Local authority social care

What local authorities do

Local authorities (city councils, county councils, unitary authorities) commission, fund and sometimes deliver social care for adults with care needs. For people with dementia, this can include:

• Care needs assessment;
• Carer's assessment;
• Homecare visits;
• Day services;
• Equipment and adaptations;
• Respite care;
• Residential care funding;
• Direct payments to commission your own care;
• Telecare;
• Safeguarding when at risk.

How to access

Care needs assessment

Anyone who appears to have care needs is entitled to a care needs assessment, regardless of finances. Contact your local council's adult social services. The assessment considers:

• Daily living tasks (washing, dressing, eating, toileting);
• Personal safety;
• Mobility;
• Mental health and wellbeing;
• Family and social relationships;
• Where you live;
• Cognitive function.

Eligibility for support is determined against national criteria (Care Act 2014 in England). Where eligible needs are identified, a support plan is developed.

Carer's assessment

A separate right under the Care Act for anyone providing regular care. Looks at your needs as a carer (sleep, work, health, wellbeing). Can result in support including respite and training. See respite care.

How social care is funded

Local authority social care is means-tested. In England (2025):

• Savings and assets above £23,250: usually pay full cost;
• Between £14,250 and £23,250: contribute according to a sliding scale;
• Below £14,250: state-funded.

Income is also assessed, with certain disregards. The property is excluded if a spouse or dependant remains there; otherwise it may be considered. Different rules apply in Scotland (free personal care above 65), Wales and Northern Ireland.

The promised £86,000 lifetime cap on care costs in England has been postponed.

Direct payments

Instead of the council arranging care, you can take a direct payment and commission your own. This gives more flexibility (choose your own carers, schedule, services) but means more administration. Direct payments are not allowed to be used to employ a close family member living in the same household (except in exceptional circumstances).

NHS Continuing Healthcare

Where care needs are primarily health-related (not social care), NHS Continuing Healthcare funds the placement fully, regardless of means. Eligibility is assessed by a multidisciplinary team using the National Framework. Many dementia cases are not eligible, but those with complex behavioural needs, end-of-life care or specific clinical complexity may qualify. Worth applying. See care homes.

Common services

• Homecare visits: 15 minutes to several hours, focused on personal care, medication and household tasks;
• Day services: half- or full-day attendance, transport often included;
• Live-in care: 24-hour carer in the home (usually expensive and self-funded);
• Residential and nursing care: long-term care home placement;
• Respite: planned or emergency breaks for the carer;
• Telecare: pendant alarms, fall detectors, door sensors, 24-hour monitoring;
• Equipment: rails, hoists, beds, wheelchairs;
• Disabled Facilities Grant: up to £30,000 for home adaptations.

Safeguarding

Local authorities have a statutory duty to investigate safeguarding concerns. Where a person with dementia is at risk of harm (financial, physical, neglect), the local authority safeguarding team can intervene. Concerns can be raised by anyone.

Where to get help

Contact your local council's adult social services:

• Phone numbers vary by council; search "[your council name] adult social care";
• Online referral forms often available;
• Citizens Advice, Age UK and Alzheimer's Society can help navigate the process.

The system can be confusing; persistence helps. Note who you spoke to, what was agreed, and follow up if action does not happen.