Health and social care

What is Fair Access To Care Services?

• Fair Access To Care Services is guidance from the Department of Health. This guidance includes a way of deciding who should receive social care services from statutory agencies (such as Social Services departments)

• Social care services are services provided to people who need help to maintain their safety and independence on a day-to-day basis, as a result of disability, illness, injury, frailty (due to old age), or mental incapacity

• Under the Fair Access system, decisions on who should receive social care services are based on risks to independence - both immediate and longer term - were help not to be provided. In other words, the system looks at what might happen if services were not provided, and targets services at those at greatest risk

• The Fair Access system applies to adults aged 18 and over

• The Fair Access system does not apply to carers

How does the Fair Access system work?

If you feel you need or might need help to maintain your day-to-day independence, you should contact local community teams, care management teams or occupational therapy services to discuss your needs. A discussion of your needs is called an assessment.

In order to help you prepare for an assessment, you may wish to think in advance about any needs you have, using the following points as a rough guide.

• Autonomy and freedom to make choices, for example, if you have a learning disability or mental health problem, you may need help to communicate your needs or views, or help to make choices. Or you may need help to ensure your views are taken into account in how your day-to-day life is organised
• Health and safety, including freedom from harm, abuse and neglect, and taking wider issues of housing and community safety into account. For example, you may be experiencing significant health (including mental health) problems, or feel that your life is in danger in some way. Someone may be ill-treating you, or not caring for you properly. You may find it difficult to remember to turn off gas rings or electric fires, and may be placing yourself and/or others at risk. Or as a result of injury or disability, you may find it difficult to use essential facilities in your home, such as the kitchen, bathroom or toilet, and may wish to find out what help could be provided
• Your ability to manage personal and other daily routines. For example, you may find it difficult or impossible to wash yourself, use the toilet, get dressed and undressed, or carry out other essential personal care tasks. You may find it difficult or impossible to shop for and prepare food and drinks, or may need help with collecting your pension. You may find it difficult or impossible to carry out essential cleaning in your home
• Involvement in family and wider community life, including leisure, hobbies, unpaid and paid work, learning and volunteering. For example, you may find it difficult to have a life outside your home, may have few or no opportunities to meet up with family or friends, and may feel isolated from other people. You may find it increasingly difficult to keep up your involvement in work, education, learning or leisure activities, and may lack sufficient stimulation to help keep you feeling interested and involved in life

These are examples only of the types of needs you might wish to discuss during your assessment. If you have time before your assessment, please write down a list of your needs, and use this list in the discussion. Otherwise you might simply forget the things you really want to talk about.

Decisions on eligibility

• Once you've talked about your needs with a member of staff, she or he will consider whether your needs give rise to risks to your independence, and how severe those risks are. Each risk you face will be classified as critical, substantial, moderate or low
• If any risks you face are critical or substantial, you will be eligible for social care services from local statutory agencies (such as Croydon Social Services) to reduce those risks. If risks you face are not yet critical or substantial, but are likely to be in the longer-term, action will be taken within a reasonable timescale to prevent those risks from worsening, where practical
• If the risks you face are moderate or low, you will not be eligible for social care services from statutory agencies
• If you are not eligible for social care services from statutory agencies, you will be given information and advice about private and voluntary organisations which may be able to help meet your needs. If necessary, you will be referred to these agencies by a member of staff

There is a local policy which sets out further 'rules' about making decisions on eligibility. This policy is likely to be too detailed for most people, but is available on request.

If you are already receiving social care services, how will Fair Access affect you?

• If you are already receiving social care services, your care package will be reviewed from time to time, to check that services are meeting your needs, and to find out if your needs have changed in any way. Services may be increased, reduced or withdrawn as a result of a review
• If you are already receiving social care services from statutory agencies, it is very unlikely that the new system will result in any changes for you. However, in the event of a decision being made that you are no longer eligible for services, any possible reduction or withdrawal of service would be fully discussed with you, prior to any action being taken

If you disagree with a decision on eligibility

If you disagree with a decision on whether or not you are eligible for social care services, you should discuss the matter with the member of staff concerned, or his/her manager. If the matter cannot be resolved in this way, you are entitled to make a formal complaint. All statutory agencies have formal complaints procedures, details of which will be provided on request. For people already receiving social care services, further information about how to make a complaint can be found in core information packs.

Services you may get if you are eligible

Services will be offered to meet your eligible needs. As individual needs vary from person to person, types and levels of service offered will also vary from person to person.

• Resources to provide social care services are limited, and statutory agencies have to balance their duties of care to an individual against their wider duties of care to everyone in need of social care services. In other words, the more money that is spent on one person, the less will be available to spend on other people. It is for this reason that local statutory social care services are targeted at people who face critical and substantial risks
• Statutory agencies will not meet needs that arise more generally across the wider population. A simple example is that if someone with a disability was unable to shop for him/herself, help might be provided to purchase food, if this is what the person wanted. However, Croydon Social Services would not pay for the food, as everyone needs food, and money with which to buy it

Charges for services

It should be noted that there are charges for social care services, though some people on low incomes are exempt. People receiving services under section 117 of the Mental Health Act 1983 are also exempt.