Appendix 1
Quick guide to adult eligibility under the Care Act 2014
Eligibility threshold
The eligibility threshold for adults with care and support needs is set out in the Care and Support (Eligibility Criteria) Regulations 2015 (the `Eligibility Regulations`). The threshold is based on identifying how a person's needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing.
In considering whether an adult with care and support needs has eligible needs, local authorities must consider whether:
1. The adult's needs arise from or are related to a physical or mental impairment or illness
2. AND as a result of those needs the adult is unable to achieve 2 or more of the specified outcomes (which are described in the guidance below)
3. AND as a consequence of being unable to achieve these outcomes there is, or there is likely to be, a significant impact on the adult's wellbeing
An adult's needs are only eligible where they meet all 3 of these conditions.
Being unable to achieve an outcome includes any of the following circumstances, where the adult:
- is unable to achieve the outcome without assistance. This would include where an adult would be unable to do so even when assistance is provided. It also includes where the adult may need prompting for example, some adults may be physically able to wash but need reminding of the importance of personal hygiene
- is able to achieve the outcome without assistance but doing so causes the adult significant pain, distress or anxiety. For example, an older person with severe arthritis may be able to prepare a meal but doing so will leave them in severe pain and unable to eat the meal
- is able to achieve the outcome without assistance but doing so endangers or is likely to endanger the health or safety of the adult, or of others, for example, if the health or safety of another member of the family, including any child, could be endangered when an adult attempts to complete a task or an activity without relevant support
- is able to achieve the outcome without assistance but takes significantly longer than would normally be expected. For example, an adult with a physical disability is able to dress themselves in the morning, but it takes them a long time to do this, leaves them exhausted and prevents them from achieving other outcomes
Specified outcomes
These are the specified outcomes as outlined in the Care and Support (Eligibility Criteria) Regulations 2015 (the `Eligibility Regulations`). They are not in any priority order and are equally important:
- managing and maintaining nutrition
- maintaining personal hygiene
- managing toilet needs
- being appropriately clothed
- being able to make use of the home safely
- maintaining a habitable home environment
- developing and maintaining family or other personal relationships
- accessing and engaging in work, training, education, or volunteering, and
- making use of necessary facilities or services in the local community including public transport and recreational facilities or services, and
- carrying out any caring responsibilities the adult has for a child
The `wellbeing` principle
Promoting `wellbeing` means actively seeking improvements in:
- personal dignity
- physical and mental health and emotional wellbeing
- protection from abuse and neglect
- control over day-to-day life
- participation in work, education, training, or recreation
- social and economic wellbeing
- domestic, family, and personal relationships
- suitability of living accommodation
- the individual's contribution to society, and
Providing information and advice
Even if a person is not determined to be eligible for formal (funded) care and support, their needs and desired outcomes should be used as a basis to signpost them to information and advice about other informal sources of care and support available locally (e.g., clubs, activities, learning, voluntary/community sector services, through the Local Offer or other universal offerings). Consideration must be given to options that will prevent, reduce or delay any increase in need for care and support.