Fair access to care

How we use government guidelines to decide how we can help you.

It is our priority to help you keep your independence but we have limited resources. We follow national guidelines from the Department of Health called 'Fair access to care services'.

These guidelines categorise what the risks to independence would be if your needs are not met. There are four categories - critical, substantial, moderate and low.

This page tells you how we use the guidelines to decide how we can help.

What are eligibility criteria?
These are the conditions you have to meet to get help from us.
Councils are allowed to decide whether they have enough resources to provide help for all four of the eligibility criteria bands, or just for some of them.

Who can we help?
In Liverpool, we have enough money to provide services to people in the critical, substantial, and moderate bands. These three bands are our current eligibility criteria.

People in the low band do not meet our eligibility criteria and so will not get a service, but we will provide information and advice on other sources of help where possible.

We will review our eligibility criteria every 12 months.

How does it work?
When you contact us for help we will offer you an assessment. This looks at your situation and shows what help you need.
Together with you, we will work out how much your independence is at risk if you don't receive help.
When working out the risk to your independence, government guidance says we need to focus on 4 factors that are central to a person's independence.

Autonomy and freedom to make choices. This is about your ability to make choices affecting your situation.
Health and safety, including freedom from harm, abuse and neglect, and taking wider issues of housing and community safety in to account.
The ability to manage personal and other daily routines.
Involvement in family and wider community life, including leisure, hobbies, unpaid and paid work, learning and volunteering.

We will also take in to account:

Help you have from carers, and other agencies.
Risks faced by others such as your carers.
Which risks are acceptable to you, or are a natural part of independent living.
What are the priorities for an assessment?

We will respond to all requests for assessment as follows:

Critical - requires a response within 48 hours of receipt of referral. People who are in a crisis situation or are actually at risk or pose a serious risk, when;

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 or other social roles and responsibilities cannot or will not be undertaken.

Substantial - requires a response within 4 weeks.
People and/or carers who are having significant difficulties in coping and are potentially at significant risk, when;

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 - response within 6 months.

People and/or carers who are finding it hard to cope and there is some risk to their health, when:

there is, or will be, an inability to carry out several personal care tasks 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 - will generally not get an assessment but will be given advice and information where possible.
People whose quality of life could be improved but their situation is stable and there is no risk to them or their carers, when:

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

Carrying out an assessment does not necessarily mean we will give you a service, more inforamtion is available by visiting the Assessment & care plan page.

What happens next?
We will give a level of risk to each of the four factors of independence by matching the risks identified to you, to the circumstances described in the Governments four eligibility bands - critical, substantial, moderate or low. Your overall eligibility band will be the highest of the four levels.

For example if the risk to your level of independence is:

low for autonomy and freedom of choice
moderate for health and safety
substantial for managing personal and daily routines
low for family and social involvement

then your overall eligibility will be the highest of the four levels - so in this example you will be in the substantial eligibility band. This means we can meet all your needs that are moderate or substantial. We can't meet any that are low as they are outside our eligibility criteria.

What happens if I'm not eligible?
We will write and tell you whether you are eligible or not. If you are not, we will provide you with advice and information about other sources of help in the community.
You can also make a complaint if you are unhappy with our decision - see 'further information' at the end of this leaflet

What happens if my needs change?
If your needs change you should contact Careline or your social worker and ask for a review.

We will work out if you still meet the eligibility criteria. You may find you are in a higher eligibility band, or that you no longer meet the criteria at all.

If you don't meet the criteria, the services will stop. We will give you notice that this is going to happen and you may still access the service for up to four weeks while you make other arrangements. We can also provide information and advice about other sources of help.

Further information
For further information you can contact Careline by email or by telephone on 0151 233 3800.
A full copy of the Liverpool City Council Eligibility criteria can be downloaded here .