Eligibility for care services

We receive a high volume of referrals for care services. To help us prioritise those people whose independence or wellbeing is most at risk, or who have the most urgent need for care, we use eligibility criteria. We aim to make sure everyone asking for help is dealt with fairly, and that people understand how decisions are made about allocating services.

A person's eligibility for services is decided after a formal assessment of their care needs. The assessment takes considers the likely risks and consequences if they do not get social work support or services at that point of time. This means, if your needs are less urgent than others, you may have to wait for services.

We review people's assessed needs regularly, to make sure their changing needs and priority for services is updated using the eligibility criteria.

These eligibility criteria will be used after your needs have been formally assessed. Although you may have multiple care needs, the social work practitioner completing your care needs assessment will reach one eligibility decision, based on these criteria.

If services must be provided as a result of a statutory order, such as that from a court or Children’s Hearing, these eligibility criteria will not apply.

For more information, please read our Eligibility Criteria for Social Work Services (pdf 576kb).

Priorities

Everyone who is assessed as needing care or support is allocated a level of priority.

There are four categories of priority:

Critical

You, or others, may be at immediate risk of serious harm or neglect or loss of independence. There may be immediate risk of your care arrangements breaking down, or your main carer being unable to continue to support you. In these circumstances, we will arrange services to reduce these risks within one to two weeks.

For example:

  • your carer is ill or admitted to hospital, and you have no-one available to help
  • you develop major health difficulties or have an accident, and you are unable to meet vital or most of your personal or domestic care needs
  • you are a vulnerable person who has been made homeless

Substantial

You, or others, may be at substantial risk of significant harm or neglect or loss of independence. There may be substantial risk of your care arrangements breaking down, or your main carer being unable to continue to support you. In these circumstances, we will arrange services to reduce these risks imminently - within six weeks.

For example:

  • you have a severe and enduring mental illness, which could result in you harming yourself or others and you need intensive support to help you manage
  • you have significant difficulty coping with daily living routines
  • you are terminally ill or have a progressive or significantly deteriorating condition and are unable to do many aspects of personal care
  • you have recently been discharged from hospital after serious illness, and are unable to manage many aspects of your domestic routine causing significant risk to your independence

Moderate

You, or others, may be at moderate risk of harm or neglect or loss of independence. There may be a moderate risk that your main carer has difficulties in continuing to support you. In these circumstances, we generally give you advice and information or point you to the support available in the community that you can access directly.

But we may arrange services to reduce these risks. If we think that providing services will prevent any increase in risk of harm or neglect to you or greater loss of independence in the future. This could involve offering you short term support, focussed on rehabilitation and enablement to help you regain the ability to look after yourself independently. In Mental Health this could involve a Recovery Programme. If appropriate services are not available, we will discuss with you alternative ways to address your needs.

For example:

  • you have health problems which mean you are unable to do some aspects of your personal care or domestic routines, creating moderate risk to your independence
  • you are looked after by a carer, whose health or responsibilities are under strain and at some risk of breaking down
  • you are a vulnerable person who may potentially be at risk of harm or neglect

Low

There is a low risk to your independence, health or wellbeing with very limited, if any, need for social work services. In these circumstances, we may consider that you do not need services in the foreseeable future. We will offer you advice and information or point you to the support available in the community that you can access directly.

For example:

  • you have difficulty coping with one or two aspects of your personal care or domestic routines
  • you need support and motivation to care for yourself
  • your need reminders to minimise the potential risk of harm or neglect

Not eligible for a service

You will not qualify for social work services if:

  • you can manage your personal care and carry out household tasks safely and with confidence
  • you need help with a household service only
  • your needs can be met more appropriately by other community services or activities

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