Adult carers eligibility criteria

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About this service

The following information explains how we provide help, support and care to adults in need in Wiltshire.

Standards of service you can expect from us

How do I get help?

You can get help by contacting us, GP Surgery/Health Centre or Housing Department. They will either help you directly or, with your permission, contact the appropriate agency with your request for help.

You can also ask someone else to make contact on your behalf.

The National Health Service (NHS) and Community Care Act requires local Social and Health Services to ensure that support and care is provided to those in greatest need.

As we receive more requests for help than there is available funding to cover, we have to decide:

1. Who should get a service
2. In what order of priority
3. How services can best be provided
4. Whether we will provide the service ourselves or suggest another more appropriate organisation

This is to ensure that people in greatest need will get most help.

How do we decide who should get a service?

Services for user

When a person asks us for help, we make an assessment. This means that we talk to you to find out more about your situation and your care needs. Your need for services may be due to physical disability or impairment, mental health problems or environmental or social factors. The more complex your needs, the more detailed your assessment will need to be.

Services for carer

If you are a carer and provide substantial and regular amounts of care to the person you look after, you are eligible for an assessment of your own care needs in relation to the person(s) you care for. As a carer, you may be able to access services provided through the Carers Special Grant.

If outside of your role as a carer, you meet the Eligibility Criteria, you are entitled to receive services in your own right.

Who is eligible for an assessment?

You are normally eligible for an assessment if you:

• have a physical impairment
• have a sensory loss
• have a terminal illness
• are developing confusion/dementia
• are frail
• are vulnerable to the risk of neglect or abuse
• have a learning disability
• have a severe mental illness
• are a carer

Your assessment can include us contacting anyone (e.g. your carer, members of your family, friends or doctor) you feel would be helpful in deciding what your needs are. We will always obtain your agreement before contacting others unless, by doing so, someone will be placed at risk of harm or abuse.

When we have completed your assessment, we will decide if you have needs that meet our Eligibility Criteria and the priority of meeting your needs. If you are not offered a service, we will be able to give you information and advice about alternative services.

A summary of your assessment will be written down. We will then agree a Care Plan and a copy will be given to you. Your Care Plan will explain how, and by whom, your care and support will be provided.

The Care Plan will continue to be reviewed with you, to make sure it still meets your needs and that you are still eligible for services. Your first review will be within three months of help first being provided or when major changes have been made to your current service. After that, you will have an annual review unless you feel there is a change in your circumstances and request an earlier review.

If we provide community care services to you, we will ask for information on your financial circumstances in order for us to tell you if, and how much, you will have to pay towards the cost of the services (see leaflet S1 - Your Contribution Towards Services).

What is our Eligibility Criteria?

Our Eligibility Criteria is divided into four bands:

1. Critical
2. Substantial
3. Moderate
4. Low

At least one of the risks in each band must apply to you and your care/support arrangements have broken down or about to break down.

CRITICAL - risk to independence

Harm or danger may occur in the next few days

• Life is and/or could be threatened
• Major health problems have developed and/or are likely to develop
• Serious forms of abuse or neglect have occurred or are likely to develop
• There is, or could be, an extensive loss of choice and control over vital aspects of the immediate environment.
• There is, or could be, an inability to carry out essential personal care, domestic, family or other daily routines.
• Vital social support systems and relationships are, or could be, at great risk.
• Individuals cannot undertake, or will be unlikely to be able to undertake, vital family and social roles and responsibilities that are important to them and others.
• Critical risk to your carers' ability to sustain any of the essential/critical aspects of their caring role

SUBSTANTIAL - risk to independence

Harm or danger may occur either now or in the next three months

• There is, or could be, some substantial loss of choice and control over the immediate environment.
• Involvement in some substantial aspects of work, education or learning is, or could be, at risk of not being sustained, causing substantial risks to your independence.
• There is, or could be, an inability to carry out some personal care, domestic or other daily routines, causing substantial risk to your independence.
• Some substantial social support systems and relationships are, or could be, at risk.
• Individuals cannot undertake, or will be unlikely to be, able to undertake, some substantial family and social roles and responsibilities that are important to them and others.
• Substantial risk to your carers' ability to sustain some key aspects of their caring role
• Substantial health problems have developed, or are likely to develop.
• Involvement in work, education or learning is, or could be, at great risk of not being sustained, causing a major loss of independence.

MODERATE - risk to independence

Either now or in the next twelve months

• Several aspects of work, education or learning are, or could be, at risk of not being sustained, causing a degree of risk to your independence.
• There is, or could be, some inability to carry out several daily routines, causing a level of risk to your independence.
• Several social support systems and relationships are, or could be, at risk.
• Individuals cannot undertake or will be unlikely to be able to undertake, several family and social roles and responsibilities, leading to a level of risk to your independence.
• Moderate risk to your carers' ability to sustain some aspects of their caring role

LOW - risk to independence

Harm or danger may occur

• There is, or could be, some inability to carry out one or two personal care or daily routines.
• One or two social support systems and relationships are, or could be, at risk of not being sustained.
• Individuals cannot undertake, or will be unlikely to be able to undertake, one or two family and social roles and responsibilities.
• Low risk to your carers' ability to sustain some aspects of their caring role

At present a person is only eligible for community care services if their needs are Critical or Substantial and their wellbeing would be at risk without a commissioned service being delivered to meet their needs. If existing local community services could be engaged which meet their need, and did not place them at risk, then this would be the preferred option. If a person's needs are assessed as Moderate or Low they will not normally be eligible for directly provided community care services.

If a person is not eligible for services, information will be provided about other agencies who provide advice and support services.

What if my circumstances change?

You can contact the Department of Community Services, your GP or another visiting professional to let them know of the changes in your circumstances. They will, with your permission, make contact with the relevant person who can help you.

What do I do if I am unhappy with what is decided?

If you find our services to be useful, or if you feel we could improve them, let us know. If you are unhappy or worried about your situation, tell someone you feel might be able to help you. The person you have been in contact with in the Department of Community Services, or their Manager, are often best placed to help you. If we cannot sort out the problem at your local Department of Community Services office, then we do have a complaints procedure. Ask for a copy of our leaflet Compliments, Comments and Complaints.

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Last updated: 14 January 2010