Understanding and improving fairness in adult social care needs assessment

Plain English summary of protocol

Background and study aims
No one can receive state support for social care without first having a "needs assessment". With over 2 million requests for support each year in England alone, this process is the lynchpin of the social care system: it determines an individual's needs, how they impact their wellbeing, and the outcomes they wish to achieve.
However, working alongside members of the public and social care users through the University of York Curiosity Partnership, we have identified three problems:
1. Little is known about how the needs assessment process works: Previous work demonstrates that people find the needs assessment process difficult. However, most research to date focuses on the outcome of a needs assessment (e.g. the support plan) rather than how Local Authorities arrive at the decision.
2. The public think the process is unfair: In our work developing the proposal, 80% of the public do not have confidence that the procedures used to decide social care applications are fair.
3. There is huge variation in practice between local authorities.
This project has three aims:
1. To understand how/why Local Authorities decide the format of a "needs assessment" for adults with social care needs.
2. To understand what social care users and the public think is a fair social care "needs assessment".
3. To change "needs assessment" processes to make them fairer.

Who can participate?
The study involves two groups of participants.
English Local Authority staff who:
1. Have direct experience of working on or managing staff who deliver needs assessments under the Care Act 2014
2. Are currently working in this area.
People with social care experience who:
1. Are between 18 and 80 years of age
2. Have had experience of receiving a Care Act 2014 needs assessment in England, or are the carer for somebody who has and have indirect experience of the process.
3. Have capacity to consent to participation.

What does the study involve?
The study has two main parts:
Local Authority case studies involving:
1. Desk-based research on social care needs assessment processes (reviewing materials on the Local Authority's website, application forms, and guidance)
2. Interviews with up to four members of staff involved in needs assessment processes at each site (20 staff in total across all sites).
3. Interviews with approximately 8 people who have had a social care needs assessment at each site (40 people in total).
A public survey involving:
1. A small sample of online interviews with members of the public (approximately 30 in total) to inform the design of the survey.
2. A survey with approximately 1,000 participants, exploring what factors and trade-offs are most important to the public regarding social care needs assessments.

What are the possible benefits and risks of participating?
We hope that across all respondents, there are three main benefits:
1. Drawing on extensive qualitative interviewing experience in social welfare research, participants often remark that they enjoy being interviewed and having the opportunity to discuss their experiences of under-explored processes.
2. Interviewees will receive a voucher for taking part in recognition of their time (at the value of £50) and survey respondents will be paid in line with the Prolific panel incentive structure (which is based on the length of the final survey instrument).
3. Some respondents might feel it is a benefit to them to be involved in research which could influence the development of better social policies and Care Act 2014 needs assessment processes in particular.
There is a low risk, likely to be of low severity impact, of someone discussing an issue with a needs assessment process they have experienced with they may find upsetting. The interviewer will be mindful of this risk and will allow participants breaks (or the opportunity to end the interview) should they wish, and the interview schedule is not designed with difficult issues in mind. Finally, we will also provide contacts for appropriate support agencies on social care issues (such as our project partner, Access Social Care).

Where is the study run from?
University of York (UK)

When is the study starting and how long is it expected to run for?
August 2024 to April 2026

Who is funding the study?
National Institute for Social Care and Health Research (NISCHR) (UK)

Who is the main contact?
Dr Jed Meers York, jed.meers@york.ac.uk

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• United Kingdom
• England

Study participating centre

Results and Publications

Editorial Notes

31/12/2025: Study's existence confirmed by the NIHR.