Screening and eligibility criteria

The guidance in Wales on the Unified assessment is significantly different to the guidance in England on the single assessment. The guidance in Wales does not refer to screening but includes reference to responding to enquiries.

Good practice examples

Screening (in Wales the guidance refers to effective means of responding to enquiries)

Eligibility criteria

Good practice examples

Milton Keynes - Adult Social Care Access Team

Tameside - Information on the Council Website

Screening (in Wales the guidance refers to effective means of responding to enquiries)

• Information gathered during assessments is used to make decisions on eligibility and appropriate services. Therefore the threshold for access to assessment should be set at a low enough level to ensure people are not screened out before full information on their needs is obtained.
• Assessors must understand, explain and consistently apply eligibility criteria
• Only those who need an assessment should be referred on for one
• Referrers should be redirected to other services quickly where there are appropriate alternatives
• There should be an equitable response following screening across an authority area

GOOD PRACTICE TIPS

Effective screening (in Wales the guidance refers to effective means of responding to enquiries) Focus assessments on those situations that require it Check reception processes are consistent across the authority and accessible to all the community Use a single point of access where possible or put in systems behind the front door that have this effect < Lever in additional resources by building up corporate-wide one stop shops Use administrative staff with appropriate training to screen and redirect service users efficiently (Good practice Milton Keynes) Ensure reception and other frontline staff have up to date information about open access services in the community and other services provided by the authority and other agencies Provide clear information so users/carers can self select/direct (Good practice Tameside) Proactively develop a range of community based alternatives to mainstream services for people who do not meet your eligibility criteria

Eligibility criteria

Councils need to explicitly link their eligibility criteria to the amount of resources available. During the budget setting process councils (see more on this) must have a clear view of the level of activity the budget is required to sustain throughout the year and ensure that the eligibility criteria are set in line with this. Overspends will result if the numbers coming in through the front door exceed the numbers planned for within the budget.

Eligibility criteria can also help a council measure the level of need for services and quantify those that are not being met. Services can then be commissioned which will more appropriately meet that need and unnecessary services can similarly be reduced or if necessary decommissioned.

The Department of Health guidance document 'Fair Access to Care Services' (The equivalent guidance in Wales: Fair Access to Care Services contained within "Creating a Unified and Fair System for Assessing and Managing Care" issued in April 2002 by the Welsh Assembly Government). In England the guidance required that by April 2003:

• Councils should have reviewed and revised their eligibility criteria, in consultation with key stakeholders including service users and carers
• Councils should operate just one eligibility decision for all adults seeking social care support - namely, "should people be helped or not?"
• Councils should assess an individual's presenting needs, and prioritise their eligible needs, according to the risks to their independence in both the short and longer-term were help not to be provided
• Councils should make changes in their practice to take a longer-term preventative view of individuals' needs and circumstances
• Councils should focus help on those in greatest immediate or longer-term need but with due regard to resources and other local factors
• Councils are required to use case reviews to compare assessed and eligible needs over time.

Handling eligibility criteria well will lead to:

• Service users and carers, partners and the community understanding why some people get a service and others don't
• Front-line staff having information to explain the rationale behind a decision
• Councillors having an opportunity to debate the link between available resources and level of demand
• Freeing up service capacity following reviews of eligibility for others with greater needs.