Make a Referral

If you or a relative need help, you can make a self referral asking for a contact / overview care assessment. This assessment identifies people’s risks and needs in different areas of life. The types and level of services offered will depend on the assessed risks and needs.

Care assessment self referral form

To ask for a care assessment, please complete this referral form. If you are completing the form on behalf of another person, please advise them that you are doing so.  Please provide as much information as possible and indicate your preference as to how and when our staff can contact you.

  1. Referral Details

  2. My Personal Details

  3. Emergency Contact Details

  4. GP Surgery & Dental Practice Details

  5. Medical Information

  6. My Carer's Information

  7. Additional Information

  8. If you would like an email confirmation that this form has been received please provide us with your email address below:
  9. Click the button below to review & check your form then click 'Confirm' on the next page.

Am I eligible for help?

In an emergency we will always act ourselves or make sure you get immediate help from other services (If you have an emergency out of normal working hours please use our Out of Hours Service).

If you ask us for help, we’ll need to do an assessment to find out what your needs are and what help we can give you. We call this a ‘Contact/Overview assessment’.

When we have got to know about you and your circumstances (through the assessment) we will look at:

  • whether you are able to make decisions and choices
  • whether you are safe from harm from yourself or others
  • whether you can manage essential routines; if you can care for yourself (your hygiene, cooking, eating, getting around etc.) and your household management
  • whether you need help to have a social, family and community life.

We then have to decide what the risk to you would be if you didn’t get help, and the help we give you will depend on this risk level. This may seem a bit clinical but we have rules we have to follow that make sure that everyone is helped fairly.

To put it another way, we are concerned if:

  • You can't do essential everyday things to keep yourself independent
  • You’re struggling to manage, e.g. you (or a carer) are at serious risk of injury or there’s a risk of your home arrangements breaking down
  • You have been or might be abused or neglected
  • Your life is in some way at risk.

The person doing your assessment will decide whether you are eligible and explain their decision to you. If you are eligible we’ll arrange help for you.

Your Care Manager will complete a Personal Plan of Care for you. This will say exactly what help you’ll get and who will help you. You’ll be given a copy of the plan and we’ll arrange a date to review it to make sure you’re getting the help you need.

If we decide that your independence is not at ‘critical’ or ‘substantial’ risk, we won’t be able to give you any longer term practical support ourselves, but we can put you in touch with other services who can help.

What if we cannot help - you are not eligible?

If you’ve not qualified for help and your needs change, please ask for another assessment.

If you need help but we can’t help you, we will give you information about services that you can use. You may need to decide whether you want to pay for help from a private business (for things like cleaning, shopping, house maintenance, equipment, some personal care).

There may be some services run by voluntary groups which are subsidised by grants.

While we work closely with the Powys Health Services, other parts of the council and the Benefits Service, and with voluntary and private services, please remember that these are all separate services and not the responsibility of Adult Care Services.


What if you disagree with a decision about whether you get help?

If you don’t agree with the decisions we make about your needs or the services we offer to you, please explain to the person who is doing your assessment with you.

If you can’t come to agreement, ask for the name of their manager and speak to them.

If you’re still not satisfied, please register a complaint.




What do services cost?

Care services provided by the Council may require you to make a financial contribution to the cost of these care services. The contribution will be decided by a financial assessment.

The most we can charge for a package of community based care is £70 a week.

Some Services are free, other services ask for a contribution to the cost. Some services have a fixed cost which everyone has to pay.

Below are examples of services we offer:

  Service 2017/18 Unit Cost
  Home care (domiciliary care) £20.50 per hour
  Family aide £20.50 per hour
  Attendance at a day centre £15.00 per day
  Attendance at day and employment services £15.00 per day
  Transport to a day centre No charge
  Respite in a care home £70 per week per single episode of care
  24 hour support (supported tenancy) £70.00 per week
  Shared lives scheme £28.85 per night (to a maximum of £70 per week)
  Meals at the day centre £7.50 per meal
  Housing Related Support Unit Cost
Level 1 Community alarm only £2.00 per week
Level 2 Warden Service
9 am – 5 pm
Monday to Friday
£9.90 per week
Level 3 Warden Service including
24 hr emergency call out
£70.00 per week
Level 4 Individual room, live in housekeeper and meals £70.00 per week

Do I have to have a financial assessment?

If you get help from services provided by the council, we may need you to pay something towards the cost. We work out whether people should pay towards the help they get according to their income and any capital they have.

The most we can charge for a package of community based care is £60 a week. (£70 from April 2017)

You can either have a financial means assessment to decide your contribution or you can choose pay for the cost of your services (up to £60 a week/£70 from April 2017). It may be best to ask for a financial means assessment as the contribution we ask for towards your services may be less than the maximum charge – or even nothing at all.

Residential and nursing care contributions are worked out differently. We ask for a minimum contribution, and some people pay the full cost.  

How do we work out the charge?

A financial assessment officer can help you fill in the assessment forms. We look at your savings, income and investments, so we’ll need to see proof of these. You can also have a welfare benefits check to make sure you are receiving all of the benefits you’re entitled to. We’ll tell you in writing what your weekly charge will be.

We’ve designed our charging policy to find the amount we can reasonably expect you to pay. It means that when you pay your charge, the income you have left does not fall below the level of your means-tested benefit plus an extra 45% we ignore. Every year we will review your financial circumstances and write to you to tell you what we have decided.

If you want to, you can ask a family member or representative to help you and act on your behalf in the assessment process. They can be with you during any assessments.

Residential/nursing home care

If you need residential or nursing home care then there are different financial assessment arrangements, set by the Welsh Government, which we have to follow.

We will have to decide whether you qualify for continuing health funding (which could mean that your needs are met by the NHS and are free). Your need has to be substantial and the application procedures can be quite complex. You can find out more by asking your care manager, the person assessing you, your doctor or Community Nurse.




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