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Find the duty first. Then build the funding around the person.
Local-authority social care, NHS Continuing Healthcare and Section 117 aftercare are governed by different tests. The right route depends on the person’s needs, legal status and required outcomes—not on which organisation answers the telephone first.
Several Duties
The same support task can sit within a different legal route
Do not classify funding solely by diagnosis, setting or service name. Ask why the support is required, what outcome it achieves and which body has the legal responsibility to arrange it.
Needs arise from physical or mental impairment or illness and affect wellbeing through specified daily-life outcomes.
Needs Assessment
The totality of needs may go beyond what a local authority can lawfully provide as social care.
Checklist / Full Assessment
The person left hospital after detention under a qualifying Mental Health Act provision and requires relevant aftercare.
Aftercare Planning
Different assessed elements may properly be commissioned or funded by different statutory bodies.
Written Division
Do not collapse distinct rights into one generic funding conversation
Each route has a different gateway, charging position and responsible decision-maker.
Care And Support
The council assesses needs and eligibility, agrees how eligible needs will be met and prepares a personal budget.
Continuing Healthcare
The Integrated Care Board assesses whether the adult has a primary health need requiring an NHS-funded package.
Mental-Health Aftercare
The responsible NHS body and local social services authority jointly arrange qualifying aftercare following specified detention.
From first contact to an accountable personal budget
A financial assessment must not replace the needs assessment. First establish what eligible support is required; then determine any lawful contribution.
Request Assessment
Anyone can ask the council to assess an adult who appears to need care and support.
The needs assessment itself is free.
Describe Outcomes
Record what the person cannot achieve, the impact on wellbeing and existing unpaid support.
Include fluctuating and foreseeable needs.
Decide Eligibility
The council applies the national criteria and gives a written decision.
Non-eligible needs still require information and advice.
Plan Support
Agree how eligible needs and desired outcomes will be met.
Involve the person and advocate where required.
Set The Budget
The personal budget identifies the cost to the council of meeting needs.
It must be sufficient for the agreed plan.
Review Delivery
Check whether the plan remains effective, safe and proportionate.
Request an earlier review when needs change.
Look at the totality of need—not the diagnosis label
CHC eligibility is not awarded because a person has a particular diagnosis, lives in a particular setting or requires an expensive package. The question is whether the characteristics and interaction of their needs demonstrate a primary health need.
What The Need Is
The type, effect and quality of the need, including the intervention required to manage it.
Quantity And Severity
The degree, frequency and continuity of support, including sustained care demands.
Interaction Of Needs
How symptoms, risks and interventions combine and require skill to manage.
Change And Response
How difficult fluctuations are to anticipate and the consequences of delayed or inadequate response.
A joint statutory duty—not a discretionary funding favour
Section 117 applies after a person leaves hospital following detention for treatment under specified Mental Health Act provisions. The responsible NHS body and local social services authority must arrange aftercare until they are jointly satisfied it is no longer required.
Confirm The Legal Route
Check the detention provision and discharge history. Qualifying routes include detention under sections 3, 37, 45A, 47 or 48 before leaving hospital.
Define Each Aftercare Need
Link every proposed service to mental-health needs and the prevention of deterioration or readmission.
Name Both Responsible Bodies
Record who commissions, funds, monitors and authorises changes to each part of the aftercare plan.
No Automatic Expiry
Moving area, entering hospital again or appearing stable does not by itself end the duty. Discharge requires the relevant authorities’ joint decision.
A mixed package needs clear borders—without gaps
One provider may deliver several types of support, but the statutory bodies should still identify the legal basis and payment responsibility for each commissioned element.
Health-Led Elements
Examples may include CHC-funded care, specialist clinical input, healthcare equipment or treatment responsibilities.
ONE PERSON
Four names every plan should contain
When roles are vague, reviews stall and providers receive conflicting instructions.
Responsible Council
Name the social-work lead, team, funding panel route and finance contact.
Confirm ordinary-residence or statutory responsibility rather than assuming the placement address decides it.
Responsible NHS Body
Name the CHC, mental-health or commissioning lead and the relevant decision forum.
Responsibility should follow the applicable NHS “Who Pays?” rules.
Care Co-ordinator
Identify who brings the multidisciplinary information together and tracks agreed actions.
This role does not replace each organisation’s legal accountability.
Person Or Representative
Record capacity, advocacy, attorney, deputy, suitable person or other lawful involvement.
Provide accessible information and support genuine participation.
Every funded pound should connect to an assessed outcome
A robust proposal explains the need, intervention, staffing, frequency, evidence, responsible funder and review trigger.
Shared And Background Staffing
Explain availability, planned interventions, communal support, overnight arrangements and how staffing safely serves more than one person.
One-To-One Support
Link hours to named tasks, risks, outcomes and an evidence-based weekly pattern.
Sleep-In Or Waking Night
Use recorded need and response requirements; do not choose by label or price alone.
Health Input
State practitioner, frequency, delegation, monitoring and escalation responsibility.
Rent And Housing Costs
Keep housing liability distinct from care and support, especially in supported living.
What Happens When Need Changes?
Agree interim authority, emergency cover, evidence thresholds, funding review timing and how reductions or increases are implemented.
Collect information that explains consequences—not just incidents
Good evidence connects presentation, intervention and outcome. A calm week may demonstrate effective support rather than absence of need.
Frequency, duration, triggers, staff response and outcome.
Diagnosis, formulation, treatment, side effects and monitoring.
Likelihood, consequence and the controls preventing harm.
Consider prompting, supervision, fluctuation and sustainability.
Section history, tribunal or discharge conditions and Section 117 plans.
Hours, rates, shared allocation, on-costs and review assumptions.
Challenge the reasoning, not simply the outcome
Use the route belonging to the organisation and decision concerned, while protecting immediate safety.
Request The Record
Obtain assessment, eligibility reasoning, tool, minutes, cost calculation and decision letter.
Check factual errors and missing evidence.
Seek Clarification
Ask which test was applied, who decided and how conflicting evidence was resolved.
Set a clear response date.
Request Review
Use the council review or complaint route, CHC local resolution or the relevant Section 117 process.
Submit focused supporting evidence.
Escalate Properly
Consider the appropriate ombudsman, NHS review mechanism, advocacy or specialist advice.
Different bodies examine different failures.
Protect The Person
Agree interim support and record unmanaged risk while the funding dispute continues.
A boundary dispute should not become a care gap.
Answers across the three routes
These answers explain the framework in England. Individual responsibility depends on assessment, legal history, ordinary-residence and NHS commissioning rules.
Bring the assessments, legal status, weekly support model, cost breakdown and the decisions already received. The gaps can then be identified precisely.
