This information is for people who support an adult over 18, in England, who has Down’s syndrome and who is having a Needs Assessment. It explains the framework of the assessment process, considers the eligibility criteria, and provides links to other sources of information.
Although it is not strictly necessary to plan ahead for the assessment meeting; as it is possible to work with the assessor on the day, many people find it helpful to gather this information beforehand. This information and the resources mentioned here will help you to do this.
The Care Act (2014) sets out the way local authorities must work when assessing and meeting the care and support needs of their local population. Local authorities must consider the person’s needs and the impact of these on their wellbeing. They must also consider the outcomes the person themselves wishes to achieve from their day-to-day life and whether the provision of support is necessary to enable them to meet these goals and maintain or improve their wellbeing.
The national eligibility criteria are a set of outcomes that all local authorities must use to determine whether people are eligible for care and support to be provided. To be eligible the person’s needs must meet the following three criteria:
- Their needs arise from or are related to a physical or mental impairment or illness (although this terminology is not how we would describe having a learning disability, a person with Down’s syndrome would be deemed to meet this criteria).
- The effect of their needs mean they are unable to achieve two or more of the following:
a) Managing and maintaining nutrition
b) Maintaining personal hygiene
c) Managing toilet needs
d) Being appropriately clothed
e) Being able to make use of the their home safely
f) Maintaining a habitable home environment
g) Developing and maintaining family or other personal relationships
h) Accessing and engaging in work, training, education or volunteering
i) Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services, and
j) Carrying out any caring responsibilities they have for a childA person would be regarded unable to meet these outcomes if they are unable to achieve them:
* Without assistance
* If achieving them would cause significant pain, distress or anxiety
* If achieving them would take significantly longer than would normally be expected
* If achieving them is likely to endanger their health or safety or that of others
- There is, or is likely to be, a significant impact on the person’s wellbeing.
Where an adult has fluctuating needs the local authority must take the person’s circumstances into account over such a period as it considers necessary to establish accurately the adult’s level of need.
Wellbeing relates to a person’s:
- Personal dignity (including treatment of the individual with respect)
- Physical and mental health and emotional wellbeing
- Protection from abuse and neglect
- Control over day to day life (including over care and support and how this is provided)
- Participation in work, education training or recreation
- Social and economic wellbeing
- Domestic, family, and personal relationships
- Suitability of living accommodation
- Contribution to society
The assessment should put the assessed person at the centre. This means their wishes and preferences should be sought and the outcomes they have for their own day-to-day life considered. As far as is possible the person should be involved with every stage of the assessment and support planning process.
By law the local authority must:
- Ensure the assessed person is able to participate as fully as possible in the process, including participation in decision making and care and support planning (this may be achieved through the support of a family member or friend or through the provision of an advocate).
- Take the view the individual is best placed to judge their own wellbeing.
- Take the persons views, wishes, feelings and beliefs into account.
- Consider the outcomes the person wishes to achieve in their everyday life.
- Consider how the person’s needs affect their wellbeing.
- Consider how the provision of information or support may prevent or delay further needs from developing.
- Consider the impact of the person’s needs on others involved in caring for them
Local authorities must also consider the Care and Support Statutory Guidance when assessing people’s needs and providing support and services. The guidance lays out how local authorities should go about assessing, planning and meeting people’s needs. You can access this guidance here.
In addition to the person’s own wishes, preferences and outcomes, it is important to provide evidence of the support the person needs on a day-to-day basis. It is therefore important to think through everything the person needs support with. Whilst it is natural to want to highlight the person’s strengths it is important to be honest about the things they need help with so they receive the right level of support.
To identify the things supporters do, it might help for them to think about what would happen if they were not able to fulfil their caring role and what would need to be organised to support the person they care for. Supporters may find it helpful to keep a diary of a week in the life of the person they support to capture the support that they and others provide to them.
Throughout the assessment process it is important to explain how the assessed person’s wellbeing is likely to be affected in the event they do not receive support to achieve the outcomes they wish/need to achieve under each of the eligibility criteria.
The local authority must take into account any relevant information that is provided to them when undertaking a Needs Assessment. It is advisable to provide evidence of the person’s needs and wishes in writing. In addition to any information the person being assessed provides, if they agree, information can come from:
- Family members
- Friends who know the person well
- Any relevant professionals, for example, the person’s GP, Nurse, Psychologist, Speech and Language Therapist etc.
Members of the DSA can purchase an assessment (for a person with Down’s syndrome) with our Clinical Psychologist. Assessment reports from this service can be used to provide evidence of a person’s social care needs. You can find out more about this service here.
Remember to collect all the information gathered from the person you are supporting and the relevant people (friends, family, and professionals) and provide this to the assessor during the face-to-face assessment. Remember to keep copies of this information.