Social Care & NHS Continuing Healthcare

Overview

Adult social care

Adult social care supports adults who need help because of disability, illness, age, mental health needs, frailty, sensory impairment, addiction, homelessness, or caring responsibilities.

Support may include:

• care at home
• equipment or adaptations
• personal care
• day services
• supported living
• residential or nursing care
• respite care
• safeguarding
• carer support
• direct payments

Official link: https://www.gov.uk/apply-needs-assessment-social-services

Children’s social care

Children’s social care supports children and families where a child has disability, safeguarding needs, family crisis, young carer responsibilities, care needs, or risk of harm.

Support may include:

• child in need assessment
• disabled children’s services
• short breaks
• family support
• safeguarding assessment
• direct payments
• SEND links
• looked-after children support

If a child may be at immediate risk of harm, call 999. Otherwise contact your local council children’s services.

Care assessments

A care needs assessment looks at what help a person needs with daily life. It should consider:

• washing, dressing, eating and toileting
• mobility and safety
• medication support
• communication
• mental health
• family and caring responsibilities
• home environment
• social isolation
• work, education or community participation

Carers can also request a carer’s assessment.

NHS Continuing Healthcare

NHS Continuing Healthcare is a package of care arranged and funded by the NHS for adults with a primary health need. It can be provided in any setting, including at home or in a care home.

Assessment usually considers needs such as:

• behaviour
• cognition
• psychological needs
• communication
• mobility
• nutrition
• continence
• skin integrity
• breathing
• medication
• altered states of consciousness
• other significant care needs

Official link: https://www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/

Personal budgets

A personal budget is the amount of money allocated to meet assessed care and support needs. It should be explained clearly in the care and support plan.

It may be managed by:

• the council
• a third party
• the person or representative through direct payments

Direct payments

Direct payments allow eligible people to receive money to arrange some of their own care and support instead of the council arranging it all.

They may be used for:

• personal assistants
• respite care
• community support
• activities linked to assessed needs
• flexible care arrangements

You should receive clear information about responsibilities, records, payroll, insurance, safeguarding and permitted spending.

Official link: https://www.gov.uk/apply-direct-payments

Children, parents and carers

Parents can ask for:

• disabled child assessment
• parent carer needs assessment
• short breaks
• direct payments
• equipment or adaptations
• social worker support
• EHCP links where education, health and care needs overlap
• safeguarding support if needed

Keep evidence of:

• daily care needs
• night-time care
• behaviour risks
• medical needs
• school impact
• appointments
• medication
• therapy reports
• family stress
• sibling impact

Legal rights

Key laws and rights include:

• Care Act 2014: adult care needs, carers assessments, eligibility and care planning.
• Children Act 1989: children in need and safeguarding duties.
• Children and Families Act 2014: SEND and parent carer support.
• Mental Capacity Act 2005: decision-making support and best interests.
• Equality Act 2010: reasonable adjustments and disability discrimination protection.
• NHS Constitution: dignity, respect, access, information and complaints.

Accessible support

Ask for:

• Easy Read
• large print, Braille or audio
• BSL interpreter
• spoken language interpreter
• advocate
• longer assessment
• home assessment
• carer involvement
• communication support
• reasonable adjustments
• written decisions

If the person has substantial difficulty being involved and no suitable person to support them, an independent advocate may be required under the Care Act.

Evidence standards

Keep:

• care diary
• medication list
• risk records
• falls diary
• continence records
• sleep/night care logs
• hospital letters
• GP letters
• therapy reports
• school reports
• safeguarding records
• financial assessment documents
• copies of decisions, care plans and reviews

Ask for:

• assessment report
• eligibility decision
• care and support plan
• personal budget amount
• direct payment agreement
• written reasons for refusal
• review date
• complaints process

Accountability and complaints

If support is delayed, refused or unsafe:

1. Ask for the decision in writing.
2. Request a review.
3. Use the council complaints process.
4. Contact safeguarding if there is risk of abuse or neglect.
5. For NHS Continuing Healthcare, ask the Integrated Care Board about review or appeal.
6. Escalate NHS complaints to the Parliamentary and Health Service Ombudsman where appropriate.
7. Seek advice from Citizens Advice, a law centre, disability charity or legal adviser.

Official links

• Adult care needs assessment: https://www.gov.uk/apply-needs-assessment-social-services
• Direct payments: https://www.gov.uk/apply-direct-payments
• Carer’s assessment: https://www.gov.uk/carers-assessment
• NHS Continuing Healthcare: https://www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/
• NHS social care guide: https://www.nhs.uk/conditions/social-care-and-support-guide/
• Care Act guidance: https://www.gov.uk/government/publications/care-act-statutory-guidance
• Children with SEND: https://www.gov.uk/children-with-special-educational-needs
• NHS complaints: https://www.nhs.uk/contact-us/how-to-complain-to-the-nhs/
• NHS Constitution: https://www.gov.uk/government/publications/the-nhs-constitution-for-england

Best rule: ask for assessments early, keep detailed care evidence, request written decisions, challenge unclear refusals, and escalate quickly if safety or dignity is at risk.