Fair access to care: Northumberland’s eligibility
criteria
These criteria set out the circumstances in
which people aged 18 and over will be offered community care
services in Northumberland. They were adopted by the
County Council in 2003, based on a national model called "Fair
Access to Care".
The criteria refer to meeting people's "critical needs".
This does not mean that the Council will only meet the needs of
people who are critically ill - a wide range of needs may be
critical to people's health, dignity and independence. In
practice, the Council's view is that what it calls "critical needs"
are much the same as what many other local authorities refer to as
"substantial needs".
Community Care services are intended
for people who due to chronic ill health or disability are unable
to meet their daily living needs.
They seek:
- to promote independence and rehabilitation,
- to offer support to ill or disabled people and their
carers,
- to provide services to assist individuals, either on a short or
longer term basis, building on the strengths and resources of the
person, family, friends and the local community
These criteria list nine areas of critical
need which may call for community care services. If you have
critical needs in any of these areas, we will offer you help to
meet those needs, unless there is no safe way to do so.
We aim to help you in the way you would
prefer. Our resources are limited, however and we may not be
able to offer help of a kind that would be your first choice.
Wherever possible, we will try to provide help in a way that lets
you continue to live in your own home, if that is that you want –
but if you need a great deal of support, we may only be able to
provide that by helping you to move into a care home or a
supporting housing scheme.
We cannot guarantee to provide services
if you could meet your critical needs in other ways, or if the help
you require is thestatutory responsibility of some other
organisation.
Critical
Need 1: Without support from community care services, life is, or
will be, threatened
Many of the common circumstances in
which care services may be important to protect people from
life-threatening hazards are described below under more specific
headings. However care and support services will also be
provided in any other circumstances where there is a significant
threat to life which no other more appropriate body is in a
position to prevent.
Critical
Need 2: Without support from community care services, significant
health problems have developed or will develop
These criteria are primarily about care
and support services rather than health treatment services.
However there are many situations where care and support services
can avoid or minimise significant risks to someone’s health.
Many of these appear under other more specific headings in this
guidance. There are also some general ways in which care and
support services can address significant health
problems:
2a: Arranging any support needed to
ensure that you do not avoidably develop a disabling health
condition, or have an existing condition deteriorate or fail to
improve in the way it could (this includes disabling mental health
conditions). Before providing services for this reason, we
will normally expect there to have been an assessment of the risks
by an appropriate health professional.
2b:Taking steps to protect you from
preventable risks in carrying out basic daily activities, or
providing basic care (for example avoidable risks of back injury,
falls or burns, or failure to recognise dangerous substances)
2c: Making sure you are able to take
prescribed medication appropriately
2d: Arranging for services to be
provided in such a way that you are free from repeated and
avoidable physical pain
2e: Addressing the causes if you suffer
from severe and persistent distress, which harms your ability to
cope with daily life, or leads you to harm yourself or others
2f: Helping you to become informed, so far
as you wish to be, about the health conditions causing your
problems or those of the person you care for, and about the
treatment you or they are receiving, unless the doctor responsible
for your medical care believes it would be harmful. (In the
case of information for a carer, the person cared for normally has
a right to withhold consent to the sharing of information, unless
there is a serious risk to the carer, for instance because of a
serious mental health problem).
Critical
Need 3: Without support from community care services, there is, or
will be, little or no choice and control over vital aspects of the
immediate environment
Control over vital aspects of the
immediate environment includes:
3a: Having satisfactory basic toileting
arrangements (dignified, hygienic and without risk to
health).
(Depending on people’s specific circumstances, this may not always
require access to a flush toilet.)
3b: Being able to transfer between your bed and a chair in your
living room, and get in and out of that chair (for people living on
their own, we may sometimes suggest sleeping in the living room to
achieve this standard).
3c: Being able to change position often
enough to avoid harm to your health (e.g. pressure sores)
3d: Keeping warm enough to avoid the risk
of hypothermia or the aggravation of serious health problems
3e: Getting advice about how to keep your
home adequately maintained to avoid risks to health and
safety
3f: Having a safe means of getting into
and out of the place where you
live. (Some people who are severely
disabled and wish to stay in their own homes may only be able to
use this entry/exit when there is someone else present to help
them).
3g: Being able to let people into your
home safely
3h: Being able to get help in a serious
emergency of a kind which there is reason to believe may be likely
to arise. (Help from community care services will normally
only be offered if there is some special reason why a normal
telephone is not available -- for instance because you live in an
extremely remote area. In those circumstances the help
normally offered will be the cheapest available solution that
enables you to make emergency calls. Publicly-funded
alarm call systems are provided through the Supporting
People service, which care managers can put people in contact with,
but which is separately funded).
3i: Ensuring that you are not forced
to live in an environment where you are prevented from exercising
your rights under the Human Rights Act – in particular the right to
respect for private and family life, freedom of thought, conscience
and religion, freedom of expression, and freedom of assembly and
association. (This does not include enabling you to carry out
activities which are illegal or which harm others)
Critical
Need 4: Without support from community care services, serious abuse
or neglect has occurred or will occur
Serious abuse or neglect includes:
4a: Violence
4b: Degrading treatment
4c: Exploitation (for instance
financial exploitation)
4d: Serious avoidable deterioration in
your health and wellbeing as a result of failure to take necessary
actions (by yourself or others)
Critical
Need 5: Without support from community care services, there is, or
will be, an inability to carry out vital personal care or domestic
routines
Vital personal care routines
include:
5a: Getting washed all over often enough
to avoid harm to your health
5b: As a minimum, getting washed all over
at least once a week (with or without help)
5c: Washing your hands and face daily, or
getting them washed with help
5d: Carrying out (or having carried out
for you) as often as appropriate the basic activities needed to
look after your body – such as shaving, hair combing, tooth
brushing, coping with periods, cutting your nails, washing your
hair, getting your hair cut, etc.
5e: Getting dressed and undressed each
day
5f: Getting into and out of bed each
day
5g: Eating and drinking adequately for
your health
Vital domestic routines include the
following. However we will only provide domestic help if
there are special reasons why you cannot reasonably be expected to
make alternative arrangements yourself. For this reason, we
will not usually provide domestic help to anyone who does not also
need a substantial amount of help with personal care.
5h:Keeping the place where you live
sufficiently clean and well-maintained to avoid serious risk of
harm to your health (e.g. through food poisoning or aggravation of
a respiratory problem)
5i:Getting clean clothes and bedclothes
when you need them. Help with washing bedclothes, where this
is needed, will normally be offered on the basis of a fortnightly
change of bedclothes, unless there is a special reason for more
frequent help, such as incontinence. We will
not provide a service to iron
clothes.
Critical
Need 6: Without support from community care services, vital
involvement in work, education or learning cannot or will not be
sustained
Most core public support with work,
education and learning does not come from health and social care
services, and health and social care budgets are not funded to
provide direct support for disabled people with the cost of
education and training, or financial support for employers to help
them to employ disabled people. However care and support
services can in some circumstances be crucial for people’s ability
to access work, education or learning, and we will provide them
where necessary. In some limited circumstances we will also
contribute in the short term to the development of services which
will ultimately fall to be funded from other public sources – in
particular where this assists with plans to change the role of day
care services to a model which does more to promote service users’
independence.
Relevant support with education
includes:
6a:Getting any care that is required to
enable you to take up education or training to which you have an
entitlement, and whose core costs are funded from other sources
(this could include the costs of escorts on transport, but would
not normally include the basic costs of the transport itself)
Relevant support with work
includes:
6b:Getting any advice and counselling that
you may need to enable you to continue in or return to the line of
work which you were in before becoming ill or disabled
6c: Getting any advice, preparation
and counselling that you may need to enable you to take advantage
of opportunities for paid employment that it is realistic for you
to aspire to (this does not normally include funding for vocational
education or training courses, which is the responsibility of other
public bodies – but see the general note above)
6d: Getting help with transport to
supported employment if your employment comes under the “permitted
work” rules of the Department of Work and Pensions and you cannot
reasonably be expected to arrange transport for yourself.
Relevant support with learning
includes:
6e: Getting any training or
rehabilitation which is required to enable you to carry out vital
care or self-care tasks safely and independently. (We cannot
provide help of this kind if there is no realistic likelihood that
you will be able to carry out the tasks yourself as a result.
Community care services will only be required if funding is not
available from other sources)
6f: Knowing where to get advice about
any financial help to which you may be entitled. (In some
circumstances, the Care Trust will provide advice itself, but its
expertise and resources are limited, so it will often provide
support only by informing people about available sources of
advice).
Critical
Need 7: Without support from community care services, vital social
support systems and relationships cannot or will not be
sustained
Sustaining vital social support systems
and relationships includes:
7a: Maintaining or developing sufficient
social contacts to prevent avoidable deterioration in your mental
health
7b: At the minimum, avoiding extreme
isolation, maintaining some regular contact with other people
7c: Being able to make your needs and
views known effectively to the people whose actions most affect
your life (if this requires, for instance, an interpreter or
signer)
Critical
Need 8: Without support from community care services, vital family
and other social roles and responsibilities cannot or will not be
undertaken
Undertaking vital family and other
social roles and responsibilities includes:
8a: Not having your children’s welfare
significantly harmed
8b: Not having your children taking
inappropriate responsibility for providing care
8c: Not having such strain in your
relationship with other household members that they are in danger
of collapsing
8d:Being protected from behaving in a way,
which is a serious danger to yourself and other people
Critical
Need 9: Without support from community care services, vital needs
of carers will not be met
Vital needs of carers include:
9a:Getting relief if you are always
exhausted through lack of sleep, frequent physical exertion or
mental stress, or the burden of multiple responsibilities
9b:As a minimum, getting at least two
hours each day free from care tasks, if you are a full-time
carer. (This means time for yourself, but not necessarily
time out of the house. It may include time when you are still
responsible for the person you care for, but not actively required
to do anything for them – though your care manager should discuss
with you whether you have to be so alert to the person’s needs all
the time that you cannot properly relax. Often achieving this
outcome will not require services, even for a full-time
carer).
9c: As a minimum, getting at least two
hours away from the person you care for at least once a week. (This
is a basic minimum which you should expect in any circumstances;
other problems will often provide a reason to ensure that you are
able to have more time to yourself)
9d: As a minimum, if you are a carer with
heavy care responsibilities, having at least a week each year
without the responsibility of looking after the person you care for
(if you want to). (Again this is a basic minimum; meeting
other vital needs will for some people mean that more short breaks
than this are required. If the best way to achieve this
objective is to arrange a short break elsewhere for the person you
look after, we will do so. However we cannot promise to fund
the kind of stay which the person would ideally choose, and we are
not able to fund holidays away for carers).
9e: Being told how to contact any groups
of carers in a similar situation which exist in your area.
Contact Adult Social Care
Telephone: 01670 536
400
Email address: Socialcare@northumbria.nhs.uk
