Care and Support Needs

The meaning of “care and support needs” The Care Act says adult safeguarding duties apply to adults with care and support needs but does not define what it means by these. Guidance from the Social Care Institute of Excellence (SCIE) can help address this, as can the regulations that accompany the Act. 

SCIE guidance in its “Adult safeguarding practice questions” (March 2015) SCIE wrote “An adult with care and support needs may be:

• an older person
• person with a physical disability, a learning difficulty, or a sensory impairment
• someone with mental health needs, including dementia or a personality disorder
• a person with a long-term health condition
• someone who misuses substances or alcohol to the extent that it affects their ability to manage day-to-day living.

This is not an exhaustive list

There may be times when a person has care and support needs and is unable to protect themselves for a short, temporary period – for example, when they are in hospital under anaesthetic

“An older person” should not be taken to mean that age alone means a person has care and support needs but is a recognition that older people are at higher risk of some conditions that can lead to care and support needs developing.

The cause of the need, the Care and Support (Eligibility Criteria) Regulations 2014 say that an eligible care and support need is one that

• Arises from or is related to a physical or mental impairment or illness;
• Results in the adult being unable to achieve two or more of the outcomes specified in the regulations; and
• Which has, or is likely to have, a significant impact on the adult’s well-being Items (2) and (3) relate to the degree of the need, which is not relevant to determining whether a duty arises under section 42 of the Care Act, but item (1) relates to the nature of the need.

The impact of the need, the regulations go on to say that care and support needs have an impact on the following outcomes:

• • Managing and maintaining nutrition
  • Maintaining personal hygiene
  • Managing toilet needs
  • Being appropriately clothed
  • Being able to make use of the home safely
  • Maintaining a habitable home environment
  • Developing and maintaining family or other personal relationships
  • Accessing and engaging in work, training, education, or volunteering
  • Making use of necessary facilities or services in the local community including public transport and recreational facilities or services
  • Carrying out any caring responsibilities the adult has for a child

In the context of adult safeguarding, any impact on these outcomes may be relevant. There is no threshold of it being a significant impact.

It must be noted that an adult does not have to be eligible for care and support under the Care and Support Eligibility Regulations (for a safeguarding concern to be raised or for the local authority S42 duty to apply).