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NHS Continuing Healthcare
Independent Social Care Needs Assessment and Care Plan: The First Step in Every CHC Case
An independent social care needs assessment is a structured assessment of a person's day-to-day care needs by a registered professional, producing a written care plan. At Nellie Supports it is included in the new client price of every NHS Continuing Healthcare service, and can also be instructed on its own: it creates the evidence base that the Checklist, the Decision Support Tool and any appeal all build on. It is charged once, at £1,100 plus VAT, and never re-charged as your case progresses.
Included in the new client price of every Nellie Supports CHC service, and available on its own, completed by a registered professional across England
At a glance
Role
Independent assessment of day-to-day care needs by a registered professional
Framework
Care Act 2014 approach, prepared for the National Framework for NHS CHC (2022 revision)
Format
Face to face with the person, wherever they live
Deliverable
A written care plan mapped to the twelve care domains
Coverage
England. Wales runs its own Continuing NHS Healthcare framework
£1,100
Fixed fee, plus VAT
One working day
Response to your enquiry
England
Cover throughout the country
Social work led
Registered professionals
Plain-English explanation
What an independent needs assessment is
An independent, professional record of what the person actually needs day to day, written in the language the NHS process scores, and charged once for the whole case.
A registered professional spends time with the person, reads the care records, speaks to the people who provide day-to-day support, and writes down what the person actually needs rather than what is currently being provided.
The care plan that follows describes those needs in the language the NHS process scores: the twelve care domains, and the nature, intensity, complexity and unpredictability of the needs taken as a whole.
What is being provided is not the same as what is needed
Care packages are built around what was available, what was funded and what the family could absorb. An assessment of need starts from the person, which is why an existing care plan is evidence of provision, not evidence of need.
Common situations
When you need this assessment
Every Nellie Supports CHC case starts here, whether you are preparing for a first Checklist, facing a Decision Support Tool meeting, or challenging a refusal. The assessment establishes an independent, professional record of the person's day-to-day needs before any NHS process begins.
It is charged once per client and never re-charged as the case progresses. New appeal clients with no previous Nellie Supports involvement also complete a Case Review and Merits Assessment alongside it, so we only take forward appeals with real merit.
A first Checklist is coming
A screening has been arranged and there is no independent record of the person’s needs.
A DST meeting is booked
The multidisciplinary team will score the twelve domains, and the evidence needs to be in front of them.
A refusal has arrived
An appeal starts from evidence of need, not from the decision letter.
Care has changed quickly
A hospital discharge or a sharp deterioration has overtaken every existing care plan.
Nobody agrees on the needs
Family, care home and health professionals are each working from a different version of the picture.
A care package is being reviewed
Funding is being reconsidered and the person’s needs have never been independently recorded.
What is assessed
The twelve care domains your care plan is written against
The care plan is not a general description of the person. It records their needs in the categories the NHS process scores, so that when a Checklist or Decision Support Tool is completed, the evidence already exists in the right language.
Breathing
Nutrition, food and drink
Continence
Skin integrity, including wounds, ulcers and tissue viability
Mobility
Communication
Psychological and emotional needs
Cognition
Behaviour
Drug therapies and medication, including symptom control
Altered states of consciousness
Other significant care needs
Written before the process, not in response to it
Evidence produced after a decision has gone against you is always read as an argument. An assessment carried out beforehand is simply the record of what the person needs, and it carries far more weight for exactly that reason.
1
Needs, wellbeing and care planning
An independent social care assessment considers the person’s needs, the effect on their wellbeing, and the outcomes they want to achieve. It can support care planning and provide relevant evidence for a CHC assessment. The local authority retains its statutory assessment responsibilities.
The person’s needs and their effect on everyday life
The outcomes, preferences and priorities that matter to the person
The support required and the risks it needs to address
How the proposed care plan supports needs and wellbeing
2
How the assessment informs CHC evidence
The assessment can record care tasks, risks and the support required in a way that helps the CHC team understand the person’s needs. CHC eligibility remains a separate decision under the National Framework, considering the nature, intensity, complexity and unpredictability of those needs.
Framework: Care Act 2014; National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); the primary health need test
For more, read our guide: The NHS Continuing Healthcare process explained
The framework
The framework for assessing care and support needs
Initial enquiry and triage
Contact us by phone, email or website form. We gather the key details and confirm the right starting point within one working day.
Scope and fee
We confirm the scope, the fee plus VAT and any travel charge, in writing before you commit to anything.
The assessment
A registered professional assesses the person's day-to-day needs, reviews the care records and listens to the family and carers who know the person best.
The written care plan
You receive a written care plan setting out the person's needs and how to meet them, with the evidence mapped to the twelve care domains and peer reviewed before release.
Your next CHC step
We recommend the right next stage, whether that is Checklist support, the full Decision Support Tool assessment, or an appeal. The assessment carries through to whichever it is.
What happens next
Our assessment process
Evidence base
What we look at
The assessment is built on records and observation, not on a form filled in from memory.
Time with the person
Wherever they live, at their pace, on more than one topic.
The care records
Daily notes, charts, incident records and handover notes.
The people who provide the care
Family carers, care staff and anyone who knows the day-to-day picture.
Medical and therapy input
GP, community nursing, SALT, physiotherapy and specialist letters where relevant.
The existing care plan
What is being provided, and where it falls short of what is needed.
Risk and unpredictability
Falls, choking, night-time interventions and how far needs fluctuate.
Deliverable
What you receive
The assessment is practical and evidence led. You receive:
An independent assessment of day-to-day care needs
A written care plan setting out needs and how to meet them
Evidence mapped to the twelve care domains
A clear recommendation on the next CHC stage
Peer review by a second qualified professional
Who we work with
For solicitors, deputies, care providers and advisers
Instruction is straightforward and the evidential standard is consistent whichever stage we are brought in at:
Scope confirmed in writing
The stage, the fee and the timescale are confirmed in writing before instruction.
Evidence in the language of the framework
Needs are described against the twelve care domains and the four key characteristics, not in general terms.
Peer review as standard
A second qualified professional reviews the work before it is submitted.
Honest merits advice
Where a case has no realistic prospect, we say so before you spend anything further on it.
One fee, charged once
£1,100 plus VAT
- Assessment by a registered professional, at home or in the care setting
- Needs written against the twelve care domains
- A written care plan as a document in its own right
- Carried through every later CHC stage, never written again
- Peer review by a second qualified professional
Included in the new client price of every CHC service, so if you go on to instruct us at any later stage you pay the returning client price for it. One fee, agreed in writing before any work starts, plus VAT and travel. Never a percentage of anything recovered.
Transparent pricing
For families
A clear fee, agreed in writing before we start, with no percentage of anything recovered. We explain what is happening in plain English and deal with the process so you do not have to.
For professionals
Scope, fee and timescale confirmed in writing before instruction. Evidence prepared against the twelve care domains and the four key characteristics, peer reviewed by a second qualified professional.
Provider evidence
Why choose Nellie Supports for the needs assessment
Registered professionals who assess needs for a living, and who know exactly what the CHC process does with the answer.
Why families and professionals choose Nellie Supports
Social work led, not a claims company
Registered professionals prepare and present the evidence of need. We are not a call centre and not a no-win-no-fee operation.
One assessment, one fee
Charged once and carried through every later stage of your case, never re-charged.
Published fees, plus VAT
The whole price is published and confirmed in writing before instruction. No percentages, no surprises.
A permanent employed team
A full-time, in-house multidisciplinary team, not an ad hoc panel of associates, with more than 11,000 assessments completed practice-wide.
Peer reviewed as standard
Everything we prepare is reviewed by a second qualified professional before it is used.
Honest about outcomes
Eligibility is the Integrated Care Board's decision. We never promise a result, and we say so plainly.
A son rang about his mother, who had dementia and diabetes and was being looked after at home by a patchwork of carers and family. He knew she needed more support and suspected CHC might apply, but every conversation with the professionals involved seemed to start from a different version of what her needs actually were.
A registered professional visited, read the care records, and spent time with his mother and the carers who knew her best. The written care plan that followed set out her needs in plain English and mapped them to the twelve care domains: the night-time checks nobody had written down, the insulin timed around her refusals, the falls that only the family knew about.
When the Checklist was completed weeks later, the family were not starting from a blank page. The evidence of need already existed, in the language the NHS process scores, and it carried through every later stage without being assessed and charged for again.
That is the difference an independent assessment makes. In most CHC cases the only account of the person’s needs is the one written by the people assessing them, and a family arrives with nothing of their own. Here a registered professional had assessed her, in her home, and written it down before the NHS process began, so the Checklist was completed against evidence rather than impressions.
This is an illustrative example. It does not describe any individual client.
How the needs assessment works in practice
Frequently asked questions
Frequently Asked Questions About the Social Care Needs Assessment
Why does every case start with this assessment?
Because every later stage depends on the quality of the evidence. The Checklist, the Decision Support Tool and any appeal all turn on how the person's day-to-day needs are described. Completing an independent needs assessment first means that evidence exists from day one, in the language the NHS process scores, and it is charged once rather than being repeated and re-charged at every stage.
Is this the same as the council's care needs assessment?
No. A local authority carries out its own Care Act assessment for its own purposes, and this assessment does not replace it. Ours is independent: it is commissioned by you, completed by a registered professional who does not work for the council or the NHS, and written to establish the strongest accurate record of the person's needs for the CHC process.
Do we need this if care is already in place?
Yes. An existing care package tells you what is being provided, not what the person's assessed needs are today or how they map to the twelve care domains. The assessment creates a current, independent record of need, which is exactly what the Checklist, the DST and any appeal will be judged against.
What does the fee include?
The fee of £1,100 plus VAT covers the assessment itself, the records review, the written care plan and peer review by a second qualified professional. Travel is the only possible addition and is confirmed in writing before booking. The assessment is charged once per client and never re-charged as your case progresses.
Is this legal advice?
No. Nellie Supports provides independent social work assessment, evidence and advocacy support. We do not provide regulated legal advice, and where a legal remedy is needed we will say so and support your solicitor's work.
A plain English guide to the Checklist, the Decision Support Tool, the MDT and the ICB decision.
What a primary health need is and how the four key characteristics are judged.
What happens at each stage of the assessment, from screening to decision.
Supporting guidance
Related NHS Continuing Healthcare guides
Evidence prepared across the twelve care domains of the Decision Support Tool (DST) and representation at the multi-disciplinary team (MDT) meeting.
Written submission and representation at local resolution with the Integrated Care Board, the first stage of a CHC appeal. The Independent Review Panel is a separate service.
Independent evidence for the 3 month and annual reviews of a care package, where a reassessment can reduce or withdraw funding.
Where your case can go next
Discuss your case
Ready to take the first step?
Contact Nellie Supports to arrange an independent social care needs assessment. We will confirm the scope, the fee and the next steps in writing.
Written by Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.