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Fair Access to Care Services (FACS) eligibility criteria

Under FACS there are four eligibility bands. These represent the following levels of need:

  • Critical - serious risks to someone's independence, which are likely to occur within 72 hours.
  • Substantial - significant risks to someone's independence, which are likely to occur within between 72 hours and six weeks.
  • Moderate - some risks to someone's independence, which are likely to occur within between six weeks and six months.
  • Low -  one or two risks to someone's independence, which are likely to occur after six months.

In Medway, people who are assessed with critical or substantial needs will be eligible for adult care services from the council. Being assessed as moderate or low does not mean that someone does not have needs; it simply means that there are people more at risk than them who need the council's help more urgently. If this should happen, the council has set up a range of advisory services where people in need (and their carers, if appropriate) can speak to someone either on the phone or face-to-face. These agencies will help them find the care they need through other sources, such as community and voluntary organisations. The council will do its utmost to help them find what they need elsewhere.

Critical needs

This band includes the most severe or urgent needs, for example something that has or will have a life-threatening impact on health, safety or continuing independence in the immediate future. For example, this means someone who:

  • needs immediate help because they have suffered or are suffering from serious abuse or neglect
  • is not able to manage their own personal care or complete vital daily tasks to maintain a safe and secure environment
  • is in a situation which is putting unacceptable strain on the people who are caring for them and because of this, their support network has broken down or is likely to breakdown very soon.

The following illustration shows what kind of situation might constitute a need presenting a critical risk to independence. Please bear in mind that this is only an example and each request for support would need to be assessed on an individual basis:

  • A 29 year-old man has recently had a car accident which has left him unable to walk and in a wheelchair
  • He lives on his own in a first floor flat and cannot leave the house without assistance to visit his doctor or the hospital, to get food or basic necessities
  • He also struggles to feed himself at home without adaptations or someone on hand to assist him.

Without food or medication there is clearly an immediate specific risk to his health, which might well prove life-threatening. His need is therefore critical.

Medway Council would, therefore, help him with the appropriate support.

Substantial needs

This band includes serious needs, which in the short term might have a significant impact on health, safety or continuing independence. For example, this means someone who:

  • is at risk of suffering from abuse or neglect
  • needs support with personal care and help to complete the daily tasks required to maintain a safe and secure environment
  • is in a situation which means their support network may shortly break down due to additional strain being placed on those who provide care and support.

The following illustration shows what kind of situation might constitute a need presenting a substantial risk to independence. Please bear in mind that this is only an example and each request for support would need to be assessed on an individual basis:

  • A couple are both in their 70s: the husband was diagnosed with Alzheimer's Disease nine months ago
  • Both were otherwise fit and active and initially, they were able to manage with help from family and support from charities such as the Alzheimer's Society
  • However, over the past three months his condition has worsened
  • He cannot now be left at all and sometimes does not recognise his wife, which they both find very upsetting and which can sometimes make him angry
  • He has wandered off on occasions and now needs significant help with washing, dressing and feeding
  • His wife is finding it very difficult to manage on her own and their children do not live locally.

In these circumstances, they have substantial needs because their situation is likely to mean that, while the health and wellbeing of both husband and wife is not at immediate risk without help, the situation could very soon become critical.

Medway Council would, therefore, help them with the appropriate support.

Moderate needs

This band includes needs which are not critical or serious and which will only have a moderate impact on health, safety or continuing independence. For example, this means someone who:

  • needs support with two or three personal care or domestic tasks.

The following illustration shows what kind of situation might constitute a need presenting a moderate risk to independence. Please bear in mind that this is only an example and each request for support would need to be assessed on an individual basis:

  • A 53 year-old woman is physically disabled with some restricted mobility
  • Her husband is physically able and can manage all the necessary personal and household chores but he does have mild learning difficulties, which means he does not deal with paperwork, bills, finances, etc
  • His wife’s health means she too cannot cope with these tasks
  • They run the risk of getting into debt and failing to pay bills
  • There is no short-term threat to either of the couple’s physical health or wellbeing but if the situation is not addressed they could risk losing gas, electricity and water supplies etc.

They do, therefore, have needs but these are moderate.

They would, therefore, be referred by Medway Council to Community Infrastructure Services to give them the help they need.

Low needs

This band includes needs are not serious and have a very limited impact on health, safety or continuing independence. For example, this means someone who:

  • needs support once or twice a week with personal care or domestic tasks.

The following illustration shows what kind of situation might constitute a need presenting a low risk to independence. Please bear in mind that this is only an example and each request for support would need to be assessed on an individual basis:

  • A 29 year-old man with mild learning disabilities lives with his parents who are in their late 60s
  • He suffers from anxiety and depression and this can sometimes lead to a tendency to lash out
  • He currently has a part-time job: this gives him an outlet, helps his self-esteem and provides time away from his parents giving all of them a break
  • His employer is supportive and his job is safe, his parents continue in good health and have the support of other children and family living nearby.

Because he has an outlet his mental health is stable. There is no reason to assume any change to his circumstances and no suggestion that his condition will be exacerbated by any additional stresses. In the longer term, the family is able to offer him continuing support even if his parents fall ill or are no longer able to look after him.

In general, given these circumstances, his and his family’s need for support currently is low.

The man and his family would, therefore, be referred by Medway Council to Community Infrastructure Services for any help he or his family may feel they need.