What happens in a care needs assessment? A family guide

Quick summary

Someone from the council visits for about an hour, asks what you can and cannot manage, and writes it up. It is free, it is a legal right under the Care Act 2014, and it happens before anyone looks at your money. The test is whether you cannot achieve two or more of ten specified everyday outcomes.

Who can have one?

Anyone who appears to need care and support. That is the threshold for getting an assessment.

Savings make no difference to whether you get one. The council has a duty to assess regardless of whether it will end up paying for anything, and a separate duty to give you information and advice either way.

Ask for one even if you know you will be paying privately. It tells you what a professional thinks your mum needs, which is useful when you are buying care and have no reference point for what normal looks like.

A carer can also request a separate carer’s assessment in their own right, based on the impact of caring on them rather than on the person they care for.

How do I ask for one?

Ring adult social care at the county or unitary council and say you would like a care needs assessment under the Care Act.

• Cheshire East Council, 0300 123 5010, for Macclesfield, Wilmslow, Handforth, Alderley Edge, Prestbury, Bollington, Sutton, Knutsford, Mobberley, Chelford, Goostrey, Holmes Chapel, Congleton, Wincle, Wildboarclough and Alsager.
• Call Derbyshire, 01629 533190, for Buxton, Harpur Hill, Whaley Bridge, Taxal, Chapel-en-le-Frith and Dove Holes.
• Staffordshire Cares, 0300 111 8010, for Leek, Meerbrook, Longnor, Hollinsclough, Biddulph, Biddulph Moor and Kidsgrove.

You can ask on someone else’s behalf, and you do not need a GP referral.

What actually happens on the day?

A social worker or assessor visits, usually at home for around an hour. Some assessments are done by phone or video, which you can push back on if the person’s difficulties need to be seen in person. 

The conversation covers what a normal day looks like, what is hard, what has changed, what support already exists, and what the person wants to be able to do. It is meant to be about outcomes rather than a tick list of tasks.

Two things people are not told. Help currently provided by a family member is disregarded when deciding eligibility, so “my daughter does that” should not count against you. And if needs fluctuate, the assessment must take account of the bad days, not just the day the assessor happened to visit.

What are they actually measuring?

The national eligibility criteria, set out in section 13 of the Care Act 2014 and the Care and Support (Eligibility Criteria) Regulations 2015. There are three conditions and all three must be met.

The ten outcomes are:

• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Being able to make use of the 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 necessary facilities or services in the local community
• Carrying out any caring responsibilities for a child

There is no hierarchy. Being unable to get to the shops counts the same as being unable to wash.

“Unable to achieve” is broader than it sounds. It includes being able to do something only with significant pain, distress or anxiety, only by taking much longer than would normally be expected, or in a way that endangers you or someone else. Getting dressed in forty minutes with three rests counts. So does getting in the bath unsafely because there is nobody to help.

How to prepare

This matters because older people consistently understate their difficulties in front of a stranger.

• Keep a diary for a week. What went wrong, how long things took, what did not get done at all.
• Describe the bad days as well as the good ones. Fluctuating needs must be taken into account, but only if you mention them.
• Say what is being done unsafely, not just what is not being done.
• Be there if you can. Someone who knows the reality can correct the “I manage fine” reflex gently.
• Mention the night. Assessments happen in the daytime, and night difficulties get missed.
• Say if you are the one holding it together. That is the trigger for a carer’s assessment.

What happens afterwards?

You should get a written record of the assessment and an eligibility decision.

If needs are eligible, a support plan and a personal budget follow, and a separate financial assessment decides what you contribute. If they are not eligible, the council must still give you written reasons and information about what else might help, including preventative services.

You can challenge the outcome. Ask for the decision in writing with the reasons, then use the council’s complaints procedure, and after that the Local Government and Social Care Ombudsman.

The part that frustrates families

It takes time.

If care is needed this week, arrange something now and pursue the assessment alongside it. The assessment does not become less valid because you did not wait for it, and starting privately does not disqualify anyone from later council support.

If the person is coming out of hospital, that is a different route. Ask the ward about reablement or intermediate care, which is normally free for up to six weeks, before agreeing to pay anyone.

Frequently asked questions

How do I get a care needs assessment?

Ring adult social care at your county or unitary council and ask for one under the Care Act 2014. No GP referral is needed, it’s not means tested, and you can ask on someone else’s behalf.

Is it free?

Yes. The assessment is always free regardless of income or savings. Charges only arise later, for care that the council arranges, after a separate financial assessment.

Will they take my savings into account during the assessment?

No. The needs assessment and the financial assessment are separate, and the needs one comes first. Money is not relevant to whether needs are eligible.

What if my mum says she is fine?

Very common. Be present, and put specifics rather than contradictions: “she missed two doses last week” works better than “that isn’t true”. You can also send your concerns to the council in advance, in writing.

Can I have an advocate?

Yes. If someone would have substantial difficulty being involved in the assessment and has nobody appropriate to support them, the council must arrange an independent advocate.

What if the decision is that she is not eligible?

Ask for it in writing with reasons. Not eligible does not mean no help exists, and the council still owes advice about preventative and community services. If you think the decision is wrong, use the complaints procedure.

About Visiting Angels Cheshire East

Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the surrounding villages of East Cheshire, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns.

• You choose your caregiver. You meet them before care starts, and if it is not right you say so and we send someone else.
• No visit is ever shorter than an hour. There is no such thing as a fifteen minute call here.
• You see the same faces. Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (Skills for Care, 2025).
• Carers trained in dementia, Parkinson’s, stroke recovery and complex care.
• Live-in care available, up to full time.

Sharon’s mother had been having visits for a fortnight when she wrote this:

“It is not something we ever thought we would need but Visiting Angels have been wonderful. They came to see us to find out exactly what we needed, even though we weren’t completely sure ourselves, but through our conversation we were able to put a package of support in place. They offered advice on other things that were available to us as well particularly financially. They put our minds at ease during what was quite a stressful time in our lives.”

Sharon Thornton, Google review

Not sure what you need yet? Start with a free assessment

Our free home care assessment is a visit at a time that suits you, with no obligation afterwards. In it we will:

• Work out what is actually difficult, and which times of day, which is usually what a visit should be built around.
• Talk through a realistic package, and what it would cost.
• Look at the money with you, and point you towards the funding, benefits and grants you may be entitled to, including the ones most families are never told about.
• Tell you honestly if you do not need us yet, or if someone else is a better fit.

If you are waiting on a council assessment and need something in place meanwhile, call us on 01625 720157. You can also send an enquiry, and you can see what our services cover.

Authored by Dr Haroon Ahmad, Managing Director, Visiting Angels Cheshire East.

Published 6 September 2026. Last updated 6 September 2026.

This article is general information about the care assessment process, not legal or financial advice, and it is no substitute for advice about an individual’s circumstances. Each council applies the national criteria through its own processes and these change over time; check the current position with the relevant council. Free independent advice is available from Citizens Advice, Age UK and MoneyHelper. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss arising from reliance on this article.