Wales is divided into 22 single-tier principal areas for local government purposes. The elected councils of these areas are responsible for the provision of all local government services, including social care. Below these areas, there are also (in most, but not all) elected community councils to which responsibility for some services may be distributed.
The council/authority makes assessments by examining:
- needs, including any support that is already in place
- which needs can be met with community care services
- how much the services will cost and who will pay for them.
Community care services include:
- domiciliary care – i.e. home carers and personal assistants
- monitoring devices
- day care (i.e. away from home in, for example, local authority run day centres for older people)
- lunch clubs
- night sitting services
- respite care (which includes a temporary stay in a care home)
- residential care
- provision of aids, equipment or adaptations to help with daily living tasks and for home safety, including community alarms and/or other assistive technology
- delivery of pre prepared meals
- community transport
- preventative and rehabilitation services
- assistance in finding a place in sheltered or supported housing
- counselling
- services to meet your parent’s psychological, social and cultural needs
- advice and information about other local services, welfare benefits etc.
How does the council decide who qualifies for free services at home?
Before making a decision, the local authority will conduct a free Care Needs Assessment (also known as a social care assessment, a community care assessment, or simply a needs assessment). Regardless of their financial situation, all older people are entitled to an assessment. If the assessment verifies the need for community care services, a means test will be conducted to determine whether the council would contribute to the costs. If savings and assets exceed £24,000 (excluding the value of the primary property), services must be paid for privately. On the local authority's website, detailed explanations of how the means test is undertaken (as well as any income that is excluded from the calculation) should be provided. There are, however, two important points to keep in mind:
Even if you pay for home care services privately, the maximum weekly payment if the council organises them is £100.
Some council services are always free of charge regardless of your financial situation (as long as an assessment has been completed and the service was found to be necessary).
Paying for a care home
The assessment of care needs will also determine whether care is best delivered in a care home or a nursing home. A nursing home provides the services of specialised nurses. Currently, if your assets are worth £50,000 or more, you must pay the care home fees. When moving into a care home permanently, the council will disregard the value of the primary property for the first 12 weeks. Following that, it will be considered when determining who should pay the fees, unless certain family members continue to live there.
When a person enters a nursing home, the National Health Service (NHS) usually contributes to the costs to cover the expense of the nursing component. The amount that can be paid varies depending on the health board.
Before engaging any care service providers, regardless of the financial situation, the council must conduct a needs assessment. Failure to do so may compromise the eventual eligibility for care funding, as well as potentially delaying admission to a care home.
The Care Needs Assessment
To obtain an assessment, contact the adult social services department. If there has been an accident that has resulted in hospitalisation, the assessment may be arranged by a hospital social worker before discharge, or the GP may make a referral.
The assessment is normally done at home (although it can also be done online or over the phone). A friend or family member should be present to take notes.
Questions will be asked regarding what tasks can be completed independently, where challenges exist, and what would like to be accomplished. As an example:
- dressing and undressing
- getting up and going to bed
- eating and drinking
- washing and bathing
- moving around the home
- managing medications
- housework and shopping
- social and cultural activities
Questions will be asked about any support that is already in place. It’s important to say if this help is not going to continue in the long term.
After the assessment, a care plan (or support plan) will be provided, which will give details of the help that can be provided.
The care plan should include information about:
- the services, who will arrange them, and how much they will cost.
- the needs and any risks that might be faced.
- why the services are being provided and how they will help
- what will happen if there is an emergency?
- any support that is already there
- the date the care plan will be reviewed.
The plan could include, for example, help with personal care, equipment or adaptations for the home, and services to help anyone who is providing unpaid care. A package that includes social care, nursing care, health services, and housing services could be proposed.
If the council decides that help is required, support services should be put in place without unreasonable delay. If you feel the wait has been unreasonable, you can make a complaint using the social work department's complaints procedure.
How to find the care needs assessment information
Services that are always free*
*when the care needs assessment identifies that they are needed.
Transport to attend a day service
A day service is a programme run by the local authority that takes place away from the participant's home and offers the opportunity to meet new people and pursue new hobbies or pastimes.
Community-based NHS services
Community-based NHS services arranged through the Local Health Board or GP are free. For example visits from a district nurse, speech therapy or physiotherapy.
Reablement and intermediate care
After an illness or accident, intermediate care (or reablement services) are offered on a short-term basis. They are intended to assist in regaining part or all of the capacity to live independently.
Intermediate care and rehabilitative services are typically planned prior to hospital discharge and are in place when the patient returns home. Services will be provided for free for up to six weeks. Extensions of more than six weeks are sometimes available, depending on the circumstances.
NHS Continuing Health Care
If the physical needs exceed what the local authority is obligated to meet, the NHS will cover the costs of the required care (in a care home or at home), but only if strict eligibility conditions are met. Learn more
Finding a home care agency or care home
To find services follow our 2 step process:
Step 1 : Locate
Use the search tool on the CareHomeUK or HomeCareUK websites to read reviews, view photos and create a short-list. Write down both the name and postcode of each service you are considering.
Step 2 : Verify
Using your short-list, search each provider by name on the Care Inspectorate website. The Care Inspectorate is responsible for the regulation and inspection of all care providers in Wales. Regular inspections take place and reports are published. Read our guide to navigating the Care Inspectorate website to check registration details and to read the latest inspection reports.