This guidance is issued under section 7(1) of the Local Authority Social Services Act 1970 and replaces Fair access to care services - guidance on eligibility criteria for adult social care which was issued in 2003. This guidance will need to be applied from April 2010.

• Download guidance on eligibility criteria for adult social care, England 2010 (PDF, 541K)
• Impact assessment of the revision of the Fair Access to Care Services (FACS) guidance

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_113154

Fair Access to Care Services

Government guidance says all Councils should apply the same eligibility criteria for Adult Social Services. These eligibility criteria are called “Fair Access to Care Services” guidance, and we use them to decide who we can provide services to.

The criteria place people within four levels of need: critical, substantial, moderate and low. These four levels apply to all Social Services departments across England. All councils decide, based on available resources and local agreements with the NHS, which bands they can afford to meet.

Which levels of need will be met by Richmond Social Services?

Richmond currently meet people’s needs if they fit into the critical, substantial or moderate needs bands.

If someone is considered to have low needs they will not be eligible for social care services. However, social services care managers will offer advice about other appropriate providers of care or information.

What are the criteria for different levels of need?

The criteria are graded into four bands, based on the seriousness of the risk to independence if problems and issues are not addressed.

Critical

• Life is, or could be, threatened;
• Major health problems have developed or are likely to develop;
• There is, or could be, an extensive loss of choice and control over the immediate environment;
• Serious forms of abuse or neglect have occurred or are likely to occur;
• There is, or could be, an inability to carry out many personal care, domestic, family or other daily routines;
• Involvement in work, education or learning is, or could be, at great risk of not being sustained;
• Many social support systems and relationships are, or could be, at great risk; or
• Individuals cannot undertake, or will be unlikely to be able to undertake, most of the family and social roles and responsibilities that are important to them and others.

Substantial

• Significant health problems have developed or are likely to develop;
• There is, or could be, some significant loss of choice and control over the immediate environment;
• There is, or could be, an inability to carry out some personal care, domestic or other daily routines;
• Involvement in some significant aspects of work, education or learning is, or could be, at risk of not being sustained.
• Some significant social support systems and relationships are, or could be, at risk; or
• Individuals cannot undertake, or will be unlikely to be able to undertake, some significant family and social roles and responsibilities that are important to them and others.

Moderate

• There is, or could be, some inability to carry out several daily routines;
• Several aspects of work, education or learning are, or could be, at risk of not being sustained;
• Several social support systems and relationship are, or could be, at risk; or
• Individuals cannot undertake, or will be unlikely to undertake, several family and social roles and responsibilities.

Low (Current threshold for services in Richmond)

• There is, or could be, some inability to carry out one or two daily routines;
• One or two social support systems and relationships are, or could be, at risk of not being sustained; or
• Individuals cannot undertake, or will be unlikely to be able to undertake, one or two family and social roles and responsibilities.

The criteria focus attention on maintaining a person’s independence over time. A range of factors are considered in looking at risks to independence including:

• Ensuring the person’s health and safety
• Promoting autonomy
• Enabling involvement in family and community life
• Ensuring people have the ability to manage their daily routines
• Eligibility criteria are normally reviewed annually and the threshold may move up or down as a result according to the council’s financial position.

What is fair about Fair Access to Care Services?

In the past, eligibility criteria for social services were decided locally. Often the criteria were poorly publicised and inconsistently applied. Some councils operated different criteria for different client groups. Sometimes separate eligibility criteria were also applied to individual services. This led to unfairness.

Fair Access to Care Services offers a single set of criteria for all adult services. Decisions will be open and transparent and there will be no other eligibility criteria for individual services. Simply put there is just one decision to be made - are you eligible to receive services?

How will Social Services decide if I am eligible for social care services?

The social services department will assess each person individually. Anyone can refer themselves to their local social care team and an initial Contact Assessment will be completed by a care manager to understand the nature of the concern or problem.

An Overview or Specialist assessment may then be done to work out the specific difficulties or problems an individual may be experiencing and the support required.

The care manager will then be able to explain whether an individual is entitled to social care services.

All assessments will involve the person requiring support and their carer(s) if appropriate. All decisions about eligibility for services will be fully explained. If you are eligible to receive services you will receive a User Held Care Record which will include a copy of your care plan and details of who will be providing your services. In most circumstances, you will also be offered the choice of having services arranged for you or of managing them yourself using Direct Payments.

Once I have been assessed are the services I get guaranteed not to change?

People’s needs change over time and a care manager will review your needs at least once a year. If your needs have changed then it may be necessary to change the services you are receiving.

All councils are required to review their eligibility criteria each year and it is possible that the levels of need that we provide help for could change so that people receiving services are not entitled to the same services any more.

What happens if I do not qualify for services?

Your care manager will give you information about alternative sources of support and help put you in touch with any services which might be helpful for you.

Who does Fair Access to Care Services apply to?

• Fair Access applies to all adults over 18 years, including:
• People with Physical and Sensory Disabilities
• People with Learning Difficulties
• People with Mental Health Problems
• People with Drug or Alcohol Problems
• Unpaid carers who provide support on a regular/substantial basis
• Refugees or asylum seekers who require assistance under the National Assistance Act.

Do the eligibility criteria apply to health services and housing services?

No, Fair Access to Care Services only applies to services that are the responsibility of Social Services. Disabled Facilities Grants, for example, are not covered by Fair Access to Care Services eligibility criteria.