Heffernan, R (on the application of) v Sheffield City Council

Local authorities applying the Fair Access to Care Services framework must assess all presenting needs and evaluate the resulting risks to independence. Eligible needs are identified by reference to the relevant risk bands, but care need only be provided where it can ameliorate, contain or reduce an eligible risk.

Significant health problems appear only in the critical band. A local authority must not wrongly treat them as merely substantial or add equivalent health-problem criteria to lower bands. Where care needs are caused by significant health problems, they should be provided for, although purely medical needs remain outside the social-work assessment.

A care allocation may require reconsideration because the assessment method was legally flawed without being irrational or perverse in amount.

The claimant, who was severely disabled by Still’s Disease, blindness and associated physical difficulties, challenged Sheffield City Council’s assessment of his community-care needs. His care allocation had increased to 24½ hours per week, but he argued that the assessment failed to apply the Department of Health’s Fair Access to Care Services guidance and did not allow adequately for flare-ups, emergencies and flexibility.

The claim was amended after the February 2004 reassessment. The central issues were whether the council had applied the eligibility framework lawfully, particularly the treatment of health problems, and whether the resulting care plan was irrational.

1. Legal framework. Under National Assistance Act 1948, section 29, and section 2 of the Chronically Sick and Disabled Persons Act 1970, the claimant fell within the statutory community-care scheme. Section 47 of the National Health Service and Community Care Act 1990 required assessment of his needs. Section 7 of the Local Authority Social Services Act 1970 required the council to act under the Secretary of State’s general guidance.
2. FACS assessment. The guidance required all presenting needs to be fully explored and the risks to independence evaluated by reference to autonomy, health and safety, daily routines, and involvement in family and wider community life. Needs associated with eligible risks need not all be met, but care should address needs which can ameliorate, contain or reduce those risks.
3. Health problems. The council’s eligibility criteria unlawfully reproduced references to health problems in the substantial, moderate and low bands. The guidance referred to significant health problems only in the critical band. In context, “significant” meant serious rather than merely non-trivial. Significant health problems might not themselves create a particular care need, and medical needs remained outside social-work assessments, but the resulting care needs should be provided for. The council therefore had to reconsider its approach.
4. Rationality and outcome. The assessment was otherwise thorough and the claimant did not challenge its factual findings. The court could not substitute its own judgment for the council’s assessment of the appropriate number of hours. Although the allocation was not generous and required regular review, it was not shown to be perverse. The Care Plan was therefore not quashed on irrationality grounds, but it had to be reconsidered as soon as reasonably practicable in light of the legal errors.

The judgment was a first-instance judicial review decision. The proceedings were commenced on 14 November 2003 and amended after the council’s February 2004 reassessment. No earlier judicial decision is stated.