Adult social care early invention and prevention

There are two components to determining an individual's eligibility for local authority funded social care:

• A care and support need
• Ability to fund their own support.

Care and support need

From NHS guidance, a local authority is required to consider whether a person's needs:

• arise from or are related to a physical or mental impairment or illness
• make them unable to achieve two or more specified outcomes (see link)
• as a result of being unable to meet these outcomes, there is likely to be a significant impact on the adult's wellbeing

People may need care and support because of serious illness, physical disability, learning disability, mental health problems or frailty because of old age. (Source: NHS Social Care and Support Guide)

There is some evidence on how individual conditions, behaviours and events increase the risk of needing social care:

• Tobacco use: twice as likely to enter social care compared to non-tobacco users and, on average need care 9 years earlier. (source: ash.org.uk)
• Falls: 1/3 of over 65s fall each year. 20% of hip fractures result in a permanent social care placement (Kings Fund Publications)
• Ageing: people over 65 account for 51% of local authority spending on social care. (source: NHS Publications )
• Stroke: 5 year risk of care home institutionalisation is 11% after a TIA and 19% after a stroke. (source: AHA Journals - Stroke)
• Long term conditions: 70% of social care spending is on long term conditions. (source: Government Policies)
• Loneliness and Isolation: research suggests links with social care use, but we have not been able to find a quantifiable risk.

Funding ability

• Means testing to determine eligibility for local authority funded social care looks at income and capital limits.
• Those at risk of local authority funded social care have fewer financial assets and lower incomes. They will likely live in more deprived areas.