Health and social care rights
Explains your rights to health and social care for your mental health. Includes information on eligibility for social care and how local authorities may meet your needs.
Are my needs eligible for social care support?
Your local authority will not meet every need for care and support that you have. Your needs will only be met if they satisfy the eligibility criteria.
When the local authority is considering whether you have eligible needs, they will look at:
- What kind of health problem causes your needs for care and support
- Whether your needs affect your ability to do certain things
- How your needs affect your day-to-day living
The law on eligibility is slightly different depending on whether you're in England or Wales.
1. Your needs for care and support arise from certain health problems
Firstly, you'll need to show that your needs for care and support arise from certain health problems. This includes:
- Mental health problems
- Physical ill-health
- Disability
- Learning disabilities
- Cognitive disabilities
- Dependence on alcohol or drugs
You don't need to have a specific diagnosis to be eligible for social care and support.
2. As a result, you're unable to do certain things
Next, the local authority will assess whether you're unable to do certain things. These are:
- Eating and drinking
- Maintaining personal hygiene
- Managing toilet needs
- Being appropriately clothed (dressed)
- Being able to make use of your home safely
- Keeping your home clean, safe and hygienic
- Developing and maintaining family or other personal relationships
- Accessing and engaging in work, training, education or volunteering
- Using necessary facilities or services in the local community including public transport, recreational facilities or services
- Carrying out any caring responsibilities you have for a child
In England, you need to show that you're unable to achieve two of these outcomes.
Example
Cate has severe depression. She's physically able to wash and dress, but will go for long periods of time without washing or dressing unless she's reminded. Cate is unable to maintain her personal hygiene or be appropriately clothed. This makes it difficult for her to find work. It also affects her social and economic wellbeing.
In England, Cate could have eligible needs for care and as she's unable to achieve two outcomes, which has a significant impact on her wellbeing.
1. Your needs for care and support arise from certain health problems
Firstly, you'll need to show that your needs for care and support arise from certain health problems. This includes:
- Mental health problems
- Physical ill-health
- Disability
- Learning disabilities
- Cognitive disabilities
- Dependence on alcohol or drugs
- Age
You don't need to have a specific diagnosis to be eligible for social care and support.
2. As a result, you're unable to do certain things
Next, the local authority will assess whether you're unable to do certain things. In Wales, you need to show that you're unable to achieve one of these outcomes. They are:
- Carrying out self-care or domestic routines, such as:
- Eating and drinking
- Maintaining personal hygiene
- Getting up and getting dressed
- Moving around the home
- Preparing meals
- Keeping your home clean, safe and hygienic
- Communicating
- Protecting yourself from abuse or neglect
- Being involved in work, education, learning or in leisure activities
- Maintaining or developing family or other significant personal relationships
- Developing and maintaining social relationships and involvement in the community
- Fulfilling caring responsibilities for a child
3. You don't have a carer or access to community support that can meet your needs
When the local authority is deciding whether you have eligible needs, they'll consider whether you have:
- A carer who is willing to meet your needs
- Access to community support to meet your needs
If you have the assistance or support of either of these, you will not be considered to have eligible needs.
4. You're unlikely to achieve a personal outcome without help from the local authority
The local authority will look at whether you're unlikely to achieve one or more of the personal outcomes identified in the needs assessment process without care and support. Or direct payments arranged and provided by the local authority.
Example
Kanak has generalised anxiety disorder and agoraphobia. He's physically able to leave his flat but becomes very anxious, especially when he's in crowded areas. He can't shop for himself or go to his local sports and leisure centre. Living more independently is an outcome that Kanak wishes to achieve. He doesn't have a carer who's willing to meet his needs.
In Wales, Kanak would be considered to have eligible needs, as he's unable to make use of facilities in the community. He's also unable to achieve one outcome identified in his assessment without care and support.
What happens after my assessment?
Based on the assessment, the local authority will make a decision about what your needs are and whether they meet the eligibility criteria. They must give you a written record of this decision. If you have an advocate or someone authorised to act on your behalf, they should also get a copy.
If you're eligible for social care, the local authority must help you plan your care and support.
But if you're not eligible for social care, the local authority must give you:
- Reasons for making its decision
- Written advice and information about what can be done to meet your needs or achieve your personal outcomes
- Information about what can be done to prevent or delay your needs for care and support from developing
- Personalised and specific advice based on your needs assessment. They shouldn't just send you a standard letter
If you disagree with the decision they've made, you can make a complaint about it. You may wish to challenge the decision in court. If you do this, you may want to take legal advice.
This information was published in February 2023. We will revise it in 2026.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.
