Care Needs Assessments and Financial Assessments

A care needs assessment is a conversation with your council about what help you need to live day to day, whether that is help with washing, dressing, meals, getting out, or support for someone who cares for you. It is the first step in getting any help from the council with care, whatever your income and savings, and it is free. If the council decides you qualify for support, it must work with you to put a care and support plan in place¹.

The assessment is separate from the money question. What you pay towards care is decided afterwards, by a financial assessment that looks at your income, such as pensions and benefits, and your capital, such as savings¹. In England, savings below £14,250 are not counted, savings above £23,250 mean you pay the full cost of care at home, and savings in between are treated as generating an assumed £1 a week of income for every £250 you hold⁴.

What a care needs assessment is and what it can lead to

A care needs assessment is an honest look at what you can and cannot do, and what would make life easier or safer. It is not a test you can pass or fail. The council looks at your personal circumstances, your health, your home and the people around you, and decides whether you are eligible for support under its rules. To get help from your local council, you must first ask for one².

If you qualify, the council must work with you to put a care and support plan in place, setting out what support you will get and how it will be arranged³. That plan is the foundation for everything that follows: the services themselves, and the financial assessment that works out your share of the cost. Any carers you have should be involved in planning the assessment, and their needs should also be considered when deciding what support you need⁴. Carers are entitled to a Carer's Assessment in their own right as well, which can be carried out at the same time or separately⁴.

The assessment can also lead to practical things beyond care services. If you need equipment to support your daily life, you can apply to your local authority for an assessment, and it may lead to free or cheap equipment for disabled people¹¹. In Northern Ireland, the Make the Call service will carry out a needs assessment based on your personal circumstances and also look at what benefits, supports and services may be available to you¹².

Everyone has the right to an assessment, whatever their finances

There is no income or savings test for the care needs assessment itself. To get any help from the council, regardless of your finances, you must first have a care needs assessment⁵. The council will not help with care costs until it has assessed your care needs¹. This matters even for people who expect to pay for their own care: circumstances change, savings run down, and an assessment already on record makes it easier to ask for council help later.

The same principle applies to carers. If you are 18 or over and you provide care for someone who is also over 18, you can ask your local council to carry out an assessment of your needs to find out if you are eligible for support¹³. As a carer, you have the right to have your own needs assessed by your local council¹⁴. The carer's assessment differs slightly across the UK, so if you live in Northern Ireland, Scotland or Wales, it is worth checking the guidance for your nation¹⁵.

One point to be aware of at the financial stage: the financial assessment will assume you are receiving all the benefits you are entitled to, even if you are not already claiming them⁶. Getting a benefits check before the financial assessment can therefore make a real difference to what you are asked to pay.

A care needs assessment is free of charge

The assessment itself costs nothing. Your local council's adult social services department will carry out a free assessment of your care needs⁶. In Northern Ireland, official guidance is equally plain: "This is free and can identify anything you may need help with."⁷

Free does not mean instant. There might be a wait before you get an assessment¹¹, so it is worth asking as early as possible rather than waiting for a crisis. What happens after the assessment may involve charges, but those are set by the separate financial assessment, not by the needs assessment, and the council must follow rules about how it carries that out. Local authorities have to make sure the way they do the financial assessment is clear, done in a reasonable time, and leaves you with enough to pay for your needs¹⁶.

How to ask your council for a care needs assessment

The first step in getting help from your council is to ask them for a care needs assessment¹. You contact the adult social services department of your local council directly. You do not need a referral from a doctor, although one can help: with your permission, your carer, GP or district nurse can refer you for an assessment on your behalf².

For carers, the route is the same: contact your local council's social services department to get a Carer's Assessment¹⁴. Someone else can make the request for you, giving their name and contact details¹⁷.

What to have ready when you ask:

• A description of what you struggle with day to day, and when
• Any health conditions and medication
• Who helps you now, including unpaid carers
• What you want the assessment to achieve

If you qualify for support following the assessment, the council must work with you on a care and support plan³. If you do not qualify, or you disagree with the outcome, you can ask the council to look again, and you can complain through its complaints procedure. At the financial stage, if you are not happy with the outcome of the financial assessment, you can ask for it to be reviewed³.

Assessments when you leave hospital

When someone is being discharged from hospital, a care needs assessment is carried out to work out what care services they may need once they are no longer in hospital². The hospital should do a needs assessment to estimate the level of care needed in order to manage safely at home after discharge⁴. Discharge from hospital should not happen until this assessment has taken place⁴.

The assessment is usually arranged by a hospital social worker or care manager, but your local council's social services should also be involved⁴. This is a moment when families need to be alert: discharge can happen quickly, and the assessment is the mechanism that decides what support is in place before you get home.

There are knock-on effects for carers' benefits. When the person being cared for comes out of hospital, a carer will need to reclaim Carer's Allowance or Carer Support Payment¹⁵. In Wales, leaving a care home or an institution such as hospital after a stay of three months or more to live independently is a qualifying circumstance for help through the Discretionary Assistance Fund¹⁹.

The financial assessment: working out what you pay

The financial assessment is a separate step that happens after the council decides you are eligible for support or care¹. Its purpose is to work out how much you will need to contribute towards the cost of the care services the council assesses you as needing⁶. Local authorities must carry out a financial assessment to decide how much to charge²⁰.

The financial assessment looks at two things:

• Income: pensions and benefits, and other money coming in⁶
• Capital: savings, and in some cases other assets⁶

For care at home, the value of your home is not included in the financial assessment³. The same applies for a short-term or temporary stay in a care home⁶. For a permanent care home move, the treatment of your home is different, and the financial assessment will look at how much capital you have and your income²¹.

Several deductions and exclusions soften the calculation. The financial assessment deducts household expenses such as rent, mortgage and Council Tax from your total income²². Certain types of income, such as money from certain disability benefits, may not be counted⁶. When the local authority has worked out what your income is, it must then assess what your living costs are²³. In Wales, how much you pay towards residential care is calculated from your eligible income, such as pensions or welfare benefits²⁰.

Two further rules matter. First, deprivation of assets: if the council thinks you have given away money or property to avoid paying care fees, it may still assess you as if you still had them⁶. The council will look at why and when you disposed of your assets, whether you could have known you would need care and support at the time, whether you expected to have to pay towards your care costs, and whether avoiding care costs was a significant motivation²⁴. Second, trusts: money in a disabled person's trust does not count towards income or savings limits for means testing, and discretionary trusts can also stop money and property counting in means testing for social care²⁵.

If you are not happy with the outcome of the financial assessment, you can ask the council to review it³.

Means test thresholds: £23,250 upper limit in England and Northern Ireland

In England, the means test works on two capital limits: £14,250 and £23,250⁸. Northern Ireland uses the same two figures⁸. Where your capital falls determines what happens:

For care at home in England, if your capital is below £23,250 your local authority contributes to your costs; otherwise you pay the full cost²². The financial assessment will not consider savings and capital below £14,250, which is the lower limit²². Between the two limits, you qualify for financial support from the council and pay a contribution from your income, plus the assumed tariff income on your savings²⁷.

The same £14,250 and £23,250 limits apply in Northern Ireland⁸. For permanent care home stays in England, the same capital bands apply, though the value of your home is treated differently from care at home, and there are special rules such as the 12-week property disregard. The details of care home charging are covered in paying for a care home.

Scotland and Wales: different capital limits

The financial assessment for care is different in England, Scotland and Wales, and it can be complicated²⁴. The capital limits are not the same across the nations:

Wales is unusual in having a single figure: a £50,000 capital limit at which the council begins to charge, with no separate lower limit⁸. In Scotland, the care home means test applies to capital between £22,000 and £35,500, and most capital between these amounts will be calculated as providing you with an income of £1 a week for every £250, or part of £250, that you have⁵. The financial assessment for care homes in Scotland looks at how much capital you have and your income²¹.

Scotland also has Free Personal and Nursing Care. Any adult who has been assessed as having needs that require nursing care, and who requires these services to be put in place, qualifies, and it does not matter what income or capital assets the person has, or whether they are married or in a civil partnership²⁸. In Scotland, if you are better off as a result of receiving personal or nursing care payments from the council, the upper capital limit for self-funding top-ups is £36,750²⁹.

In Scotland and Wales, what you pay towards any aids or adaptations you need will depend on your council's charging policy³. Nation-specific detail is in paying for care in England, Scotland, Wales and Northern Ireland.

Tariff income: £1 a week for every £250 over £14,250

Tariff income is the rule that treats savings as if they generated income, even though they sit in a bank account earning little. For every £250 over £14,250 you own, the council will consider you to have extra weekly income of £1¹⁶. The tariff income assumes you have an extra £1 per week in income for every £250, or part of £250, you have in capital between £14,250 and £23,250³⁰. So someone with savings in that band is charged as if those savings paid them £1 a week per £250, on top of their real income⁹.

A worked illustration: savings of £15,250 are £1,000 over the lower limit, so four lots of £250, which means £4 a week of assumed income. The council adds that to your actual income when working out your contribution. The rule applies between the two limits in England and Northern Ireland⁹, and in Scotland the same £1 per £250 rate applies to capital between the Scottish limits⁵.

The same idea appears elsewhere in the benefits system, which is why the figures can be confused:

The care tariff is less generous than the pension-age benefits tariff: care charging assumes £1 a week per £250, while Pension Credit and Housing Benefit for older people assume £1 a week per £500³¹. Someone sitting just above £14,250 in savings should expect the care means test to treat their capital more harshly than their benefits do.

Where to get free help

Several charities and official services will help you through this at no cost:

• Age UK publishes free information on care needs assessments, financial assessments and paying for care, and runs a national advice line¹.
• Independent Age offers free advice on paying for care services at home and in a care home, and on specific issues such as top-up fees and giving away assets³.
• Turn2us explains hospital discharge, carers' rights and help from the council, and runs a free benefits calculator⁴.
• Carers UK covers carer's assessments and, for Scotland, free personal care²⁸.
• Disability Rights UK and Scope publish factsheets on paying for non-residential care, equipment and trusts²².
• MoneyHelper, the government-backed money guidance service, and your council's own social services department are the first ports of call for a request.

If you disagree with a council decision about your assessment or charges, ask for a review first, then use the council's complaints procedure. Complaints about adult social care that cannot be resolved with the council can be taken to the Local Government and Social Care Ombudsman in England, or the Public Services Ombudsman in Wales. For benefits that interact with care costs, such as Carer's Allowance, the charity guidance above explains the claiming process.