To achieve this, money which had been used by the DSS to pay for people in residential care was passed over in 1993 to social service departments, so they could provide more help for people in their own homes. The object was that fewer people would need to go into residential care because there would be a greater range of care in the community, and the local authority would act as a gatekeeper for such care.

Assessment of a person’s needs is seen as fundamental as this triggers the provision of services either directly from the local authority or arranged by them from the independent sector, at home or in residential or nursing homes (called collectively, residential care). Local authorities have the lead role in this, but both health authorities (boards in Scotland) and housingrtments are recognised as key players in helping someone remain at home. There is a duty on local authorities to invite these agencies to assist in the assessment where there is a health or housing need.

For Information on the Fairer Charging Policies for Home Care and other
non-residential Social Services starting in 2002 see http://www.doh.gov.uk/scg/homecarecharges

Health care and social care:

Because there is no obvious dividing line between what is a social care need and what is a health need, it is often an area of dispute. More so as most health care is free at the point of delivery, whereas people are increasingly being charged for social care.

Health authorities can decide not to provide services where they consider such services are not reasonably required, and can take into account there own resources in deciding what services to provide. Local authorities can provide health services where they may reasonably be considered to be part of a ‘social services package’ for an individual. Health services which go beyond this remain the responsibility of the health authority, and this is a matter of the scale and type of service required.

It is largely left to health authorities to agree their policy and eligibility criteria with the local authority. There is guidance to clarify the NHS responsibilities for meeting continuing care needs (new guidance is expected in the near future).

Each health authority has to publish its policies, plans and eligibility criteria for meeting continuing health care needs in its area. What is provided by the health authority and therefore free will vary from area to area. Likewise, each local authority has to publish its community care plans, and must have a Community Care Charter publicly available which sets out their standards of service. In England these will be replaced by Long Term Care Charters in June 2000.

In law there is no single piece of legislation which covers community care, but a complex web of Acts, Regulations, directions and guidance going back to the National Assistance Act 1948.

Where to go for help?:

Go to the local area office of the social services department. In Scotland, it is the social work department. For help with housing you may be passed on to your local housing department.. The social services department has the lead responsibility for assessing your needs and ensuring that services are provided to meet the assessed needs. Social services should involve the housing department and the health authority where there is a need for their services.

Although occasionally a health authority may undertake the community care assessment at the request of social services, the social service department is always the place to start.

If you already have a social worker, discuss your needs with them. Otherwise, look up the address of your nearest office in the phone book under the name of your local authority. For example, look up ‘Essex County Council’ and find the heading ‘Social Services Department, Area Office’. If you outline the type of help you want, they can put you through to the right section. Your health visitor or occupational therapist may also be able to help arrange for the services you need.

Caring Matters
http://www.caringmatters.dial.pipex.com/
Provide information about the rights, responsibilities, and resources for people whose lives are touched by long term care. Legal and financial matters related to mental incapacity are their speciality.

Assessment of needs:

Basically, if you have difficulty managing at home because of your age, illness or disability, you can ask for an assessment. If it is apparent to the local authority that you might have a need for services, then you should not have to ask for it. However it is not only disabled people who can get an assessment from the local authority.

The assessment should look at the whole range of community care services, your capabilities and incapacities, your preferences and aspirations, what support you have available and other sources of help. Some local authorities ’screen’ people by asking a few questions over the phone. Others have decided to carry out assessments in limited circumstances, for example only assessing a person at ’severe physical risk’. However, the decision to provide a care assessment is separate from a decision about whether to provide services. Even if the local authority, because of its resource constraints, is unlikely to provide a service, you should not be denied an assessment.

In order to decide whether a person’s needs for service is great enough to actually receive it , authorities draw up a general list of ‘eligibility criteria’, ie the criteria which must be present in any particular case before a person is considered eligible for services. Local authorities produce information about their assessment procedures and their ‘eligibility criteria’ and it may be useful for you to refer to this.

Guidance states that you should be informed in writing of the result of your assessment. If your needs are urgent, services can be provided before an assessment takes place. It should then be carried out as soon as possible.

If you are refused an assessment, or feel it has not taken account of your needs, or there is a delay in carrying it out, you can use a complaints procedure or seek legal advice if it is very urgent (see ‘If you are not satisfied with your care services’).

How can you register as disabled?:

Anyone whose disability is ‘substantial and permanent’ can register with their local authority. But you don’t have to register in order to qualify for an assessment or for services. The requirement to keep registers only applies to England and Wales. This section does not apply in Scotland.

To register, contact the area office of your local social service department. They will arrange for someone, usually a social worker or occupational therapist, to visit you and complete a registration form. Registering may not have any immediate benefit, but it is a useful thing to do. The more accurately the register reflects the number of disabled people in the community, the better services can be tailored to meet their needs.

Some local authorities may automatically register you when you apply for help from them. In some cases, the authority will send you a card confirming your registration and all should give you information on the services available to disabled people. Other authorities give no written confirmation.

What help can be provided?:

Local authorities have various duties and powers to provide services. Certain services must be provided by the local authority. There is a legal duty to do so. Other services may be provided but there is no requirement to do so.