Am I entitled to a service?

Vulnerable people may be in one or more of the following groups:

Older people
People with physical disabilities
People with a visual impairment
Deaf people
People with learning disabilities
People with mental health problems
People with HIV and AIDS
People who misuse substances
Carers of any of the above

We follow the 'Fair Access to Care Services' criteria for assessing whether a person’s needs make them eligible for statutory social care services. Laid down by the Department of Health, the criteria are graded into 4 bands: Low, Moderate, Substantial and Critical. It is for each local authority to decide which level they can afford to fund.

Eligibility criteria for Wokingham Borough residents

Following a major consultation, the Council’s Executive decided on 22 February 2007 to set an eligibility threshold, according to available resources, at the following level:

Assessed needs which fall within the Critical band only are eligible for specialist statutory social care services.
People with needs assessed as Substantial, Moderate or Low will generally not be eligible for long-term statutory services.
It is the need that is eligible, not the person, so someone with both Critical and, for example, Substantial needs would be eligible only to meet the Critical needs.
We will however treat as eligible any needs which are likely to become Critical within a 3 month period.
In addition, any vulnerable adult for whom there is a risk or an allegation of abuse, we will consider eligible for services to ensure safety.
We have also set out what carers’ needs we consider as Critical and therefore eligible for services.
We also have duties under a range of legislation which may require services to be enabled. These include: Human Rights Act, Mental Health Act aftercare, Disability Discrimination Act, Chronically Sick and Disabled People Act.
Some services are also available on a short-term or preventative basis to people with substantial, moderate or low needs.

Who is eligible?

Everyone is entitled to an assessment of their needs, including anyone who cares for a person aged 18 or over. If you have needs that don’t meet the Critical criteria we would give you advice and information about where to go for help.

Only people with needs that meet the eligibility criteria above the threshold in Critical are eligible to receive long-term statutory community/social care services from us. These services may be supplied directly, commissioned from an independent provider or through a direct payment. See the Direct Payments leaflet available from the Communications Unit: telephone 0118 974 6777.

However, there may be other reablement, preventative, health or voluntary services available. We are working with our partners to develop even more local support and preventative services. It could be worth making an enquiry even if you think you may not meet the criteria as help may be available to you in other ways. We can offer advice or put you in touch with someone who can.

Definition of criteria and levels of need

Below, we have set out the basic levels of need, as defined by the Department of Health in their guidance on Fairer Access to Care. Further details on our agreed definitions of the eligibility criteria are available as well as case examples which may help illustrate the way we would determine the levels of an individual’s needs, using our eligibility criteria.

Critical

Life is, or will be, threatened and/or
Significant health problems have developed or will develop and/or
There is, or will be, little or no choice and control over vital aspects of the immediate environment and/or
Serious abuse or neglect has occurred or will occur and/or
There is, or will be, an inability to carry out vital personal care or domestic routines and/or
Vital involvement in work, education or learning cannot or will not be sustained and/or
Vital social support systems and relationships cannot or will not be sustained and/or
Vital family and other social roles and responsibilities cannot or will not be undertaken

Substantial

There is, or will be, only partial choice and control over the immediate environment and/or
Abuse or neglect has occurred or will occur and/or
There is, or will be, an inability to carry out the majority of personal care or domestic routines and/or
Involvement in many aspects of work, education or learning cannot or will not be sustained and/or
The majority of social support systems and relationships cannot or will not be sustained and/or
The majority of family and other social roles and responsibilities cannot or will not be undertaken

Moderate

There is, or will be, an inability to carry out several personal care or domestic routines and/or
Involvement in several aspects of work, education or learning cannot or will not be sustained and/or
Several social support systems and relationships cannot or will not be sustained and/or
Several family and other social roles and responsibilities cannot or will not be undertaken

Low

There is, or will be, an inability to carry out one or two personal care or domestic routines and/or
Involvement in 1 or 2 aspects of work, education or learning cannot or will not be sustained and/or
1 or 2 social support systems and relationships cannot or will not be sustained and/or
1 or 2 family and other social roles and responsibilities cannot or will not be undertaken