The 12 care areas in the assessment
The full assessment, the Decision Support Tool, scores 12 areas of care. Not every area can reach every level, which matters for the eligibility threshold.
| Care area | Highest level possible | Records that often help |
|---|---|---|
| Breathing | Priority | oxygen and suction records, nursing notes, hospital letters |
| Nutrition: food and drink | Severe | food and fluid charts, weight records, choking incidents, speech and language therapy notes |
| Continence | High | continence assessments, catheter and stoma care notes |
| Skin and tissue viability | Severe | turning charts, wound records, pressure ulcer reports |
| Mobility | Severe | falls logs, moving and handling plans, how many staff are needed |
| Communication | High | care plans, daily notes describing how needs are understood |
| Psychological and emotional needs | High | daily notes, mental health team letters |
| Cognition | Severe | memory assessments, notes on awareness of risk, mental capacity assessments |
| Behaviour | Priority | behaviour charts, incident forms, daily notes on agitation and resistance to care |
| Drug therapies and medication: symptom control | Priority | medication records, pain charts, notes of when medication needs skilled judgement |
| Altered states of consciousness | Priority (no severe level) | seizure charts, records of episodes and responses |
| Other significant care needs | Severe | any significant need not covered above |
Why the levels matter
A clear recommendation of eligibility would be expected with a priority level in any one of the four areas that have it, or severe in two or more areas. Other combinations may also show a primary health need. Try the score checker.
The written description of each level is in the assessment form itself. When you disagree with a level, find dated examples that match the wording of the higher level.
Source
- Decision Support Tool guidance (domains and levels; paragraph 35 on thresholds)