A needs assessment is your council working out what help you need. It is free, it does not depend on your savings, and anyone who appears to need care can ask for one. Most people arranging care privately skip it, and that is usually a mistake.
Why ask for one if you are paying anyway
Three reasons.
It is the door to everything else. Direct payments, equipment, a carer’s assessment for the person doing the day-to-day, reablement after a hospital stay: all of it runs through this assessment. No assessment, no access.
Money runs out faster than families expect. If your capital drops below the threshold later, the council picks up the cost, and having been assessed already makes that handover far less painful.
And the assessment itself is worth having. A social worker who does this every week will spot things the family has stopped noticing.
How to ask
Ring adult social care at the council for the area where the person lives. Not the district council if you are in a two-tier area: it is the county or the unitary authority. Most councils also have an online form.
You do not need a GP referral and you do not need permission from anyone. You can ask on behalf of someone else, though they can refuse the assessment if they have capacity to do so.
What happens on the day
Someone comes to the house, or does it over the phone, and talks through how the person manages: washing, dressing, meals, medication, getting out, staying safe, seeing people. It usually takes an hour or two.
Two things help. Write down what a bad day looks like before they arrive, because people instinctively describe a good one to a stranger. And have the family member who does the most in the room, since they know what actually happens at 6am.
The assessment produces a list of needs and says which of them the council considers eligible. That is the care and support plan.
Money is a separate conversation
The needs assessment is free and it is not means tested. What you contribute towards the care is decided by a second, financial assessment that looks at income and capital.
Keep the two separate in your head. Plenty of people talk themselves out of the first because they assume they will fail the second.
In Scotland the second conversation is smaller than people expect. Personal care at home is free where the assessment says it is needed, whatever your savings, and only the help that is not personal care can be charged for.
How paying for care at home works →
If you disagree with the outcome
Ask for the written assessment and the eligibility decision. Read what they recorded about a typical day, because that is where the disagreement usually sits.
If it is wrong, say so in writing and ask for a reassessment. If that gets nowhere, the council’s complaints procedure comes first, then the Local Government and Social Care Ombudsman.
While you wait
Waiting times vary a lot by council and can run to months. Nothing stops you arranging care privately in the meantime, and doing so does not withdraw your request.