment’ The local authority uses it to decide whether the person is eligible for support. If so, the person is considered to have eligible care needs. The Social Services and Wellbeing (Wales) Act 2014 introduced a new national threshold for eligibility. For more information see Assessment for care and support in Wales.

The local authority will then talk to the person (and carer or independent advocate, where appropriate). Together they produce a care and support plan, to work out how the person’s needs will be met. After that, they will consider whether the person is eligible for financial support to meet their needs. The local authority cannot refuse to assess a person just because they appear to have enough money to pay for their own care (see ‘Care home fees for self-funders’ below).

Direct payments

If a person’s care is funded by the local authority, they may choose to receive this funding in the form of 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. Direct payments allow people to make their own choices about their care and support.

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 these see factsheet 473, Personal budgets. This mainly deals with the system in place in England, but the information on direct payments is still relevant for Wales.

Informal advocacy from family members, friends of volunteers can be a good source of support for some people with dementia. However, there will be occasions when this support is not available and formal or independent professional advocacy will be needed.