In short, anyone in England who appears to need care and support can ask their local council for a needs assessment under the Care Act 2014, whatever their income. The assessment is free and looks at what a person can and cannot do day to day. A separate financial assessment then decides what, if anything, they contribute.
This post is for people living with the effects of a stroke, a brain injury or another neurological condition, and for their families. It covers the local authority route only. For the wider picture, read our guide to funding for neuro-rehabilitation. This is general information, not legal or financial advice. Axon Neuro is a reablement service, not a council or an NHS body. We do not carry out Care Act assessments and we do not decide funding. For advice on a particular situation, speak to the council's adult social care team or an independent adviser.
Who can ask the local council for a care needs assessment?
Anyone can ask. Under the Care Act 2014, a council in England must assess an adult who appears to need care and support, whatever their income or savings (Last verified July 2026). The NHS guide to getting a care needs assessment says the needs assessment is free and that anyone can ask for one.
Two steps, in this order:
- The needs assessment asks what support a person needs.
- The financial assessment asks who pays for it.
A family carer has a separate right of their own. If you give unpaid care to an adult, you can ask for a carer's assessment, whether or not the person you care for has had one. The NHS says a carer's assessment is free and that anyone over 18 can ask for one (Last verified July 2026). Carers under 18 come under separate young carer rules, so ask the council about those instead.
What does a Care Act needs assessment look at, and who is eligible?
It looks at what the person can and cannot do, and the impact that has on their wellbeing. A social worker or occupational therapist from the council usually asks about washing, dressing, cooking, moving around the home, getting out, and getting through an ordinary day. The NHS says this can happen face to face, by phone or online, or as a self-assessment.
Wellbeing is the legal thread running through the Act. Councils must promote a person's wellbeing, so the conversation should reach dignity, control and daily life, not only physical tasks (Last verified July 2026).
England has one national eligibility threshold with three parts, and all three must be met. In outline, the council considers whether:
- The needs arise from a physical or mental impairment or illness
- Because of those needs, the person is unable to achieve two or more specified outcomes
- As a result, there is, or is likely to be, a significant impact on their wellbeing
The specified outcomes are set out in regulations and cover everyday things: nutrition, personal hygiene, toilet needs, being appropriately clothed, using the home safely, keeping it habitable, family relationships, work or training, community facilities, and caring for a child. The gov.uk care and support statutory guidance explains how councils apply this (Last verified July 2026).
"Unable" is broader than it first sounds, and that matters after a neurological injury. The Care and Support (Eligibility Criteria) Regulations 2015 treat someone as unable to achieve an outcome if they cannot do it without help, or can do it but only with significant pain, distress or anxiety, or in a way that endangers their own or someone else's health or safety, or takes significantly longer than would normally be expected (Last verified July 2026).
After a stroke or brain injury, two things can be easy to leave out unless someone raises them: cognitive changes such as memory and planning, and fatigue that builds through the day. If needs are not found eligible, the council should still give free advice about local support.
How does the financial assessment (means test) work?
It is a separate step that follows the needs assessment. It looks at income, pensions, some benefits, savings and sometimes property, then decides what the person contributes. According to the NHS financial assessment guide, councils in England generally help with care costs when savings are below £23,250, and the more money a person has, the more they are expected to pay (Last verified July 2026). The Department of Health and Social Care charging circular for 2026 to 2027 sets the upper capital limit at £23,250 and the lower capital limit at £14,250, with a means-tested contribution from capital between the two (Last verified July 2026). Those figures are for England.
A person's home is normally set aside when care is given in that home. Property rules differ for long-term care in a care home. A council finance officer usually makes contact, and this assessment also costs nothing.
What is a care and support plan, a personal budget and a direct payment?
If needs are eligible, the council must produce a care and support plan and set a personal budget. The plan records the needs, how they will be met, and what the support should cost. NHS guidance on personal budgets and direct payments sets out how that money can be handled, and says most councils ask for evidence of how a direct payment has been spent every three months (Last verified July 2026).
A personal budget can be taken in three ways, or a mix:
- A direct payment into an account, so the person arranges their own support
- The council arranges the care and pays providers on their behalf
- An organisation of their choice manages the budget for them
Direct payments come up at the care and support planning stage, and a person can ask for one; the council then has to consider the request. A direct payment can give more say over who comes into the home and when, which some people find matters while rebuilding routines. It is worth asking when the plan will next be reviewed, and how to ask for a review sooner if things change.
How is this different from NHS Continuing Healthcare?
Different funder, different test. NHS Continuing Healthcare is care arranged and funded solely by the NHS for adults assessed as having what the national framework calls a primary health need. The NHS describes it as free health and social care funded solely by the NHS, so it is not means tested. Council social care is means tested, and eligibility rests on the Care Act threshold above. The NHS explains how Continuing Healthcare is decided (Last verified July 2026). The framework described here is the England one; the other UK nations run their own.
The two routes are assessed separately, by different organisations. A decision on one does not settle the other, so it is reasonable to ask about both.
How do you ask for an assessment, and what should you prepare?
Contact adult social care at the local council, by phone or through its website, and ask for a Care Act needs assessment. The gov.uk page on applying for a needs assessment has a postcode tool that finds the right council.
Preparing can help, especially when fatigue or memory changes make the day harder:
- Keep a diary for a week or two, describing a typical bad day rather than a good one
- Note how long tasks take, and what has already happened when nobody was there to help
- Write down what has actually happened, rather than testing it by going without support you normally have
- List medicines, hospital contacts and any therapy already in place
- Write down two or three goals that matter to the person
- Ask someone who knows you well to sit in, or ask about an advocate
- Ask about timescales, and for the decision, the reasoning and the plan in writing
Describing a bad day is not exaggerating. Some people manage more than usual while a professional is in the room, then struggle for days afterwards.
If anything at home already feels unsafe, say so early and ask for it to be looked at in person rather than waiting. That includes stairs, getting in and out of bed, the bath or a chair, using the hob, and managing medicines. Equipment, hoists, moving and handling, changes to what someone eats or drinks after swallowing problems, exercise after a stroke or brain injury, driving, and medication should all be assessed face to face by a qualified professional who knows the person. Nothing in this post is a substitute for that, and no article can judge what is safe in a particular home.
A note on geography. This post covers England. Scotland, Wales and Northern Ireland have their own social care law and assessment routes, so check the guidance for your own nation (Last verified July 2026).
Frequently asked questions
Do savings stop me getting an assessment?
No. The right to a needs assessment does not depend on income or savings. Money is only looked at later, in the separate financial assessment (Last verified July 2026).
What if I disagree with the decision?
Every council has a complaints procedure, and you can ask for a decision to be reviewed. Ask for the reasons in writing first, as they make a complaint easier to put. If you are still unhappy once the council's own procedure has finished, the Local Government and Social Care Ombudsman looks at complaints about English councils.
Can a direct payment pay for rehabilitation support at home?
It depends on the plan. A direct payment must be spent on meeting the needs agreed in the care and support plan, so ask for rehabilitation goals to be written into the plan itself. The council sets the conditions and has to be satisfied that the spending meets those agreed needs, so check with it before committing to anything.
Is a carer's assessment worth asking for if I am coping?
Many carers find it useful even when things feel manageable, because it can open up practical help and breaks. Our post on looking after yourself as a carer covers this further.
Talking it through
Funding conversations are tiring, and they often arrive at an already difficult time. Reablement support at home is practical, day-to-day support with routines. It sits alongside NHS treatment and council care rather than replacing either, and it does not change what a council decides. If you would like to think out loud about what reablement at home might look like alongside a council assessment, you are welcome to get in touch at your own pace.