The way in which councils are interpreting the eligibility criteria for adult social care is inequitable and has produced a post code lottery. This is a key finding of a review by the Commission for Social Care Inspection, commissioned by the Care Services Minister. The review report ‘Cutting the Cake Fairly’ also calls for greater clarity and transparency so that both professionals and service users understand how decisions are reached.

The report describes a lack of fairness in the way criteria are applied, due to variations in professional judgements and different approaches taken by councils. Some councils acknowledged in their written submissions to the review that the eligibility criteria is subject to wide and varied interpretation, with different custom and practice in different teams and specialisms.

The report is also critical of councils for continuing to take a service-led, rather than needs-led approach. The Commission believes that the problem results from a misunderstanding by some councils that ‘low-level’ needs equate with ‘simple’ services, and ‘complex’ needs always require ‘complex’ and expensive services. One result of this is that some councils have stopped providing or commissioning entire types of ‘simple’ or ‘low-level’ service.

Phil Hope, Minister for Care Services, said “I am disappointed to read about people who have been declined help because of particular rules councils may have introduced in addition to their own interpretation of FACS. It was always the intention, within the guidance, that everyone was entitled to an assessment of their needs and information on how those needs might be met, irrespective of who might meet the costs of the services that might be arranged.”

The Minister has promised to issue revised guidance and to ensure that learning is transferred from areas that operate effectively to those that need support.

The report is available from the CSCI. http://www.csci.org.uk/pdf/FACS_2008_03.pdf