What is adult social care?

Do you or a loved one need help with social care? Read the article below and find out answers to key questions about who can access adult social care and how to pay for it.
Man at home with carer

Last updated 11 March 2022

Social care can be very different from the health care you receive from the NHS. Although it can include medical help, social care offers more practical support to enable people to live independently. These services are usually provided in people's homes, care homes or elsewhere in the community, rather than at a GP practice or hospital.

If you or a loved one needs social care, it's important to understand what types of care and support are available, where to find the correct information, and how services are paid for.

How do I receive help through social care?

The first step is to speak to your local authority's adult social services department and request an assessment.

If you need social care for yourself, this is called a 'care assessment', a 'customer assessment' or a 'needs assessment'.

If you provide unpaid care for someone else, your assessment is called a 'carers assessment'. Carers UK has developed some key tips on requesting a carers assessment for the first time.

Alternatively, you may be offered a care assessment at home after being discharged from the hospital. This is called a 'discharge to assess' or a 'home first' approach.

The NHS can also assess people with very complex and long-term health needs for social care support, known as 'NHS Continuing Healthcare' or 'NHS CHC', and involves a separate assessment process from the needs assessments carried out by local authorities.

Who can access adult social care support?

Older people, people living with a physical or learning disability, people living with particular long-term conditions, or people recovering from a stay in hospital can require support from social care services.

There is no charge for a social care assessment. All adults over 18 are entitled to an assessment to determine whether they could qualify for help or support. 

Sometimes, the adults who require care don't pay for services from their council as family or friends support them instead. The loved ones helping in these cases are 'informal carers', 'family carers' or 'unpaid carers'. If this describes you, you could also be entitled to support for your mental health, finances, care training or finding others to take over caring responsibilities while you take a break.

If you are eligible for social care support following an assessment, you can speak with your council to agree on your social care support details. These details are your 'support plan', 'care plan' or 'care package'.

How do I pay for social care?

Another assessment called a 'financial assessment' or 'means test' will determine whether you qualify for free social care or whether you need to contribute towards the cost of your care plan.

The criteria used in means tests are quite complicated and involve the local authority looking at your 'financial assets'. Assets can include:

  • Your earnings, savings or any other investments you've made
  • Any benefits you receive, (including your pension)
  • The cost of your home (if you live or plan on living in a residential care home or nursing home
  • If you plan on receiving care at home, the council will not include the cost of your home under your assets

The current means test thresholds means that:

  • If you have assets below £14,250, the local authority will pay for your care in full.
  • If you have assets between £14,250 and £23,250, you local authority will pay for some of your care 

If you are eligible for any financial support, your local authority will provide you with a 'personal budget' which you can spend on local services. This is money you are entitled to, so you can ask the council to either:

  • Manage your personal budget for you and arrange for services based on your care plan.
  • Pay the money to a care organisation of your choice to arrange for services based on your care plan.
  • Pay the money directly to you to arrange for care services yourself – this is known as 'direct payments'.

As mentioned, some people can also qualify for free social care through NHS continuing healthcare. However, if your assessment finds you are not eligible, you might be eligible instead for 'NHS-funded nursing care', where the NHS will contribute to the cost of your nursing care, for example, in a care home.

The organisation Beacon provides free independent advice on NHS continuing healthcare.

Unpaid carers do not have to contribute towards the support services they access following an assessment.

Social care reform

The Government has published its ten-year vision for adult social care.
This includes a plan to introduce a new £86,000 cap on care costs, meaning that from October 2023, nobody should spend more than £86,000 on personal care over their lifetime. We have provided more information on what ‘personal care’ is in the section below this one.

 It is important to note that for people living in a residential care home, their care home fees won't count towards the cap. Under the latest government proposals, neither would a local authority’s contribution towards the care costs for people who are eligible for financial support. 
 

The thresholds for financial support will also change

  • People with assets below £20,000 will be eligible for free care.
  • People with assets between £20,000 and £100,000 will have to contribute towards their care on a sliding scale. Once these people reach the £86,000 cap, they will no longer need to pay for their personal care costs, though there may still be charges for other types of care or accommodation.
  • People with assets over £100,000 will have to pay for their care in full. Once these people reach the £86,000 cap, they will no longer need to pay for their personal care costs, though there may still be charges for other types of care or accommodation.

What type of support is available through social care?

Your local authority is responsible for managing social care services in your area. Councils may provide some services themselves, or they may buy services from care providers to meet the needs of their community.

Local services can include:

  • Support to help people develop the skills needed to live independently. Sometimes these services are referred to as 'reablement services' or 'short-term support'. They can involve help with doing certain activities again after illness or injury.
  • Support with getting up in the morning, washing, dressing, and using the toilet. These services are referred to as 'personal care'.
  • Help with household tasks, such as cleaning, cooking and eating meals or shopping.
  • Support with organising physical, leisure or social activities. These services are called 'day care services' or 'day care opportunities'. They can involve the serving of meals or refreshments, help with health issues, or just provide an opportunity to meet and chat with other people.
  • 'Respite care' or ‘carers breaks’, which provide opportunities for unpaid carers to take a break from caring. During these breaks, the person being cared for would have their care needs met by different carers, sometimes in a different location for a few hours, an overnight stay, or even longer.
  • Support finding housing for people affected by homelessness who have care needs following a needs assessment.

The local council can offer social care services in different settings too:

  • At home – often called 'domiciliary care' or 'home care', this is where your care plan needs, including personal care and short-term care, are provided in your own home. Sometimes you might need adaptations made in your home to help with living there independently, such as installing a stairlift, fitting a shower rail or adding a ramp to your property.
  • In a care home or nursing home – often called 'residential care', this is where your care plan needs, including personal care, reablement and any health care needs, are provided in the care home where you live.
  • In a specialist home – instead of a home care team coming to your house to provide support, you might live in a home where care and support are offered on-site. These homes include 'sheltered housing', 'supported living', 'assisted living', 'shared lives schemes' and 'extra care housing'.
  • In a daycare setting – the local council can provide daycare opportunities in a range of locations in the community, including daycare centres, sports centres, cafes, restaurants, or outdoor spaces.

Where can I find more information about social care?

All local authorities have a dedicated information and advice service which can provide people with details about local social care so you can make well-informed choices and plans based on the help you need.

Information and advice services will provide more information on:

  • Assessments and eligibility
  • Personal budgets
  • Choosing the right care option
  • Safeguarding
  • Independent advocacy

Speak to your local Healthwatch

Wherever you live in England, you'll have a local Healthwatch nearby. We're here to listen to the issues that really matter to local communities and hear about your experiences of using health and social care services. Local Healthwatch also provide advice and information about health and social services and support. 

Find your local Healthwatch

You can also find more advice on social care here:

Watch James' Social Care Story

James' Social Care Story