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New rights for carers from April 2015

The Care Act 2014 strengthens the rights and recognition of carers in the social care system, and will come into effect in April 2015.

This information applies to carers living in England and relates to the Care Act 2014 and the Children and Families Act 2014. The page will be updated with new materials and resources about the Care Act 2014 in time for Carers Rights Day on 28 November 2014. 


The Care Act covers adult carers of adults as well as young carers approaching adulthood and carers of disabled children approaching adulthood. The Children and Families Act 2014 includes assessment rights for parents of disabled children and young carers.

Both Acts include a clear right to an assessment. Following an assessment the Care Act also gives adult carers of adults a clear right to receive services where their needs meet a nationally set eligibility threshold.

There are new obligations on local authority social services relating to assessments, provision of information and advice, preventative services and duties to shape a local market that can deliver a wide range of sustainable high-quality care and support services. These responsibilities apply equally to those funding their own care as well as where the local authority is meeting the costs of care.

The Act also sets out a new model of paying for care, putting in place a cap on the care costs which an individual is liable for. This new funding model will operate from April 2016.


Carers Assessments and eligibility

The Care Act 2014 means that any carer who appears to have a need for support should be offered an assessment by the local authority.

To determine what is needed and how they can help, social services must carry out a carers assessment. Instead of having to ask for a carers’ assessment, from April 2015 any carer who appears to have a need for support should be offered one by social services.

As a carer you will be entitled to an assessment no matter what your level of need, the amount of care you provide or your financial means. You can have an assessment whether or not the person you care for has had a community care assessment/needs assessment or if they have been considered not to be eligible for support.

The assessment will look at how caring affects your life, including health issues and whether you are able or willing to carry on caring. It will also look at other important physical, mental and emotional needs you have to help you achieve things important to you such as your work, education, maintaining relationships, and social activities.

Following the assessment, social services will decide if you are eligible for services to be provided either to you as the carer or to the person you care for to reduce the impact of caring on you. The decision about whether social services pays for services to support you will depend on your financial situation (if services are provided to you) or on the financial situation of the person you care for (if services are provided to them as a result of your assessment).
At a minimum, social services must provide all carers – including those not considered eligible for support – with information and advice on local services to prevent their needs from developing further.


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Assessments for people with care needs

The Care Act 2014 places a duty on the local authority to carry out an assessment of an individual on the appearance of need.

To determine what is needed and how they can help, social services will carry out a needs assessment. This is done with the person who needs the care, and must be carried out no matter what their financial situation, or whether social services think their needs make them eligible for support.

The assessment must look at a person’s physical, mental and emotional needs and consideration must be given to the person’s choices, goals and preferences for their day-to-day care. Social services must consider the types of services, information, advice, facilities and resources which will prevent or delay further needs from developing.

Carers are entitled to be involved in the assessment and the needs of the family of the person being assessed must also be considered. When the assessment is completed social services will decide whether their needs are high enough to meet the national threshold of eligibility. Where someone has eligible needs social services will carry out a financial assessment to determine whether people need to pay for their care.

Everyone (including people whose needs are considered not to be eligible) must receive information and advice from social services about the needs that have been identified, how to access care and support, the care providers and services they can choose from in their locality, how to obtain financial advice and how to raise concerns about safeguarding.


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Paying for care

The Care Act allows social services to charge for services, including services for carers. However carers cannot be charged for services provided to the person being cared for.

The Care Act sets out that social services may charge for services, including carers’ services, although some services are usually provided free (such as reablement services to help disabled people manage tasks in their home.)

Following a financial assessment the person may be expected to meet the full costs, the local authority may meet the full costs, or the cost may be shared between the person and the local authority.

Where a person has been identified as having care needs by the local authority but the financial assessment finds that they can afford to pay, they can still ask social services to meet those needs. However, the Act allows the authority to charge for services, as well as the arrangement and management of those services.


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When your caring role changes or ends

Looking after someone may be a large and significant part of your life, but often your caring role will change over time, and may come to an end. This may be because the person you are looking after has recovered and no longer needs care, because they can no longer be cared for at home or because they have died.

We have set out below some of the different ways in which your caring role may change or end, and outlined some of the practical, financial and emotional considerations to be aware of as these changes take place.


This information applies to people living in England, Wales, Scotland & Northern Ireland

Planning for emergencies

As a carer you need to know that if an emergency happens, replacement care will get sorted out speedily and efficiently.

When emergencies happen, our lives are put on hold whilst we deal with the aftermath. For many carers life cannot simply be put on hold, when the person they are looking after relies on them for vital help and support. When a carer is rushed into hospital, who else will step in?

If carers face an emergency they need to know that replacement care will get sorted out speedily and efficiently. For many, this may simply involve contacting a family member, friend or neighbour who is willing to cover in an emergency.

This section suggests things you can do to create an emergency plan and information about the emergency 'carer card' scheme.


Creating an emergency plan

We advise all carers to create an emergency plan - for you and the person you look after. Having a plan in place can help ease your worries if you are not able to care for the person you look after at any point in the future.

In order to create an emergency plan that fits your needs, you will need to consider:

  • Details of the name and address and any other contact details of the person you look after.
  • Who you and the person you look after would like to be contacted in an emergency – this might include friends, family or professionals.
  • Details of any medication the person you look after is taking.
  • Details of any ongoing treatment they need.
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Involving others in the plan

You may be able to arrange help and support from family and friends but it can be reassuring to have the involvement of your local council/trust in case informal arrangements fall through.

One way to do this is through an assessment for the person you look after or a carer's assessment for yourself. See our webpage on assessments for the person you look after and carer's assessments for further information.

Every carer who has an assessment should be asked about emergencies and offered help to plan for them. In addition, people who provide care for people with mental health problems under the care programme approach should have a written care plan which includes contingency planning.

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Emergency 'carer card' schemes

In some areas there are emergency card schemes that have been set up for carers, often by the local council/trust or a local carers centre. This might be called:

  • Carer card scheme
  • Carers emergency card
  • Emergency care scheme

In these instances, carers are usually asked to register and, with help from a skilled worker, draw up their emergency plans. The plans are held by the scheme which provides a 24-hour response service. Carers carry a card with the scheme's telephone number and a unique identification number to avoid any personal details appearing on the card.

In some areas they are integrated with police, fire and ambulance services. In the event of an emergency you or someone with you would call the scheme. An operator would look up your emergency plan and make arrangements for replacement care. This could be contacting friends or family, or putting in professional help. Plans will have been shared with them so they know the individual requirements of the person requiring care, such as medication.

Check with your local carers' organisation to see if such a scheme operates in your area.

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Coming out of hospital

Deciding to care or continue caring for someone who is coming out of hospital and who can no longer care for themselves in the same way as before can be very difficult.

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The information in this section applies to people living in England. 

If you live in Wales or Northern Ireland, please click the relevant link below.

WALES   NORTHERN IRELAND


If the person you care for is in hospital you may be faced with important decisions. You may be considering taking on this caring role for the first time and don’t know what to expect. Or you may have already been caring for the person, but their needs have now increased or changed.

One important thing to remember is that it is your choice whether or not to take on a caring role. Think about the type and amount of support you are able to provide and what help you might need. For example, you may be able to help with shopping and meals but feel that you would both like someone else to help with personal care. It is important for you to consider how your caring role is likely to affect your life and wellbeing.


An outline of the discharge procedure

Each hospital will have its own discharge policy based on guidance from the Government. You can request a copy of the hospital’s discharge policy from the ward manager or from the Patient Advice and Liaison Service (PALS) department of the hospital.

Discharge planning starts as soon as the person you care for is admitted to hospital. It is important to let the hospital staff know as early as possible if you are a carer or thinking of taking on the role. A discharge coordinator (or ward care coordinator) should be available to coordinate the planning process. They will act as a key person for you to contact to find out what the discharge plans are.

Should I, as a carer, be involved in the discharge procedure?

The hospital discharge policy should emphasise the importance of involving you and the person you care for at all stages of discharge planning, so long as the person you care for consents to this.

Hospital wards can sometimes seem like busy or intimidating places and you may feel pressure from the hospital to get the person you care for home as soon as possible. The person you care for may be anxious to come home. However, it is important that you feel your views have been taken into consideration and that the person you care for is not being discharged before necessary support has been put in place.

In situations where the person you care for does not want you to be involved or be given information about their care, you should be informed of this.

If the person you care for lacks mental capacity you may be able to make certain decisions about health and welfare matters if you have a Lasting Power of Attorney (LPA). If there is no LPA the law requires professionals to act in the ‘best interests’ of the person you care for and you should be involved in this decision making process.

What should happen before the person I care for is discharged?

When the person you care for is nearing their expected date of discharge the following steps should be taken:

  • An assessment should be carried out to see if they are medically fit to be discharged.
  • A discharge assessment should be carried out to see if they need support once discharged.
  • A carer’s assessment should be carried out (or at least arranged), to see whether you as a carer need support once the person you care for is discharged .
  • A written care and support plan should be given to the person you care for (and a support plan for yourself if you have had your own carer’s assessment), which outlines the support required and how this will be provided.
  • The support outlined in the care and support plan (for the person being cared for) and the support plan (for you) should be put in place.

What should happen on the day the person I care for is discharged?

On the day of discharge you and the person you care for should expect to be given both verbal and written information, with details of any services involved and information about future treatment and care. The information should be available in a language and format suitable for you. It is common that people do not remember or understand all the information they are given so don’t be afraid to ask for it to be repeated or explained in a different way.

You and the person you care for should expect the following type of arrangements to be made for the day of discharge:

  • appropriate transport should be organised if it is required
  • you should both be given copies of the care or support plan (for the person being cared for) and the support plan (for you)
  • a discharge letter should be sent to the GP of the person you care for within 24 hours
  • medication and any equipment needed at home should be dispensed to the person you care for, as well as instructions and information about its use
  • any necessary support should be put in place to start on the day of discharge

A discharge ‘lounge’ (or similar space) should be available for use in the hospital while waiting for transport, medication etc.

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The discharge assessment

The discharge assessment, which is to see if the person you care for needs support once discharged, might be carried out by a multidisciplinary team of health or social care professionals. This is to avoid multiple assessments being carried out.

This discharge assessment should look to see whether the person you care for is eligible for any intermediate or reablement care, NHS continuing healthcare or NHS funded nursing care, other NHS services and/or community care services from the local authority.

Intermediate or reablement care

Intermediate care is a short term package of care which is provided with the aim of assisting the person you care for to maintain or regain the ability to live independently at home. Government guidance states that intermediate care should be available to all adults over the age of 18 who might need it and certain young disabled people while managing their transition to adulthood.

Intermediate care could include any of the following:

  • crisis response services providing short term care
  • home-based care services provided by health professionals such as nurses and therapists
  • bed-based care away from home such as in a community hospital
  • reablement

Reablement is a particular type of intermediate care which has a stronger focus on helping the person you care for to live independently. It is generally provided by local authorities.

Before the intermediate care or reablement ends, there should be another assessment to determine whether the person you care for has ongoing needs for care and support (if this has not already been decided).

Intermediate and reablement care should be provided free of charge for up to six weeks (although this can be longer in some circumstances). After the six weeks if there are ongoing support needs which are being met by the NHS, these should be free of charge. If there are ongoing support needs which are being met by the local authority, they can charge for such services.

NHS continuing healthcare or NHS funded nursing care

NHS continuing healthcare is a package of care for those who are 18 or over who have a ‘primary health need’ that is arranged and funded by the NHS. This package of care can be provided in the home of the person you care for, in a care home, or via a personal budget.

If it seems like the person you care for might be eligible for NHS continuing healthcare an assessment should be carried out for this. Generally there is an initial checklist assessment which determines whether the person you care for will be told they don’t meet the criteria for a full assessment and are therefore not eligible, or whether they will have a full assessment of eligibility. Be aware that the eligibility criteria are very tight and most people with ongoing care needs won’t qualify. Around 60,000 people in England are currently in receipt NHS continuing healthcare.

NHS funded nursing care is available if the person you care for is 18 or over and is not eligible for NHS continuing healthcare, but they are assessed as requiring nursing care in a care home that is registered to provide nursing care. This means that the NHS will pay a contribution towards the cost of their registered nursing care.

Note: NHS continuing care is the alternative provision for children under 18. It is different to adult NHS continuing healthcare in that the whole package of care is not normally arranged and funded by the NHS. Rather, a holistic approach is adopted when assessing children for continuing care that incorporates social services and education departments in addition to the NHS, which may lead to joint funding arrangements, depending on the child’s assessed needs.

Other NHS services

Palliative care can be provided free on the NHS and is for people who have a health condition which is not expected to be cured by medical treatment. Palliative care can consist of pain relief and other appropriate medical care, as well as providing emotional and practical support. It can take place in a hospice, residential care or the person’s own home.

Medical equipment and incontinence products can be provided free on the NHS if the person you care for is assessed as needing such items.

Community care services from the local authority

Most people being discharged from hospital won’t need or be eligible for NHS continuing healthcare. Instead they can have an assessment from the local authority, to determine whether they are eligible for any support. Support could include things such as equipment or adaptions to the home, a care worker to help provide personal care etc.

The hospital should give an assessment notice to the local authority so that they can carry this out as part of the discharge assessment. For those who are 18 or over this will be called a needs assessment and for a child (under 18) this will be called a Children Act assessment.

If the person you care for is assessed as needing support from the local authority, they will carry out a financial assessment to determine whether, and if so how much, the person will need to contribute towards the cost of any support provided.

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The carer’s assessment

As a carer you can have an assessment from the local authority, to determine whether you are eligible for any support. Support could include services provided directly to you, or services provided to the person you care for, which in turn would help you in your caring role.

There are various different types of assessments depending on whether you are an adult yourself, and whether the person you are caring for is an adult.

If you are assessed as needing support from the local authority, the local authority might carry out a financial assessment to determine whether, and if so how much, you will need to contribute towards the cost of any support provided. However, it is hoped that a lot of local authorities will not charge carers for support provided to them. If the support is provided to the person you are caring for, you as a carer cannot be charged.

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Discharge from a mental health facility

If the person you care for is in a mental health facility, then they may be there as a voluntary in-patient (which means they can choose to leave if they want), or they may be there because they are detained under the Mental Health Act. There are special rules which apply to discharge from hospital following a section under the Mental Health Act.

Before the person you care for is discharged from a mental health facility, there should be a meeting to assess what support or care services may be needed once they are back in a community setting. In addition to having a needs assessment for community care services, the person you care for may receive some of the mental health specific support outlined below. As a carer you should be involved in this process if the person you care for consents to this.

Community Mental Health Teams

If the person you care for is being discharged from a mental health facility, they may be referred to a Community Mental Health Team (CMHT) which is made up of different mental health professionals from both health and social care. There are also specialist CMHTs that the person you care for may be referred to, depending on their assessed mental health needs at the point of discharge.

If the person you care for is under 18, then they may be referred to Child and Adolescent Mental Health Services (CAMHS). If the person you care for is over 65 then they may be referred to an Older People’s CMHT.

The Care Programme Approach

If the person you care for is assessed as having complex needs requiring long term support at the point of discharge, then they may be placed under the Care Programme Approach (CPA). The CPA is a national framework that CMHT’s work within to coordinate the care and support services received by patients with complex mental health needs. If the person you care for qualifies for the CPA, some of the things they should expect to receive include:

  • a full assessment of their health and social care needs
  • a care plan that is regularly reviewed
  • a Care Coordinator who is responsible for making sure the care plan gets implemented and meets assessed needs

Note: As a carer you should be involved in the Care Programme Approach (CPA) meetings if the person you care for consents to this.

Discharge from the Mental Health Act

If the person you care for is detained under a section of the Mental Health Act, there are certain restrictions on how they can be discharged from section. The different ways this can be done can include where:

  • the section runs out and is not renewed
  • the professional in charge of the person you care for (the Responsible Clinician) discharges them
  • the nearest relative of the person you care for (as defined in the Mental Health Act) discharges them (although the Responsible Clinician can override this)
  • the Mental Health Act Managers discharge them
  • a tribunal discharges them

Mental Health Act guidance suggests that the person you care for should not be discharged from section or from hospital by their Responsible Clinician until arrangements have been put in place for care and support in the community. In terms of what type of care this might include, in most cases the person you care for will receive specialist support from an appropriate CMHT under the CPA.

If the person you care for has been detained in hospital under section 3, 37, 45A, 47 or 48 of the Mental Health Act, then they are entitled to free aftercare services under section 117 of the Act. The free aftercare is funded by the NHS and local authority in the area where the person you cared for lived before they were admitted to hospital. Aftercare services will be based on the health and social care needs identified in the care plan of the person you care for. As a carer you should be involved in the care plan if the person you care for consents to this.

Note: Discharge from the Mental Health Act is a complicated area and therefore if this applies to the person you care for, you may need to seek further advice from a specialist mental health charity.

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Other important things to think about if the person you care for is in hospital

Benefit claims

It is important to notify the relevant benefit office that the person you care for is going or has gone into hospital, as this may affect their benefits as well as your own.

If the person you care for was 18+ when they went into hospital then some benefits such as Disability Living Allowance (DLA) , Personal Independence Payment (PIP) or Attendance Allowance will stop if the person you care for has been in hospital for more than 28 days.

Stays in hospital or a care home which are separated by 28 days or less are added together when working out when the benefit should stop (called the 'linking rules').

If the person you care for was under 18 when they went into hospital then their DLA or PIP can continue to be paid for the whole time they are there.

If the Disability Living Allowance, Personal Independence Payment or Attendance Allowance of the person you care for stops, your Carer’s Allowance will also stop.

When the person you care for is ready to be discharged, inform the office dealing with the particular benefit to make sure that payments restart. The person you care for may also be eligible for benefits at an increased rate if their care needs have changed.

Help at work

If you are in paid work you may need to make some adjustments if the person you care for goes into hospital and/or when they come out of hospital. This could be anything from needing to make regular phone calls to check on them, through to taking off an extended period of leave. Most working carers have the following rights:

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Complaints

Unfortunately there may be times when you need to make a complaint. When making a complaint, what matters is that you explain as clearly as possible what went wrong and what you would like to happen instead. You should make your complaint as soon as you can.

Complaints about the discharge procedure

To start with you may want to make an informal complaint by speaking to the discharge co-ordinator or social worker immediately involved with the arrangements. This is often sufficient to resolve the matter.

If this informal approach does not resolve matters you can use the NHS two stage formal complaints process listed below. Either you or the person you care for can make a complaint about how they or you have been treated or the care provided. The complaint should normally be made within 12 months of the incident in question.

  • First stage complaint – local resolution: You can contact the hospital or the clinical commissioning group (CCG) who should have a complaints procedure in place, and you should ask for a copy of it. You can complain verbally or in writing. A large health centre will normally have a complaints manager. The manager should make a written record of your complaint. A smaller centre or practice may not have a complaints manager, but they will still have someone who is responsible for dealing with complaints.
  • Second stage complaint – Parliamentary and Health Service Ombudsman: If you are not happy with the outcome of your initial complaint you can complain to the Parliamentary and Health Service Ombudsman (P&HSO). The Ombudsman is independent of the NHS and Government.

Complaints about an assessment for NHS continuing healthcare

If you are not satisfied with the way an NHS continuing healthcare assessment was carried out, or the outcome of the assessment, make your complaint to the NHS professionals involved in making the decision.

Assistance in making an NHS complaint

PALS (Patient Advice and Liaison Service) provide a confidential service that is designed to help patients get the most from the NHS. They can tell you more about the NHS complaints procedure, and they may be able to help you to resolve your complaint informally. To find your nearest PALS call NHS 111.

Complaints about the local authority

If your complaint is about the local authority you should use the local authority’s statutory complaints procedure. Ask your local authority for a copy of their complaints procedure.

Once your complaint has been dealt with fully by the local authority in question, if you are not happy with the outcome you can refer your complaint to the Local Government Ombudsman (LGO) and ask for it to be reviewed. The LGO provides a free, independent service.

Assistance in making a complaint to the local authority

You may be able to get assistance with making a complaint to your local authority from a local carers’ centre, Citizen’s Advice Bureau or advocacy service. You can also speak to your local Member of Parliament.

Judicial review

In some cases an application for Judicial Review of an NHS decision or local authority decision by the High Court may be possible. An application for judicial review must be made without delay and within a maximum period of three months so it is important to get legal advice as quickly as possible.

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Managing someone's affairs

Some carers may want to help manage the affairs of the person they are looking after, or may want to know how to plan for doing this in the future.

There are different ways of managing someone’s affairs depending on whether the person you are looking after can currently make decisions for themselves (which is called having mental capacity) or whether they are unable to make decisions for themselves (which is called lacking mental capacity).

This information in this section applies if the person you are looking after is aged 16 or over (unless otherwise specified).


The information on managing someone’s affairs can vary depending on whether you live in England, Scotland, Wales or Northern Ireland. Each page in this section explains which nation(s) it covers.

In Northern Ireland there has been no single piece of legislation dealing with mental capacity and managing affairs, and instead there was a variety of different Orders covering these topics. The Mental Capacity Act (Northern Ireland) 2016 has now been introduced, which brings together all of the different Orders surrounding mental capacity and managing someone’s affairs, however this Act has not yet been implemented, and so this webpage will be updated when it has been implemented. For now, contact Carers NI for further information on 028 9043 9843 or This email address is being protected from spambots. You need JavaScript enabled to view it..

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