What to Ask — and What to Bring — to a Care Needs Assessment

The Week of Notes That Changes the Outcome

An assessment is a snapshot, and a snapshot of a good afternoon is not a description of a week. Your parent will underplay it — not to deceive anyone, but because saying you cannot manage out loud, to a stranger, in your own kitchen, is hard.

So bring evidence rather than impressions. For seven days before the visit, write one line a day: what happened, at what time, how long it took, and who did it. Include the nights. Include the phone calls you made from work. Include the days nobody was available.

Write what you observed, not what you concluded. "Took forty minutes to get dressed, 8.10 to 8.50" is a fact an assessor can use. "Struggling in the mornings" is an opinion they must set aside.

Hand the notes over at the start and ask for them to be attached to the record. Then ask that they are referred to if your parent's answers differ. That request, made calmly at the beginning, is entirely normal and changes what gets recorded.

• Seven days, one line a day: what happened, at what time, how long, who did it
• Nights: how many times, and for how long
• Hours a week the family currently puts in, per person
• Days and times when nobody is available
• What has changed since anyone official last looked
• Your parent's own words about what they find hard, written down and dated

Questions About the Assessment Itself

Start by establishing the mechanics. Who is doing this, what exactly is being assessed, and how long it takes. Assessments are done by different bodies for different purposes, and knowing which one you are in changes what is worth saying.

Ask about the shape of the visit before it begins. Whether your parent should be alone with the assessor for part of it, and whether you can be present for the rest. Many assessors prefer both, and agreeing it up front avoids an awkward moment when you are asked to leave the room.

The good-day question is the one to ask out loud. Is this being recorded as a good day or a typical day, and how do you account for the difference? It is a fair, professional question and it makes the point without contradicting your parent in their own kitchen.

• What exactly is being assessed today, and who are you assessing for?
• How long will it take, and does any of it happen elsewhere?
• Should my parent be alone with you for part of it, and may I be present for the rest?
• May I give you written notes about a normal week, to be attached to the record?
• Do you want to see the house as well as talk, and which rooms?
• What do you need to see today — documents, ID, the medication list?
• Is today being recorded as a good day or a typical day, and how do you account for that?

Questions About What Happens to the Answers

An assessment is a document that other people act on, so ask about the document. Who reads it, when you get it, and in what form.

Ask for a copy of what is written, including the notes rather than just the outcome letter. Ask how you record a disagreement if you think something has been written down wrongly — there is almost always a route, and it is much easier to use in the first fortnight than in the third month.

The question about the difference between what is recommended and what is funded is the most important one on this page. They are frequently not the same number, and knowing which one you are looking at tells you whether to be planning around it or appealing it.

Get a reference number and the name of whoever you chase. Write both down before the assessor leaves the house.

• Who reads this after you?
• When will we get the written outcome, and in what form?
• May I have a copy of what you write, including the notes?
• If I disagree with something in it, how do I get that recorded?
• Which parts get shared with the doctor, the hospital or an agency?
• How is the hours figure arrived at, and may I see the working?
• What is the difference between what you recommend and what is actually funded?
• Who do I contact to check progress, and what reference do I quote?

Questions About Money and What Is Charged

Ask these plainly. Assessors are used to them and they are not rude questions.

What is means-tested here and what is not. What documents will be asked for about your parent's finances, and by whom — sometimes it is a separate department with a separate form and a separate timescale, and nobody mentions this unless asked.

Ask what would be charged, and from when. A service that begins before the financial paperwork completes can produce an unexpected bill, and asking about the start date now is much easier than querying an invoice later.

Anything they cannot answer, ask who can. That is the point of the last question in this group: you are not looking for financial advice from an assessor, you are looking for the name of the person or department whose job it is.

• What is means-tested here, and what is not?
• What financial documents will be asked for, by whom, and on what form?
• What is likely to be charged to my parent, and from what date?
• What is provided regardless of income?
• Which separate applications does this not cover, and where are those forms?
• Who helps with filling in the forms?
• Who should we ask about the financial questions you cannot answer?

Questions About Review, Appeal and the Next Three Steps

Assessments are snapshots, and circumstances change faster than review cycles do. Ask when it is looked at again, who can trigger an earlier review, and what would have to change for you to ask for one.

Ask about the appeal or complaints route now, while nothing has gone wrong. Ask particularly about the deadline, because appeal windows are short and they run from a date you may not notice.

Then ask the practical questions. What can we put in place while we wait. Which services can we contact directly without waiting for this outcome. There is almost always something — a voluntary organisation, a day service, a directory — and assessors know the local landscape better than anyone you will speak to all year.

Finish with the closing question. What do families most often fail to mention in this conversation? It is free, it takes them ten seconds, and it is frequently the most useful sentence of the visit.

• When is this reviewed again, and who can trigger an earlier review?
• What would have to change for us to request one sooner?
• What is the appeal or complaints route, and what is the deadline?
• What can we put in place while we wait for the outcome?
• Which services can we contact directly without waiting for this?
• What are the next three steps, and what are their dates?
• What do families most often fail to mention in this conversation?

After the Visit: One Page, Filed the Same Day

Write it up the same day, while you can still hear the answers. Header: date, assessor's name, organisation, direct number, reference number. Then two columns — question and answer — in the order you asked them.

Underneath, three lists. What was promised, with dates. What we have to do, with names. What we disagreed with, in the exact words used, because that list is the beginning of any appeal.

Send a short email the same week to the assessor, or the department, saying what you understood and asking them to correct anything you have got wrong. This is the highest-value ten minutes in the whole process. It creates a dated record that you can point at, and it very often produces a correction you would otherwise have discovered months later.

Put the week of notes, the one-page record and the outcome letter behind one tab in the folder. Diarise the review date and the appeal deadline. When the next assessment comes round, you will start it with a written history instead of a memory.

• Header: date, assessor, organisation, direct number, reference number
• Two columns: question and answer, in the order asked
• Three lists: promised with dates, our tasks with names, disagreements in their exact words
• Email your understanding to the department within the week and ask for corrections
• File the week of notes, the record and the outcome letter together; diarise the review and appeal dates

Questions