The Care Act – implications for self-funders

The Care Act – implications for self-funders

Bernie Crean, Care Review Services LtdIf you or a relative need long term care, The Care Act has implications for self-funders, as there will be a new system of social care assessments for people who have to pay for their own care.

This applies to local authority assessments, not NHS Continuing Healthcare assessments.

Bernie Crean from Care Review Services Ltd outlines some of the issues relating to the new social care assessment system, and he highlights the potential flaws in the process:

Most if not all Social Services teams across the country use a computer based assessment tool to generate an ‘estimated care budget’ (EB). They then look to meet care needs within this estimated budget.

This online assessment tool has mainly been used to assess the care needs and costs for individuals who were below the current local authority financial threshold of £23,500. It has not generally been used for those above this financial threshold and who are classed as being self-funders.

This electronic assessment process will soon be the assessment tool that is used to consider the care needs and costs for self-funders, too – under the new Care Bill that comes into effect in April 2015. It will also be of importance when the ‘Dilnot care meter’ and financial cap on care fees is implemented in April 2016. (Since this article was written, the government has postponed this until 2020.)

However, unlike in NHS Continuing Healthcare assessments where a team of assessors is required, in the new social care assessments it will be the sole responsibility of one single assessing social worker to ‘score’ care needs using this new online assessment tool.

It is possible, therefore, that decisions about how social care needs have been scored will be challenged at a later date …

Read the full article on the Care Review Services website here.

Read more about financial means testing for care.


  1. Maureen Knights 7 months ago

    My mum was taken into care on November 21st 2016 this was without my mum’s or mine concent. She lived in retirement flat the house manager had some concerns about mum. She said she was making a nuisance of herself wandering (not true) and talking through the film when they had film night so I contacted social services and the care co ordinator came out to see mum she was happy with how mum was being looked after. I told her the house manager was complaining about mum and wanted to see her. The care coordinator said managers of retirement flats didn’t like residents with Dementia living there so I thought the care co ordinator would sort it out and stop her complaining. However after seeing her she then said mum was compromising her dignity and putting herself in danger so she would need to go into Respite care for two weeks then she would come home and I would have time to look for a home that was suitable. Mum had at that time about £14000 in savings. So I found a home. She went in on the 21st of November but after four days I had a call from the care coordinator saying mum couldn’t come home after two weeks as she the care coordinator would be putting her job on the line and she wasn’t prepared to do this! So mum stayed in the home. The care coordinator arranged a best interest meeting with a colleague of hers and myself and her they asked me what I wanted for mum. I said more carers and an extra day at the day centre. They said did I want the best for mum and I said of course. They then said they thought mum should stay in the home and made me feel that if I didn’t agree. It was like I was saying that I didn’t want the best for mum. So she stayed in the home but it turned out not to be suitable. Mum had three falls, her clothes taken, someone defecating in her commode and a resident putting his fists up at her and sickness bug and a urine infection. So I tried to get her into a different home but after eventually seeing the care plan said mum’s needs were more than they could cope with. I did eventually find another home but Mum was not happy and wouldn’t eat. She was assessed and put on anti depressants and is now eating again and is a little more settled. A financial assessment was done on the 22nd of December last year. I asked for Continuing Healthcare and I was told no chance. I asked for a health assessment and mum had psychiatrist visit her on March 30 th this year and prescribed anti depressants as I mentioned. Mum is paying towards her care. Her flat worth £110,000 is up for sale – so far no buyers. She is on a deferred payments at the moment. As there is a flat like mum’s up for sale already and has been for two years it seems mum will be paying the money back with interest when the flat eventually sells. Very unfair I think if mum hadn’t been self funding I think she would be still living in her flat. Mum has deteriorated but she is still nowhere near as bad as some of the other residents but the fact she was made to go in a home was like having her human rights taken away from her on the say so of a house manager and an inexperienced but over confident care co ordinator .

  2. HELEN DAVIS 11 months ago

    Hello, i need some advice please. My step Father fell and went into Hospital 6th December 2016 and is still in. He has Dementia and broke loads off bones with his fall. Mom mom is disabled and unable to have him back home. Long story but he isn’t entitled to any of the house and only has £2,600 to his name. We are trying to get him in a care home and have social services pay for him. He cant get out of bed himself, can’t dress, drink or eat properly. Many more things are wrong with him. Social services and the occupational therapist (OT) say he can walk a flight off stairs, walk and dress himself. HE CAN’T. I got the OT to re-assess him with me and agreed, but they say he doesn’t meet the needs to go in a care home and will have to go into Social Housing. I have registered him with council but will take months and months for some something to come up. In the meantime they have told me they will put him in a budget motel and send in a carer 2/3 times a day. I have just asked for the Continuing Healthcare (CHC) test to be done but what is it and do we have to be pressent when done. We need help as this is killing my mom, and i mean that. Her doctors have written a letter my step dad cant go home. HELP

  3. Chris-G 3 years ago

    Since when was a social worker qualified to identify specific medical needs?

    How can a social worker use some kind of calculator to means test someone that has not yet had an assessment for NHS CHC funding? That would be a data processing act offence. (Unnecessary Data Gathering and processing springs to mind).

    The longer they patch and Pee about with this, the more obvious is the fact that it is not fit for purpose at all.

    • Bernie 3 years ago

      Hi Chris

      It isn’t a case of a social worker being qualified to identify a specific health need.

      A social care worker plays a significant role in the CHC assessment process. The first step in determining CHC eligibility is to assess if care needs are more than being a social care need. This has been law since the NAA 1948 and is clearly stated in CHC guidance. It has been underlined in case law, Coughlan, Grogan and many other cases. The new Care Act carries the same legal requirement to consider if needs are above the threshold of being merely social care. The law states ( as does CHC national framework) that if needs are above social care, then needs ‘must’ be seen as being a primary health need and eligible for CHC. Only a social care worker from the relevant local Authority can make a judgement on needs not being social care. They are qualified to do this and it is a statutory duty for them to carry out this function. Given that the threshold for social care is low then more clients who have care needs could and probably should be eligible for full CHC funding. Especially those that are in 24 hour care.

      I hope this clarifies the role of social care staff in the CHC process.

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