How Do You Get Help with Care at Home — and Who Pays for It?

What is a care needs assessment and how do you get one?

A care needs assessment is a free conversation with your local council’s adult social services team. Its purpose is to understand what support you need to live safely and independently at home. Anyone can request one — you do not need a GP referral, a diagnosis, or to be in crisis. You simply contact your local council and ask for an adult social care assessment.

The assessment usually takes place at home and involves a social worker or care coordinator asking about your daily life — what you can manage alone, what you struggle with, and what matters most to you. It typically takes one to two hours. You can have a family member, friend, or advocate present if you would like.

What kinds of support can the council arrange?

• Home care visits — a paid carer comes to your home to help with personal care such as washing, dressing, and taking medication
• Meals at home — hot meals delivered to your door, sometimes known as “meals on wheels”
• Day centres — social activities, meals, and health support outside the home, with transport often included
• Reablement — short-term intensive support (usually up to six weeks, often free) to help you regain skills and confidence after an illness, fall, or hospital stay
• Respite care — short-term cover so that an unpaid carer can take a break
• Equipment and home adaptations — grab rails, shower seats, raised toilet seats, and larger adaptations to help you stay safe at home

Will you have to pay for home care?

This depends on your income and savings. The council carries out a financial assessment (sometimes called a means test) alongside the care needs assessment. If you have savings and assets below £23,250 (the current threshold in England), you may qualify for council-funded support. If you are having care at home — as opposed to moving into a care home — the value of your own property is not included in the financial assessment. This surprises many people and is an important distinction worth knowing.

Even if you do not qualify for council funding, the assessment is still valuable — the council can advise on what services are available locally and help you arrange private care more effectively.

What if the council says your needs do not meet the threshold?

Councils in England use the Care Act 2014 eligibility criteria, which focus on whether unmet needs have a significant impact on your wellbeing. If you are told you do not meet the threshold, you have the right to request a review and to challenge the decision. Age UK can help you do this — call their free advice line on 0800 678 1602. You can also contact your local Healthwatch organisation, which independently monitors health and social care services in your area.

What about support for unpaid carers?

If you are looking after a family member or friend, you are also entitled to a carer’s assessment from the council — separate from the assessment for the person you care for. This looks at your own needs, your wellbeing, and what support might help you continue caring without it damaging your health. Carer’s assessments are free and available to anyone providing regular unpaid care, regardless of income.