Practitioner resource

Care Act assessment template: a strengths-based structure you can use

A Care Act assessment records a person's needs, the outcomes they want, and the impact on their wellbeing, in a way that supports a fair eligibility decision and a plan that fits their life. The template below sets out the sections practitioners in England commonly use, with prompts for each and a short worked example. It follows the strengths-based approach described in the Care Act statutory guidance.

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What a Care Act assessment is

Under section 9 of the Care Act 2014, a local authority in England must assess an adult who appears to have needs for care and support. The assessment looks at the impact of the person's needs on their wellbeing, the outcomes they want to achieve in day-to-day life, and whether care and support could contribute to those outcomes. Section 10 makes the same provision for carers.

Section 1 of the Act places a general duty on the local authority to promote the individual's wellbeing, and lists the areas wellbeing covers: personal dignity; physical and mental health and emotional wellbeing; protection from abuse and neglect; control over day-to-day life; participation in work, education, training or recreation; social and economic wellbeing; domestic, family and personal relationships; suitability of living accommodation; and the individual's contribution to society. An assessment that is organised around those areas is easier to write and easier to defend.

The statutory guidance describes a strengths-based approach: starting from what the person can do, what matters to them, and the support already around them, before recording what they cannot do. This template is built that way round. Wales, Scotland and Northern Ireland have their own legislation; the structure below still transfers, but the legal references do not.

The template: sections and prompts

Use the sections in order. Under each is what the section is for and the questions that tend to draw out a full answer. Where your local authority's form uses different headings, map these onto them rather than duplicating.

Section 1

Presenting circumstances

Why the assessment is happening now. Who requested it and what prompted it (a hospital discharge, a carer's concern, a change in health, a request from the person). Who was present and how the person took part. Any communication or advocacy needs, and whether an independent advocate was considered under section 67.

Section 2

What matters to the person

In their own words. What a good day looks like. What they are most worried about. What they want to keep doing, start doing, or stop having to do. This section sets the tone for the whole assessment and should be written before needs are listed.

Section 3

Strengths and existing resources

What the person does for themselves. Skills, routines, equipment already in place. Family, friends and neighbours who help, and what that help looks like in practice. Community groups, faith communities, services already involved. Be specific: "daughter does the weekly shop on Saturdays" rather than "family support".

Section 4

Needs

What the person needs help with, and why, organised around the ten outcomes in the eligibility regulations (listed below). For each, say whether the person can achieve it without assistance, and if not, in what way: unable, or able only with significant pain, distress or anxiety, or only by endangering themselves or others, or only in significantly longer than would normally be expected.

Section 5

Impact on wellbeing

For the needs identified, the consequence for the person's wellbeing across the areas in section 1 of the Act. This is where the assessment moves from a list of tasks to a picture of a life. Fluctuating needs should be recorded over a period, not just on the day of the visit.

Section 6

Desired outcomes

What the person wants to be different. Outcomes are about the person's life ("get back to the Thursday lunch club"), not about services ("day centre two days a week").

Section 7

Informal and community support

What family, friends and community could provide, and whether they are willing and able to. Whether a carer's assessment is needed. Any prevention, information or advice that could reduce or delay needs (section 2 of the Act).

Section 8

Risks

Risks to the person and to others, described specifically. The person's own view of each risk. What was weighed, including the person's right to make choices others might consider unwise. Any safeguarding concern and what was done about it.

Section 9

Practitioner analysis

Your professional view, labelled as such, drawing the sections together. What the evidence shows, where accounts differ and how you weighed them, what you are uncertain about. This is the section a reviewer or a tribunal reads most closely.

Section 10

Eligibility considerations

Your findings against the three conditions in the eligibility regulations, with reference to the evidence in sections 4 and 5. The eligibility determination itself is the local authority's, made under section 13, and should be recorded with reasons.

Section 11

Agreed actions

What happens next, who is doing it, by when. Whether the person agrees. Whether a care and support plan follows. Review date.

Eligibility considerations

The Care and Support (Eligibility Criteria) Regulations 2015 set three conditions for an adult's needs to be eligible, all of which must be met:

  • The needs arise from or are related to a physical or mental impairment or illness.
  • As a result of those needs, the adult is unable to achieve two or more of the specified outcomes.
  • As a consequence, there is, or is likely to be, a significant impact on the adult's wellbeing.

The specified outcomes in the regulations are:

  • managing and maintaining nutrition
  • maintaining personal hygiene
  • managing toilet needs
  • being appropriately clothed
  • being able to make use of the adult's home safely
  • maintaining a habitable home environment
  • developing and maintaining family or other personal relationships
  • accessing and engaging in work, training, education or volunteering
  • making use of necessary facilities or services in the local community, including public transport and recreational facilities or services
  • carrying out any caring responsibilities the adult has for a child

"Unable to achieve" has a specific meaning in the regulations: it includes being able to achieve the outcome only with assistance, only with significant pain, distress or anxiety, only in a way that endangers the health or safety of the adult or others, or only in significantly longer than would normally be expected. Recording which of these applies, and the evidence for it, is what makes an eligibility finding transparent.

Whether needs are eligible is a decision for the local authority. This page describes how to record the evidence that decision rests on; it does not, and cannot, make the decision.

A short worked example

Fictional, and much shorter than a real assessment. It shows the shape of the sections, not the depth.

What matters to Mr D

"I want to stay in my own house. I don't want to be a burden on my son. I miss going to the allotment."

Strengths and existing resources

Mr D manages his own medication using a blister pack. He prepares breakfast and lunch. His son visits on Wednesdays and Sundays and does the shopping. A neighbour takes his bin out. He has a pendant alarm and uses it.

Needs (extract)

Maintaining personal hygiene: Mr D can wash at the sink but has not used the bath since a fall in July because he is frightened of getting stuck. He described this as "not worth the worry". Able only with significant anxiety. Making use of the home safely: Mr D uses a frame and manages the ground floor; he cannot manage the stairs and has been sleeping in the living room since July.

Impact on wellbeing (extract)

Personal dignity: Mr D said he feels "grubby" and has stopped inviting his neighbour in. Suitability of accommodation: sleeping in the living room means no private space and disrupted sleep. Participation: he has not been to the allotment since July and described low mood linked to this.

Practitioner analysis (extract)

In my assessment, Mr D's needs arise from reduced mobility and balance following a fall and ongoing osteoarthritis. He is currently unable to achieve at least two of the specified outcomes without significant anxiety or risk, and the impact on his dignity, accommodation and participation is significant. Mr D has capacity to make decisions about his care and has been clear about what he wants. I have referred to the eligibility conditions in section 10 and recorded the evidence above for the local authority's determination.

Agreed actions

OT assessment for bathing equipment and stair options (me, referral by 20 Sep). Explore allotment transport with son, with Mr D's agreement (me, by 22 Sep). Eligibility determination and care and support planning to follow. Review in six weeks.

Pitfalls in Care Act assessment recording

  • Starting from services. "Needs a care package" is a conclusion; the assessment has to show the needs and outcomes it rests on.
  • A needs list with no wellbeing section. The regulations turn on impact, and impact has to be written down.
  • The person's voice appearing only in a quote box. What matters to them should shape the analysis, not decorate it.
  • Assessing a single day. Fluctuating conditions need a picture over time.
  • Leaving the eligibility reasoning implicit. Say which outcomes, in what way unable, and what the impact is.
  • Forgetting the carer. A carer's assessment under section 10 may be needed alongside.

Where ScribisH fits

ScribisH helps health and social care professionals turn spoken or captured information into structured professional documentation, ready for practitioner review.

A Care Act assessment conversation can run over an hour. ScribisH lets you record it with consent, or talk it through afterwards, and drafts what was said into the sections above: what matters to the person, strengths, needs against the specified outcomes, impact on wellbeing, desired outcomes, risk, and a space for your analysis. You then write the analysis and the eligibility considerations in your own professional voice, check every section against your notes, and copy the approved assessment into your local authority's system.

Sources: Care Act 2014, sections 1, 2, 9, 10, 13 and 67; the Care and Support (Eligibility Criteria) Regulations 2015; Care and Support Statutory Guidance (Department of Health and Social Care). This page is general information for practitioners and is not legal advice.

Frequently asked questions

A needs assessment carried out by a local authority in England under section 9 of the Care Act 2014 for an adult who appears to have needs for care and support. It looks at the person's needs, the outcomes they want to achieve in day-to-day life, and how those needs affect their wellbeing.

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