What Is a Care Needs Assessment?
If someone you care about is struggling with everyday life, you may be told they need a care needs assessment. But what actually happens during one — and what should you do before and after it?
The short answer
A care needs assessment is an assessment of a person’s care and support needs. In England, the local authority uses it to understand what help a person may need and whether their needs meet the eligibility criteria under the Care Act 2014.
It is not simply a test of whether someone can wash, dress or cook. A good assessment considers the person’s circumstances, abilities, risks, existing support, wellbeing and the outcomes they want to achieve.
For families, it is an important opportunity to make sure the assessment reflects what actually happens at home.
Preparing for an assessment?
Start by writing down the things your relative struggles with, the help they receive and what happens when that help is not available.
Explore free Carentis resources →What does a care needs assessment look at?
The exact format varies between councils, but the assessment should build a picture of the person’s day-to-day needs rather than concentrating solely on diagnoses.
Personal care
Can the person manage:
- Washing and bathing
- Showering safely
- Dressing and undressing
- Using the toilet
- Continence care
- Getting in and out of bed
Mobility
Consider:
- Walking around the home
- Stairs and transfers
- Falls and near misses
- Walking aids
- Getting outside safely
- Whether supervision is required
Eating & drinking
The assessment may consider whether the person can:
- Prepare food
- Eat and drink safely
- Maintain adequate nutrition and hydration
- Use the kitchen safely
- Follow dietary requirements
Medication
Explain whether the person can:
- Remember medication
- Take the correct dose
- Understand their medication
- Order repeat prescriptions
- Manage medication safely
Memory & cognition
This can include:
- Memory and orientation
- Decision-making
- Awareness of risk
- Confusion or disorientation
- Getting lost
- Needing supervision
Communication
Consider whether the person can:
- Understand others
- Explain what they need
- Use the telephone
- Read information
- Communicate when something is wrong
Safety
Tell the assessor about risks such as:
- Falls
- Leaving appliances on
- Wandering or getting lost
- Unsafe use of the cooker
- Medication errors
- Being unable to respond to emergencies
Wellbeing & relationships
Care is not only about physical tasks. The assessment can also consider relationships, social activities, hobbies, independence, community involvement and the things that matter to the person.
What information should you give as a relative?
This is one of the most important parts of the process. Families often underestimate their relative’s needs because they have gradually adapted to providing more and more help.
Describe what actually happens
Instead of saying, “Mum can wash herself,” explain the circumstances.
For example: “Mum can physically wash herself, but she needs somebody nearby because she has fallen getting into the shower and needs prompting because she often forgets.”
Explain the difficult days
If needs fluctuate, explain how often this happens, what a typical day looks like, what a difficult day looks like and what support is needed.
Explain the care you already provide
Don’t allow substantial family care to disappear into the words “family support.”
Explain how often you visit, what you do, how long it takes and what would happen if you stopped doing it.
Give examples
Specific examples are often much more useful than general statements. Falls, missed medication, episodes of confusion, continence accidents, poor nutrition or unsafe behaviour can all help demonstrate the reality of someone’s needs.
What should you tell the assessor about family care?
If you are providing unpaid care, make sure the assessor understands exactly what that involves.
Daily visits
How often do you visit? How long do you stay? What do you do while you are there?
Practical support
Shopping, cooking, cleaning, appointments, transport, medication and personal care can all be relevant.
Overnight support
Does your relative wake during the night? Do you respond to calls, falls, confusion or other problems?
Supervision
Does someone need to remain nearby because of falls, confusion, wandering or another safety risk?
Emotional support
Does your relative need repeated reassurance, prompting or encouragement to manage everyday activities?
What happens without you?
This is often revealing. Explain what would happen if your existing support suddenly stopped.
Keep a short record before the assessment
You do not need to create a huge dossier. But keeping a simple record for a week or two can make the assessment much easier.
A few examples like this can be much easier to communicate than trying to remember everything during a conversation with a social worker.
Questions to ask during the assessment
“What needs have you identified?”
Ask the assessor to explain what they believe the person’s main care and support needs are.
“Which needs are eligible?”
Ask which needs meet the Care Act eligibility criteria and why.
“What support could meet those needs?”
This may include care at home, equipment, adaptations, community support or other services.
“What happens next?”
Find out who is responsible for the next step and when you should expect to hear from them.
“Can I have a copy?”
Ask for a copy of the completed assessment and the eligibility decision.
“Has our information been included?”
If you have provided important examples or evidence, make sure you know whether they have been recorded.
What happens after the assessment?
The assessment itself does not automatically mean that someone will receive a particular number of care hours or be offered a care home place.
Instead, the local authority uses the assessment to understand the person’s needs and determine whether they meet the relevant eligibility criteria. If eligible needs are identified and the person wants the council’s help to meet them, the next stage will normally involve planning how those needs will be met.
Read the assessment
Do not simply file it away. Check whether it accurately describes your relative’s circumstances.
Check for missing information
Look particularly for omitted risks, family support, night-time needs, fluctuating needs and significant incidents.
Understand the eligibility decision
Make sure you understand which needs the council considers eligible and the reasons for its decision.
Find out what happens next
This might involve a care and support plan, financial assessment, occupational therapy, equipment, home care or another service.
Challenge inaccuracies
If important information is wrong or missing, raise it with the social care team and ask how the assessment can be reviewed.
What about the financial assessment?
A care needs assessment and a financial assessment are different things.
Needs assessment
“What care and support does this person need?”
Financial assessment
“How much, if anything, should they contribute towards that care?”
Don’t assume that someone cannot have a care needs assessment because they have savings or own their home. The assessment of need is separate from the assessment of finances.
Could NHS Continuing Healthcare be relevant?
A local-authority care needs assessment is not the same thing as an NHS Continuing Healthcare assessment.
NHS Continuing Healthcare, usually called CHC, is a separate NHS funding pathway for people whose overall needs amount to a primary health need.
If your relative has significant or complex health needs, it may be worth understanding the CHC process and asking whether a Checklist assessment should be considered.
Could your relative need NHS Continuing Healthcare?
Carentis has practical resources to help families understand the CHC process, prepare evidence and understand what happens during the assessment.
Understand NHS Continuing Healthcare →What if your relative needs a care home?
A care needs assessment can be an important part of understanding whether someone can continue living safely at home or whether a different care arrangement needs to be considered.
But choosing a care home is a separate decision. The right home depends on the person’s actual needs, not simply their diagnosis.
What if the assessment says they don’t need care?
A decision that someone does not meet the council’s eligibility criteria does not necessarily mean that they have no difficulties.
Read the assessment carefully and look for anything that has been missed or inaccurately described.
If you believe the assessment is inaccurate, ask the council to review the information and explain how you can challenge the decision if necessary.
Useful Carentis resources
Your next step depends on what your relative’s assessment reveals. These Carentis resources can help you explore the areas that may matter most.
Care needs assessment: frequently asked questions
Does everyone have the right to a care needs assessment?
In England, local authorities have duties under the Care Act to assess adults who may have needs for care and support. The assessment is about identifying needs; it is separate from deciding whether the person will have to contribute financially towards their care.
Can a family member attend the assessment?
Families can often be involved, particularly where they have important information about the person’s day-to-day needs. If someone has substantial difficulty being involved in the assessment and there is nobody appropriate to support them, independent advocacy may need to be considered.
Should I talk about things that happen only occasionally?
Yes, if they are genuine and relevant. Explain how often they happen, what the consequences are and what support is required when they occur. The aim is an accurate picture, not an exaggerated one.
Should I mention the care I provide for free?
Absolutely. Explain what you do, how often you do it and what would happen if you could no longer provide it.
Does a care needs assessment mean someone will go into a care home?
No. A care needs assessment does not automatically mean residential care. Depending on the person’s needs and circumstances, support may be provided in their own home or through other services.
Is a care needs assessment the same as a CHC assessment?
No. A Care Act assessment is carried out by the local authority to assess care and support needs. NHS Continuing Healthcare is a separate NHS funding process based on the person’s overall healthcare needs.
The assessment is about the person — not just the diagnosis
The most useful thing you can do is help the assessor understand what life is really like for your relative: what they can manage, what they cannot, what support they already receive and what happens when that support is not there.
Be specific. Give examples. Don’t minimise the care you provide. And always read the assessment afterwards.
Explore Carentis Free Resources →