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NHS and Community Care Act 1990

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Introduction

The main purpose of this act was to expand the State’s duties from those of a supplier of health and social care provisions to those of an enabler. As a result, it imposed a duty on local authorities to assess people for social care and support – to ensure that individuals who need community care services or other types of support get the services they are entitled to.

Note that the purpose of this act is to ensure that social care needs are assessed by the local authorities. Although this assessment is the first step in receiving any social care, this page does not deal with the provision of said care.

Social Care vs Healthcare

As it stands, there is no legal definitions for “social care” or “healthcare”. The NHS however produces guidance in an attempt to distinguish healthcare from social care. This distinction can be important because while healthcare is provided by the NHS; free of any charge, social care is provided by local authorities who may charge for their services.

  • Social Care
    • Social care services can broadly be defined as help and support clients practically (as opposed to medically) need due to their age, illness or disability. It therefore focuses on assistance with:
      1. the activities of daily living
      2. maintaining independence
  • social interaction
    1. enabling the individual to play a fuller part in society
    2. protecting them in vulnerable situations
    3. helping them to manage complex relationships
  • accessing a care home or other supported accommodation.
  • Healthcare
    • Healthcare is focussed on the medical treatment, control or prevention of illness, injury, disease or disability and the aftercare needed following treatment.

What are Clients entitled to?

  • Duty to Provide Needs Assessment:
    • Any adult, aged 18 or above, is entitled to have their needs fully assessed if it appears they are eligible for services which the Local Authority must provide.
    • They are also entitled to have those services tailored to their individual needs based on this assessment.
    • Individuals being assessed have a full right to be involved in said assessment.
    • The Local Authority must have regard to the results of the assessment and must individualise the services they provide to their needs when practicable.
    • The Local Authority must allocate a Case Manager to be responsible for the execution needs assessment and providing a care plan if necessary.
    • The Local Authority must ensure that all care plans are assessed every year.
    • The Local Authority may charge for the services provided following a financial assessment unless the individual is exempt based on income or mental capacity. They CANNOT however charge an individual for carrying out a needs assessment under any circumstance.
    • Local Authority resources can be taken into account during the assessment process, but if it is deemed that services are required, those services must be provided by law and services cannot be withdrawn at a later date if resources become limited.
  • Local Authority Services Include:
    • Disability equipment and adaptations to your home
    • Home care help with things like cleaning and shopping
    • Day centres to give you or the person who cares for you a break
    • Day care for your child
    • Help with parenting, such as parenting classes
    • Care homes
  • Working Example
    • X is contacted by the local council because of he has not been paying council tax. X explains to the local council that he has been unable to care for himself or work due to mental health struggles. Although the department which handles council taxes is separate from the social care department, the fact that the local authority were informed that X may need social care support would trigger their duty to assess him.

Summary of Eligibility Criteria

  • To summarise, a local authority is under a legal duty to assess the needs of the client if they are:
    1. An adult (18 or above)
    2. It appears that the client may have a need for social care and support (defined in section 2.1)
  • Please note that the Local Authority are discharged from their duty to provide a needs assessment if the client refuses to be assessed.

How do Clients initiate an assessment?

  • There are three main ways to initiate an assessment:
    1. Referral from a third party – A needs assessment may be initiated by a third party adult who informs the relevant local authority because they believe the client is in need of care and support. This can be done by St Mungos support workers or volunteers.
    2. Referral from the client – The client themselves can initiate a needs assessment by contacting the Local Authority by phone or online. Clients can find the relevant local authorities’ contact details for a needs assessment on the following link: https://www.gov.uk/apply-needs-assessment-social-services
    3. Referral from Medical Institution or Professional – Alternatively, an individual may ask their GP about getting an assessment or if an individual is in the hospital, he/she may ask the social work team in said hospital for a referral.

When can a new assessment be triggered?

A new assessment can be triggered by a change in need or in circumstance. This means that if an individual’s impairment deteriorates such that they might require additional social care, the Local Authority will be under a new duty to assess said individual’s care needs.

Timescale for Assessment

There is no official timeframe for how long the assessment process will last however practice shows that an assessment should not take longer than 6 weeks unless the case is particularly complex.

Can an assessment be refused?

The Local Authority is under a duty to assess even if they believe that the client is not eligible for social care. Their duty arises simply if an individual may need social care.

What can Clients do if they are not satisfied with the assessment?

  • If a client feels that they are being deprived of their rights or they are not satisfied with the conclusions or methodology of the needs assessment, they should take the following steps:
    • Clients must speak to the Social Work Department of the their Local Authority and express their concerns and dissatisfaction.
    • If the problem is not resolved, clients should use the official complaints procedure of the relevant Local Authority. The official complaints procedures of each Local Authority may be found on the following link: https://www.gov.uk/complain-about-your-council.
    • If the client is still not happy with the Local Authority’s response to the official complaint, they should submit a complaint to the Local Government Ombudsman. This can be done by registering with their website and completing the online form. The online form and registration can be found on the following link: https://complaints.lgo.org.uk/.
    • For those who do not have easy access to the internet, they can contact the Legal Government Ombudsman hotline to submit an official complaint or receive general advice. The hotline is available Monday to Friday from 10:00-16:00 on the following number: 0300 061 0614
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