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Request for a social-care needs assessment

A completed request to a local authority for a Care Act assessment for an adult who may need help at home.

Jurisdiction: England and Wales - completed fictional worked example

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Important: This sample provides general legal information only and is not legal advice. Check the law, prescribed forms and signing requirements that apply to your exact jurisdiction and circumstances before use.

# REQUEST FOR A SOCIAL-CARE NEEDS ASSESSMENT

Date: 14 July 2025

Parties: From Michael Evans for himself, to the Adult Social Care Access Team, Westshire County Council

## 1. Person and request

I am Michael Evans, aged 72, of 18 Willow Close, Westshire. I request an assessment of my care and support needs under section 9 of the Care Act 2014. I live alone after my wife died on 2 May 2025 and presently struggle with washing, preparing meals, stairs and taking medicines safely.

## 2. Chronology and daily impact

Since a fall on 28 June 2025 I have used a frame and fallen again on 9 July. My daughter Laura visits on Tuesdays and Saturdays but cannot provide daily care because she works in Bristol. I often eat cereal instead of cooking, have missed two doses of medication, and cannot get into the bath without assistance.

## 3. Legal basis and assessment

Section 9 requires the authority to assess an adult who appears to have needs for care and support, regardless of financial resources. I ask the assessor to consider the Care and Support (Eligibility Criteria) Regulations 2015 and my desired outcomes, without assuming that I meet the threshold or that a particular package will follow. Please arrange communication support if needed and offer a separate carer assessment to Laura if she requests one.

## 4. Outcome and timing

Please acknowledge this request by 21 July 2025 and offer an accessible assessment appointment by 4 August 2025, or explain the current lawful timetable. I would like to discuss morning personal care, meals, safe mobility, medication support and equipment, including direct payments or a managed service. I understand a financial assessment and current local-authority process will determine contributions and available options; I will verify any review or appeal route when a decision is issued.

## 5. Evidence and status

I enclose my 28 June discharge note, 9 July fall report, medication list, occupational-therapy recommendation for rails, and Laura’s written availability. I consent to the council contacting my GP with necessary information and ask for a written care-plan decision. Signed, Michael Evans, 14 July 2025; Laura is a supporter, not my attorney.

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