Understanding the Foundations of Local Authority Care
Local authority care refers to the care and support services funded and arranged by a person's local council, rather than the NHS, which focuses on healthcare needs. The legal framework governing this is the Care Act 2014, which mandates that local authorities in England must assess anyone who appears to have care and support needs, regardless of their financial situation. The assessment determines a person's eligibility for care and how their needs impact their overall wellbeing.
The Care Act 2014: National Eligibility Criteria
Central to understanding what counts as local authority care is the concept of eligibility. The Care Act sets out a national standard to ensure fairness across England. For an adult's needs to be eligible, they must meet all three parts of the following criteria:
- The adult's needs arise from a physical or mental condition or illness.
- As a result of those needs, the adult is unable to achieve two or more specific outcomes (see section below).
- As a consequence of being unable to achieve these outcomes, there is a significant impact on the adult's wellbeing.
The 'Care Outcomes' Assessment
During a needs assessment, a local authority will look at a person's ability to achieve specific daily outcomes. If a person struggles to achieve two or more of these due to their condition, they may be eligible for care. These outcomes include:
- Managing and maintaining nutrition (e.g., preparing food).
- Maintaining personal hygiene (e.g., washing, bathing).
- Managing toilet needs (e.g., using the toilet, managing incontinence).
- Being appropriately clothed (e.g., dressing, undressing).
- Making use of the adult's home safely.
- Maintaining a habitable home environment.
- Developing and maintaining family or other personal relationships.
- Accessing and engaging in work, training, education, or volunteering.
- Making use of local community facilities or services, including public transport.
- Carrying out any caring responsibilities the adult has for a child.
Types of Local Authority Care
Local authority care is not a single service but a range of support tailored to an individual's needs. This can be a mix of community services and residential options. The most common types include:
- Home Care (Domiciliary Care): Support with daily tasks in one's own home, such as personal care, meal preparation, or domestic chores.
- Supported Living: For those with more complex needs, this provides accommodation and support to help people live as independently as possible.
- Residential Care: Moving into a care home for personal care support. This includes both standard care homes and those specializing in nursing or dementia care.
- Day Care Centres: Community hubs that provide activities, meals, and social opportunities, offering a break for carers.
- Assistive Technology and Adaptations: Equipment, like grab rails or stairlifts, that helps a person stay safe and independent at home.
The Financial Side: The Means Test
Once eligibility is established, a financial assessment (means test) is conducted to determine how much, if anything, a person needs to pay towards their care. This process is complex and depends on the type of care and where you live in the UK. The means test considers both income and savings.
The Financial Assessment Process
- Requesting an Assessment: A person can ask the council for a financial assessment, which is usually offered at the same time as the needs assessment.
- Income and Savings Limits: A person's financial assets are compared against the upper and lower capital limits set by the government. As of 2025, for example, a person with capital above the upper limit would be expected to pay for their full care costs.
- Third-Party Top-Ups: If a person chooses a more expensive care home than the council is willing to pay for, a third party (e.g., a family member) may be asked to pay the difference, known as a 'top-up' fee.
- Deferred Payment Agreements: In some cases, if a person owns their home but does not wish to sell it immediately, they can enter a deferred payment agreement. This allows them to use the value of their property to pay for care home costs after they pass away.
Comparison Table: Local Authority Care vs. NHS Continuing Healthcare
| Feature | Local Authority (Social) Care | NHS Continuing Healthcare (CHC) |
|---|---|---|
| Funding Source | Local Council | National Health Service (NHS) |
| Primary Need | Personal and social care needs (e.g., washing, dressing) | Primary health needs (e.g., complex medical conditions) |
| Eligibility | Statutory needs assessment (Care Act) and financial means test | Comprehensive health assessment to determine a 'primary health need' |
| Financial Test | Means-tested; contributions may be required | Not means-tested; free at the point of use |
| Services Covered | Home care, care homes, supported living, day centres | All healthcare and associated social care costs for eligible individuals |
Next Steps: Arranging Your Care
After the needs assessment, the local authority will produce a care and support plan. This plan details the needs identified and how they will be met, either through a direct payment to the individual or by the council arranging services directly. The person in need of care and their family should be fully involved in the creation of this plan.
The process can seem daunting, but resources are available to help. Advocacy services can support those who find it difficult to express their needs, and detailed guidance is provided by charitable organizations specializing in elderly care. You can find comprehensive legal and practical advice on the Care Act from organizations like Age UK, ensuring you are well-informed throughout the entire process.
For a detailed overview of the Care Act 2014 and the responsibilities of local authorities, you can visit the official UK Government website.
