Your guide to a carer's assessment

Carers have a legal right to an assessment of their needs.  The purpose of a carer's assessment is for you as a carer to discuss with social services what help you need with caring as well as any help that would maintain your own health, and balance caring with other aspects of your life such as work and family commitments.  Social services use the assessment to decide what help to provide.

Carers Wales has a bi-lingual booklet "How do I get help?" which explains how to get an assessment and and tells you about services to help you care.  Contact us on info@carerswales.org or ring 029 2081 1370 for your copy.  One copy is free to carers.

The Wales Carers Alliance has done a survey into the quantity and quality of carers' assessments in Wales. Click here to see the results of the survey

Here are some common questions carers ask us about assessments:

Do I qualify for a carer's assessment?

The law says you have a right to an assessment if you look after a friend or relative who cannot manage without your help.

If you are aged over 16, your right to an assessment is not affected even if the person you care for does not want to receive help from social services.

You also have a right to an assessment if you intend to look after someone.  This is important, for example, if your friend or relative is in hospital and you expect to look after them when they come back home (See Coming out of hospital).  If you look after a disabled child you also have a right to an assessment. You do not necessarily have to be the child's mother or father, but have parental responsibility for the child.

Unfortunately, not all professionals are aware of carers' right to an assessment and some carers are wrongly told that they are not entitled to one.  If this happens to you and you believe you are entitled to an assessment, you should put in writing your request and ask why they are refusing you an assessment.  You should seek advice from a local carer's organisation or Citizen Advice Bureau (For contact details visit Finding Help).

What is the purpose of a carer's assessment?

The purpose of a carer's assessment is for you to discuss with social services what help you need with caring as well as any help that would maintain your own health and balance caring with other aspects of your life such as work and family commitments.  Social services use the assessment to decide what help to provide. The range of help available is discussed in What help is available.

The social worker or person carrying out the assessment should not assume you want to take on a caring role or continue caring.  They should ask whether you are able and willing to carry out the range of tasks involved in your caring role.  For instance, you may be finding it harder to move someone in a wheelcair because of your own health problems or you may be finding it hard to cope because the behaviour of the person you look after is becoming more challenging and causing you stress.  You still care about the person you look after, but you may no longer be able to care for them.

As well as looking at the help you need to look after someone, the assessment can be useful to

• explore how you feel about caring with a professional - someone who is not part of the family or close to you.
• provide you with information on benefits and support such as carers groups.
• explore whether you want to stay in work or return to work and how to make this happen.
• look at how caring may affect you in the future and what help you might need.

How do I get an assessment?

You can ask for a carer's assessment from your social services department.  The telephone number and address of the social services department will be listed in the phone book under the name of your local authority.  You can ask your GP or district nurse to contact social services on your behalf.  We have provided a sample letter to ask social services for an assessment. This can be downloaded at the bottom of the page.

If the person you look after is in hospital, speak to a nurse and ask to be put in touch with a hospital social worker.

Is there anything I can do to help me prepare for my assessment?

Many carers find it hard to think what is involved in caring - it is part of everyday life, part and parcel of the relationship with the person they look after. It is particularly hard to pinpoint what is involved in looking after someone with mental health needs.

If at all possible, talk to the person you look after before you call social services, and agree what points you want to raise.  Both of you will be involved in the assessment.  If there are aspects of your situation which you would rather discuss in private with a social worker, you are entitled to ask for a separate assessment on your own, in private.

If either you or the person you care for has difficulty communicating you should let social services know ? they will provide help.

You may find this checklist useful to help you prepare for your assessment and get the most out of it. 

Housing

• Do you and the person you care for live together or apart?  Is this arrangement satisfactory eg long distance caring?  If not, what changes are needed?
• Does the person you look afer have any difficulty moving about in the home? (For example, can they climb the stairs, or have a bath on their own?  special equipment (aids or adaptations to your home) could make life easier for the person you look after and caring easier for you.

Health

• Does the person you look after have any health problems you find hard to deal with? 
• Are you getting enough sleep?
• Do you have any health problems?  Are you stressed, anxious or depressed?

Work

• Are you struggling to combine work and caring?
• Have you had to reduce your hours of work?
• Would you like to return to work?

Other interests

• Do you want to do any training or adult education?
• Do you want to pursue any leisure interests but are prevented from by your caring role?

Time

• How many hours a week do you care? (Include all the time you spend with the person you care for, the things you do for them and how long they take you - the answer may surprise you!)
• Do you have to help with:
• Housework?
• Shopping?
• Extra laundry?
• Bathing?
• Toiletting?
• Cooking?
• Other personal care (like dressing)?
• Keeping an eye on them so they do not come to any harm?
• Dealing with money (cashing pensions, etc)?
• Helping the person take medications?
• Keeping them company - sitting with them to stop them becoming anxious, going to the shops with them, accompanying them to hospital outpatients?
• Do you have to help during the day, or night, or both?
• Does anyone else help?  If so, who and for how long?
• Would you like some help (or some extra help) with these jobs?
• List the tasks you would most like some help with, putting the most important first.
• Are there things that you find enjoyable and relaxing which you can?t do any more because of your caring responsibilities? (For example, you may have given up a hobby or you may want to visit friends, or miss going to the cinema)
• When was the last time you had a whole day to yourself to do as you pleased?

Feelings

• Do you feel that you don?t have a choice about providing care? (You may feel that you cannot carry on at all, or only if you reduce the amount that you do. It is not unusual to feel that way. Tell the social worker about these feelings.)
• What would you most like to change about your situation?

Relationships

• Is caring having an impact on your relationships, either with the person you look after or other members of the family, friends etc?
• If you are a parent, is caring making this role harder?  Do you feel you have time for your children?

Dealing with emergencies and unplanned events.

• Do you need help to plan what needs to happen should you suddenly become ill or have an emergency?
• Do you know who to contact in an emergency?

The future

• Are you concerned at all about the future for you and the person you care for?

What will happen at the assessment?

Normally one person usually a social worker or other social services staff will carry out the assessment.  But a meeting may be needed with your GP or nurse as well if a lot of care is needed. You can ask to talk confidentially to the person carrying out the assessment without the person you are caring for being present.

The quality of carers' assessments varies enormously, with some workers having a very good understanding of how to help carers, but this is not always the case.  Make sure the social worker is aware of as much information about your situation (see Preparing for an assessment checklist above).  You are entitled to have a friend or advocate present at the assessment. 

If for any reason you feel certain aspects of your caring role were not fully covered during your assessment, you may wish to contact the social worker and arrange a follow up visit.  This is quite common - people's lives are often complex and it can be emotionally difficult to talk about what can be difficult issues regarding close relationships.

The social worker should explore with you the kind of help and services which will help you to look after the person you care for.  Social services can provide help and support directly to you, or provide help directly to the person you are looking after.  This is covered in What help is available?

If your caring situation is likely to continue for at least the foreseeable future, the social worker should set a date to review your needs and see if the help provided is working out.  This is usually at least on an annual basis and a shorter time if, for example, you are new to caring and your situation is complex.

What will happen after the assessment?

It is important that you are able to make an informed choice about how much you do or want to take on in the future as a carer. When social services decide what help and services to provide they have to take into account the results of both your carer’s assessment and the community care assessment of the person you care for.  They will summarise this in a care plan for the person you look after – a copy will be given to both of you.

Local authorities are required to set out how they make decisions about whether or not to provide services.  These are termed eligibility criteria.  The needs identified in the assessments are compared against their eligibility criteria.  If the needs of the person that you look after match these eligibility criteria, the local authority must provide services to meet their needs. You can obtain a copy of their eligibility criteria by phoning your local authority and asking for their Better Care, Higher Standards Charter.

Social services are only required to meet the needs that no-one else is willing to meet.  It is important  that if you are unable or unwilling to provide care or any aspect of caring, that this should be taken into account by the local authority when deciding what services to provide.  For example, you may be willing to provide the bulk of the care as long as you get a regular break or services to fit around your job. Try to be clear about what level of care you can manage.  If you feel under pressure to accept inadequate services, seek advice from a carer support service or Citizens Advice Bureau or ring CarersLine 0808 808 7777.  

Social services cannot refuse to meet a need they have identified solely on the basis that they do not have the money or other resources.

The person that you look after can refuse help from social services.  This may leave you as a carer with very little or no support.  If this is the case, it is important that the local authority should consider other areas of support  which may ease some of the pressures of caring.  For instance, help with cleaning your own house or washing could benefit you.  Taxi fares may assist you to get to hospital appointments or help get you to work on time.  A mobile phone could help you keep in touch and give you peace of mind.  These services are examples of carers' services which will be provided to you rather than the person you care for.

Social services must make it clear which services are for you and which are for the person you are looking after.

What happens if I am not satisfied with the outcome?

You may be unhappy with how your assessment was carried out.  You may be dissatisfied with the decision about what services will be provided to you and the person you look after.  Advice centres like the Citizens Advice Bureau or a disability organisation can help you make a complaint or give you details of lawyers able to advise on community care law.

Social services have a procedure for dealing with concerns and complaints which fall into three stages.  Read our Guide to challenging decisions and making a complaint.