1. Introduction to adult social care
  2. Guide to care needs assessments
  3. Common questions about care needs assessments
  4. Support for carers and carer’s needs assessment
  5. Care and support accommodation
  6. Paying for adult social care
  7. NHS continuing healthcare
  8. Other countries
  9. Further support
  10. Give us your opinions about how helpful you found this information
  11. Contact us

Introduction to adult social care

Social care is usually provided by your local council. This guide helps you to navigate this system.

The information applies to England only. Details of where to find information for other countries is included on section 8.

What is adult social care?

Adult social care provides practical support. It can include:

  • Help at home with tasks like shopping, cleaning and bathing
  • Live-in care services
  • Day services
  • Help with transport costs
  • Home adaptations
  • Accommodation

Who is it for?

Adult social care is provided to people aged 18 and over with:

  • Physical or learning disabilities
  • Physical illnesses
  • Mental health conditions
  • General frailty.

It can also help you if you are caring for someone receiving social care.

Who pays for it?

Social care is normally paid for by you, your family or the local council.

Is it the same as healthcare?

No. Adult social care is provided by local councils and private companies rather than the NHS. This is the case even if the need arises from an illness or disability.

Guide to care needs assessments

If you, or someone you know, needs help to cope you can ask for a care needs assessment from your local council.

The assessment is free and anyone can ask for one. Below is a guide to the process.

Step 1 – contact the council

Contact social services and ask for a needs assessment. You can do this over the phone or online.

Step 2 – prepare for your assessment

This is your chance to have your say.

Give as much detail as you can about everyday tasks you struggle with.

If you can, keep a diary for a few days before the assessment noting things you can do on your own, things you manage with difficulty and things you are unable to do.

Step 3 – the assessment

A social worker or occupational therapist from the council will ask you questions about how you manage day-to-day tasks.

This can be face-to-face or over the phone. Assessments usually last at least an hour.

Step 4 – getting the results

This will usually happen within a week.

The results identify what kind of care and support would help you.

Step 5 – paying for your care

If the assessment finds you need help, there will be a second assessment to see if the council will help pay for it. More information on paying for social care is available on section 6.

You will usually be expected to pay towards the cost of social care.

Common questions about care needs assessments

When does the council have to assess me?

The local council has to assess you if you are an adult and it seems you need care and support. The council might think you need support if:

  • You tell them about it yourself
  • Someone else tells them they think you need support
  • You are referred to social services from hospital or by a healthcare professional.

Can I have someone with me during my assessment?

Yes. It is a good idea to have someone with you. They can help explain your situation and take notes.

Can I get more advice?

Yes. If you want to speak to someone on the phone you can call:

  • Age UK: 0800 055 6112
  • Independent Age: 0800 319 6789
  • Mind: 0300 123 3393
  • Mencap: 0808 808 1111

Can they say I do not need care?

Yes. But even if this happens you should still be given free advice on where to get help in your community.

Can I complain?

Yes. If you disagree with the results or how your assessment was done you can complain.

How do I complain?

First complain to your council. They should have a formal complaints procedure.

If you are still unhappy, complain to the Local Government and Social Care Ombudsman. Visit or call 0300 061 0614 for more information.

Support for carers and carer’s needs assessment

If you care for someone you can have an assessment to see what might make your life easier. It is free and anyone over 18 can ask for one.

How do I get a carer’s assessment?

Contact adult social services at your local council. You can do this over the phone or online.

What do I need for the assessment?

You will need:

  • Your NHS number (if you have one)
  • Your GP’s name, address and telephone number
  • Contact details of anyone coming to the assessment with you
  • The name, address, date of birth and NHS number (if you have it) of the person you care for
  • Your email address.

What happens in the assessment?

You will be asked how you are coping with caring. Give as much detail as you can.

What help might I get?

In their assessment your carer can recommend things like:

  • Someone taking over caring so you can have a break
  • Exercise classes to relieve stress
  • Help with gardening and housework
  • Training on how to lift safely
  • Advice about benefits
  • Information on carer support groups and websites.

How long will I have to wait for the result?

You should normally receive the results of your assessment within a week.

Care and support accommodation

These are some of the types of residential care available.

Home care

Home care is delivered in your home. It can cover things like cooking meals, helping you get dressed and help with housework.

Supported living

Supported living includes houses or flats which have been purpose-built or adapted to help people live as independently as possible.

It can also include special adaptations to your own home.

Residential care home

A residential care home will offer help with everyday needs. For example, washing, eating and going to the toilet.

Nursing home

Nursing homes offer the most extensive care you can get outside of a hospital. They still offer help with tasks like washing, eating and going to the toilet. However, you will also have access to medical care, delivered by a registered nurse.

Paying for adult social care

Paying for care and support can be confusing. Unlike healthcare, social care is not usually paid for by the NHS.


Self-funding means you pay for your care yourself.

You can choose to self-fund your care or the council might say you have to.

When the council might pay for your care

Your local council might pay towards the cost of your care depending on how much you have in savings. Once you have had your needs assessment the council will arrange a financial assessment. This is also known as a means test. It works out if:

  • The council pays the full cost of your care
  • The council pays some of the cost and you pay the rest
  • You pay for all of your care.

You do not need to book your means test. It will be arranged automatically after your needs assessment.

What you can get for free

There are some services the council has to pay for:

  • Small bits of equipment or home adaptations if your assessment shows you need them
  • Care after you leave hospital.

If you are in a nursing home, the NHS pays for your nursing care. However, you still have to pay for other costs like food and board.

Benefits for under 65s

You can get a range of benefits if you are under 65 and have an illness or disability. These can help with the cost of your care. Your carer may also be entitled to a Carer’s Allowance.

More information on benefits is available from

NHS continuing healthcare

If you have long-term, complex health needs you may qualify for free social care arranged and paid for by the NHS. This is NHS Continuing Healthcare.

Where can it be provided?

Continuing Healthcare can be provided in any setting, including your own home, a care home, supported living or hospice.

Can I get Continuing Healthcare?

To get Continuing Healthcare you have to be assessed by a team of healthcare professionals. This is called a multi-disciplinary team. They will look at:

  • What help you need
  • How complex your needs are
  • How intense your needs can be
  • Any risks to your health if the right treatment is not provided at the right time

Can this change?

Yes. Your eligibility for Continuing Healthcare is based on your needs rather than a condition. If your needs change your eligibility might change.

How long will I have to wait?

A decision should usually be made within 28 days of your assessment.

What if I am not eligible?

You will be referred to your local council who will assess whether they can help you.

Where can I get more advice?

Beacon gives free independent advice on NHS Continuing Healthcare. Visit or call the free helpline on 0345 548 0300.

Other countries


Information on care and support services in Wales is available at

Care Inspectorate Wales is responsible for inspecting and reporting on social care services:

Northern Ireland

Information on care and support services in Northern Ireland is available at

The Regulation and Quality Improvement Authority is responsible for regulating health and social care services:


Information on care and support services in Scotland is available at

The Care Inspectorate regulates social care in Scotland:

Further support

Useful websites – factsheets on paying for residential care – practical advice for carers – responsible for regulating social care services in England – information on home adaptations  – advice on care home fees – support accessing social care with a learning disability – advice on your legal right to social care if you have a mental health condition – information on types of adult social care and how to get support – advice on preparing for the care needs assessment


Source material for the information contained in this leaflet is available on request.

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Contact the Patients Association helpline

The Patients Association offers a free national helpline providing specialist information and advice to help patients make sense of their health and social care.  

Patients can talk directly to trained advisers in strict confidence about any concerns, questions or general experiences they have regarding the NHS and social care systems.  

The helpline is open from 9.30 am to 5pm, Monday to Friday, and calls outside these times are returned as soon as possible during opening hours. 

If you would like to contact the helpline, please call free on 0800 345 7115, or visit the Patients Association helpline page on our website for more information.