ELIGIBILITY FOR SOCIAL CARE SERVICES: FAIR ACCESS TO CARE SERVICES (FACS) –STATEMENT OF NEED
Initial Assessment Form (Please attach to Core Assessment Form)
This form is to be used to assess and record the service user’s need for social care services and should be completed in conjunction with the Core Assessment and Care Plan. It should not be used for health care services as FACS applies only to social care services.
Use also with reference to Mental Health Service Eligibility Criteria.
Eligible social care needs should be detailed in the Core Assessment and must provide the appropriate information on which to base your FACS bandings. See also Bexley Council FACS Eligibility Framework for details of the current eligibility bands and threshold.
This FACS Eligibility form, the Care Plan and risk assessment must be sent to social care providers with the appropriate service referral forms before social care services can start.
Name of Service User: DOB: RIO ID:
Name of worker completing assessment: Date:
SOCIAL CARE NEEDS /RISKS TO INDEPENDENCE
Level of Risk
(Tick as appropriate)
Description of Service User’s eligible need(as identified in Care Plan) /
Critical
/Subs
/Mod
/Low
1. Autonomy and freedom to make choices:2. Health and safety (include freedom from harm, abuse and neglect from and to others):
3. Ability to manage personal care and other daily routines:
4. Involvement with family and wider community (include work, childcare, learning and leisure):
NB. Needs will vary from individual to individual and will not be in pre-set format. Examples could be: service user needs social stimulation, personal care, respite for carer etc.
Worker’s Signature: Date:
Service User’s Signature: Date:
Senior Worker Name: Date:
Please note that a Senior Professional or Team Co-ordinator must confirm this assessment before Social Care service can start.