4.2.2 Eligibility Criteria for Carers and Carers’ Budgets

1. Introduction

This policy sets out how Lancashire County Council determines a carer’s eligibility for care and support, and the budgets assigned to that care and support.

2. Policy Aims

This policy aims to support carers to:

• Get the relevant support they need to continue to care.
• Achieve the outcomes identified that will support their wellbeing.

3. The Legal Framework

Many of the core aims of the Care Act (particularly its focus on preventing, delaying or reducing the need for care and support) apply equally to adults and their carers.

The national eligibility threshold for carers is set out in the Care and Support (Eligibility Criteria) Regulations 2015. The threshold is based on the impact that a carer’s need for support has on their wellbeing. Determining a carer’s eligibility for support should be made without consideration of whether or not the adult the carer cares for has eligible needs themselves.

4. Eligibility Criteria for Carers

If you are a carer, you can be eligible for support in your own right. The national threshold is used to establish eligibility for support, based on the impact of your needs, as a carer, for support with your wellbeing.

4.1 Eligibility: Conditions to be met

Three conditions need to be met for a carer with support needs to be considered as having eligible needs:

1. The needs arise as a consequence of providing necessary care for an adult.
2. The effect of the carer’s needs is that any of the circumstances specified in the Eligibility Regulations apply to the carer.
3. As a consequence of that fact there is, or there is likely to be, a significant impact on the carer’s wellbeing.

4.2 Eligibility: interpreting the criteria

Condition 1: The needs arise as a consequence of providing necessary care for an adult.

Lancashire County Council must consider whether your need for support arises because you are providing care to an adult. You can be eligible for support as a carer regardless of whether the adult you care for has eligible needs. The decision about eligibility is based on your needs and how these impact on your wellbeing.

Determining your eligibility for support will be made without consideration of whether or not the adult you care for, has eligible needs.

The care provided has to be ‘necessary’. If you are providing care and support to meet needs that the adult is capable of meeting themselves, you may not be providing necessary support. In such circumstances, information and advice will be provided to you and the adult about how the adult can use their own strengths or services available in the community to meet their needs.

Condition 2: Consideration has to be given to whether the carer’s physical or mental health is deteriorating or is at risk of doing so, or whether the carer is unable to achieve certain outcomes

Being unable to achieve outcomes, includes circumstances where you:

• are unable to achieve the outcome without assistance. For example, you might be unable to fulfil your parental responsibilities unless you receive support in your caring role.
• are able to achieve the outcome without assistance, but doing so causes or is likely to cause significant pain, distress or anxiety. For example, you might be able to care for the adult and undertake full time employment, but if doing both causes you significant distress, you should not be considered able to engage in employment.
• are able to achieve the outcome without assistance but doing so is likely to endanger your health or safety or that of any adults or children you provide care for. For example, you might be able to provide care for your family and deliver necessary care for the adult, but, if this endangers the adult with care and support needs because the adult receiving care would have to be left alone while other responsibilities are met, you should not be considered able to meet the outcome of caring for your family.

Outcomes

The Care and Support (Eligibility Criteria) Regulations 2015 set out a range of outcomes which Lancashire County Council must consider whether you (as a carer) are able to achieve. You will have eligible needs if you are unable to achieve any of these outcomes and as a result there is, or there is likely to be, a significant impact on your wellbeing.

Condition 3: Wellbeing

The third condition that must be met is that your needs and your inability to achieve the outcomes described in the regulations must present a significant impact on your wellbeing.

Wellbeing is defined by referring to examples of specific areas in Section 1 of the Care Act (see Wellbeing Principle policy).

In doing so, Lancashire County Council should consider whether there is or is likely to be a significant impact on your wellbeing, including:

• personal dignity (including treatment of the individual with respect).
• physical and mental health and emotional wellbeing.
• protection from abuse and neglect.
• control over day to day life (including over care and support provided and the way it is provided).
• participation in work, education, training or recreation.
• social and economic wellbeing.
• domestic, family and personal relationships.
• suitability of living accommodation.
• the individual’s contribution to society.

The term ‘significant’ is not defined by the Regulations and must therefore be understood to have its everyday meaning. Lancashire County Council will consider whether your needs and your inability to achieve the outcomes will have important consequences for your daily life, independence and wellbeing.

In making this judgment, Lancashire County Council will view your needs in the context of what is important to you. The impact of needs may affect different carers in different ways, because what is important to the individual’s wellbeing may not be the same in all cases.

When considering the type of needs you may have, Lancashire County Council will note that there is no hierarchy of needs or of the areas of wellbeing (see also Wellbeing Principle policy).

Fluctuating needs

If you have fluctuating needs, you may have needs which are not apparent at the time of the assessment but may have arisen in the past and are likely to arise again in the future. Therefore, your needs must be considered over an appropriate period of time to ensure that all of your needs have been accounted for when the eligibility is being determined.

Where fluctuating needs are apparent, these will be included in the care plan, detailing the steps Lancashire County Council will take to meet needs in circumstances where needs fluctuate.

For example, you could be caring for an adult with a mental illness, who has managed their condition well in the past eight months, but who could deteriorate if circumstances in the adult’s life change.

In such situations, consideration must be given to how your needs may change as a result of the fluctuation in the needs of the person you are caring for. Lancashire County Council must get a complete picture of your level of need over an appropriate period.

The level of your need can also fluctuate irrespective of whether the needs of the adult for whom you care, fluctuate. For example, if you are a parent of school children, you may not have the same level of need for support during term time as during school holidays.

5. What Happens After the Eligibility Determination

When the eligibility determination has been made, Lancashire County Council will provide you with a copy of its decision.

Where you are found to have no eligible needs, Lancashire County Council must provide information and advice on what can be done to meet or reduce the needs (for example what support might be available in the community to help you) and what can be done to prevent or delay the development of needs in the future.

If you have some eligible needs, Lancashire County Council must:

• Agree with you which of your needs you would like Lancashire County Council to meet. You may not wish to have support in relation to all your needs – for example, you may intend to arrange alternative services of your own to meet some needs. Or you may not wish for Lancashire County Council to meet any of your needs, and only approached us for the purposes of determining eligible needs.
• Consider how Lancashire County Council may meet those needs. This does not replace or pre-empt the care and support planning process, but is an early consideration of the potential support options, in order to determine whether some of those may be services for which Lancashire County Council makes a charge. Where that is the case, Lancashire County Council must carry out a financial assessment however, Lancashire County Council has agreed to waive its powers to financially assess and/or impose charges on carers.
• Establish whether you meet the ordinary residence criteria.  Where you are a carer, the person you provide care for must be ordinarily resident in the Lancashire County Council area. This is because carers’ needs are met by the local authority where the adult with the needs for care and support lives, not the authority where the carer lives. Determining ordinary residence at this stage will not lead to a delay in meeting eligible needs.

6. Information and Advice

Information and advice will be provided, in an accessible form, about what can be done to prevent, delay, or reduce development of your needs. Where you have some needs that are eligible, but also some other needs that are not deemed to be eligible, Lancashire County Council must provide information and advice on services facilities or resources that would contribute to preventing, reducing or delaying the needs which are not eligible, and this will be aligned and be consistent with your support plan.

7. Carers’ Budgets

Following the eligibility determination, if you are eligible, you will receive a carer’s budget as part of your support plan. It is an important tool that gives you clear information regarding the money that has been allocated to meet the needs identified in your assessment and recorded in your support plan.

Lancashire County Council uses a consistent method for calculating carer’s budgets. You will be provided with indicative budget at the start of the support planning process to help you develop the plan and make appropriate choices about how your needs are met. The final amount of the carer’s budget will be confirmed through this process. The detail of how the carer’s budget will be used must be set out in the plan.

Lancashire County Council will ensure that your carer’s budget is always a sufficient amount to meet your support needs. The final annual carer’s budget must only be for the cost of the remaining unmet needs that cannot be met by universal preventative services, such as information and advice and/or care and support that is, or will be provided, to the person that they care for, such as respite.

7.1 What are carer payments?

A carer’s personal budget is known as a carer payment and is paid as a direct payment you for the sole purpose of paying for services which you have arranged for yourself and not for the person you are caring for.

 7.2 How much money will a carer receive?

Lancashire County Council use a banded approach to calculate the value of a carer’s payment. The band awarded will be linked to the extent that your caring role is impacting on you as a carer as identified in the carer’s assessment (see Carer’s Assessments policy).

7.3 What can carer payments be used for?

The carer payment must be used to support you and meet your needs as identified in your carer’s assessment. Examples of purchases made using carer payments include:

• funding towards the cost of a holiday or day out.
• transport for a break away or visiting family.
• funding for a hobby, for example, fishing, golf, cooking or exercise equipment.
• college courses or training.
• home improvements, gardening or domestic help.
• equipment to help caring, for example, washing machine, dishwasher.
• funding to support a return to work.

There are some things the carer payment cannot be used for, and these include:

• the cost of a break for the person you care for.
• items for the cared-for person.
• goods or services that have already been purchased.
• debts and household bills.

With respect to a holiday / day trip, the carer payment can cover a break for you going on holiday alone or you and the person you care for taking a break together; however, it does not fund the cost of the break for person you care for.

The carer payment is one of a range of support options. Access to good quality information, advice and signposting is crucial to carers, and this is at the forefront of the Lancashire County Council approach to providing support.

The carer payment is not a right for all carers. Carer support can take many forms and does not automatically translate into funded services or a carer payment. In some situations, the provision of formal care and support to the person you care for will meet the carer’s eligible needs.

7.4 How are carer payments paid to the carer?

Carer payments will be paid annually directly to your specified bank account to maximise your ability to exercise choice and control. If you are already in receipt of services and have a Direct Payment Card, the carer payment will also be made to the same card.

7.5 Reviewing needs 

A review of your carer’s assessment and support plan must be carried out annually. The review may be carried out face to face or by telephone / online depending on your preference. The review will determine eligibility for a further carer payment which may increase/decrease or stop if there has been a change in your needs or circumstances, or as a result of changes to the Lancashire County Council policy.