Optalis - Choices for living

Wokingham Advice Line
0118 977 8600

Windsor & Maidenhead Advice Line
01628 683744

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National Eligibility Criteria for Care and Support

In order to decide whether the Royal Borough should assist you with your care needs we have eligibility criteria. Since April 2015 the Royal Borough have been using the national eligibility criteria for access to adult care and support and for access to carer support.

The eligibility threshold for adults with care and support needs is based on identifying how a person's needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing.

Eligible needs

Local authorities must consider whether the 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
as a result of being unable to meet these outcomes, there is likely to be a significant impact on the adult's wellbeing

An adult's needs are only eligible where they meet all three of these conditions.

Advice and Information Team

For further information, please contact us by:

Email: access.services@rbwm.gov.uk

Telephone: 01628 683744

Advice and Information team - Royal Borough of Windsor and Maidenhead
Town Hall
St Ives Road
Maidenhead
SL6 1RF

Social care contact us form
Notification of change of circumstances

Outcomes

The specified outcomes measured include:

managing and maintaining nutrition, such as being able to prepare and eat food and drink
maintaining personal hygiene, such as being able to wash themselves and their clothes
managing toilet needs
being able to dress appropriately, for example during cold weather
being able to move around the home safely, including accessing the home from outside
keeping the home sufficiently clean and safe
being able to develop and maintain family or other personal relationships, in order to avoid loneliness or isolation
accessing and engaging in work, training, education or volunteering, including physical access
being able to safely use necessary facilities or services in the local community including public transport and recreational facilities or services
carrying out any caring responsibilities, such as for a child

Local authorities do not have responsibility for providing NHS services such as patient transport, but they should consider needs for support when the adult is attending healthcare appointments.

What happens if I am eligible?

Once we have established that a person has needs that meet the national eligibility criteria, we have to make sure that these needs are met. To find out what the next steps are please read our Self directed support and personal budgets webpage.

We will not refuse to meet eligible needs on the grounds of cost, although if there is more than one option, we are allowed to choose what we believe is the most cost effective one.

What happens if I am not eligible?

If your needs do not meet the national eligibility criteria, we will give you information and advice on what support might be available in the community to support you.

Alternatively, you may want to consider funding your own care and support to help with the needs identified as a result of the assessment.

If you are not eligible for financial assistance you can view the Adults, Family and Local Offer Directory for information on services that could help you. You can contact My Care, My Home, an organisation that provides advice and support to anyone who has to pay for part or all of their care themselves. The Care Homes Directory publishes a booklet detailing care homes in Berkshire annually.

If you disagree with your needs assessment, support plan or personal budget, there are ways that decisions can be challenged or you can make a complaint.

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