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Eligibility criteria

The Care Act introduces a national eligibility threshold for care and support. The eligibility threshold consists of three criteria, all of which must be met. The eligibility threshold for service users is based on identifying:

1. whether a person’s needs are due to a physical or mental impairment or illness; and
2. whether those needs mean that the person is unable to achieve two or more specified outcomes; and
3. as a consequence whether there is, or is likely to be, a significant impact on the person’s wellbeing.

There is also a new national eligibility threshold for carers.

The carer’s eligibility threshold is based on the three following conditions;

1. their needs are a consequence of providing necessary care for an adult;
2. those needs mean that they are unable to achieve specified outcomes, or puts their health at risk; and
3. as a consequence this has a significant impact on their wellbeing. All of these conditions must be met for a carer to be eligible.

Changes made by the Care Act 2014

The new eligibility threshold replaces the Fair Access to Care (FACS) guidance.

All councils must comply with this national threshold. The Government’s intention is that people whose needs would be ‘Substantial’ or ‘Critical’ under FACS would meet the new threshold.

For someone to have eligible needs there are three eligibility tests that must be met:

  1. whether the needs are due to a physical or mental impairment or illness and are not caused by other circumstances. This includes conditions such as physical, mental, sensory, learning or cognitive disabilities or illnesses, brain injuries and substance misuse. A formal diagnosis of a medical condition is not required; and
  2. whether the person is unable to achieve two or more of the following specified outcomes:

  • Managing and maintaining nutrition
  • Maintaining personal hygiene
  • Managing toilet needs
  • Being appropriately clothed
  • Being able to make use of the adult’s home safely
  • Maintaining a habitable home environment
  • Developing and maintaining family or other personal relationships
  • Accessing and engaging in work, training, education or volunteering
  • Making use of necessary facilities or services in the local community including public transport and recreational facilities or services
  • Carrying out any caring responsibilities the adult has for a child; and

      3. whether as a consequence of being unable to achieve two or more of the specified outcomes there is, or is likely to be, a significant impact on the person’s wellbeing.

Wellbeing is defined in Section 1 of the Care Act as relating to any of the following:

  • personal dignity (including treatment of the individual with respect)
  • physical and mental health and emotional wellbeing
  • protection from abuse and neglect
  • control by the individual over day-to-day life (including over care and support provided and the way it is provided)
  • participation in work, education, training or recreation
  • social and economic wellbeing g. domestic, family and personal relationships
  • suitability of living accommodation
  • the individual’s contribution to society.

Significant impact is not defined in the Act, Regulations or Guidance, so the decision relies on professional judgement. The local authority must produce a written record for the individual stating whether any of the individual’s needs meet the eligibility criteria, and the reasons why they do or why they do not.

Where the individual does not have eligible needs, the local authority must also provide:

  • information and advice on what support might be available in the wider community; or
  • what preventative measures might be taken to prevent or delay the individual’s situation deteriorating

for further information on the Care Act 2014, see Section 13 in the links to the right

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Page last reviewed: 02/05/2017

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