Adult Social Care Glossary, v 0.6

Care and Support Statutory Guidance 2.30 In particular, local authorities must consider how to identify unmet need - for example, those people with needs which are not currently being met, whether by the local authority or anyone else. Understanding unmet need will be crucial to developing a longer-term approach to prevention that reflects the true needs of the local population. This assessment should also be shared with local partners, such as through the health and wellbeing board, to contribute to wider intelligence for local strategies. Preventative services, facilities or resources are often most effective when brought about through partnerships between different parts of the local authority and between other agencies and the community such as those people who are likely to use and benefit from these services. 2.31 Local authorities should consider how they can work with different partners to identify unmet needs for different groups and coordinate shared approaches to preventing or reducing such needs, for example working with the NHS to identify carers, and working with independent providers including housing providers and the voluntary sector, who can provide local insight into changing or emerging needs beyond eligibility for publically (sic)-funded care.

Unmet need has been identified where participants indicated that they needed help with a particular ADL or IADL but had not received any help with it in the last month

An Ethical Approach to Meeting Needs in Adult Social Care (BASW England: Draft policy, 12 November 2021)
The impact on ethical responsibilities in meeting need

1. Where people with care and support needs and carers have had their needs assessed as being eligible, the local authority has a legal duty to meet these needs (in most circumstances). Where the individual's financial circumstances are below certain levels, there is also a requirement that the local authority fund (wholly or partly) the personal budget that is deemed necessary to meet their needs.

2. Unmet need can occur as a result of delays in providing the necessary funding. It can also be due to misinterpretation of the law and statutory guidance (as evident in judicial reviews and complaints to the Ombudsman) or as a result of poor practice.

3. Unmet need can also occur where people wait for an assessment for an unreasonable amount of time, and therefore have potential unmet needs. From recent data produced by ADASS it has been calculated that in England there are over 7000 people who have been waiting for more than six months for an assessment. The requirement of the statutory guidance is that assessments should be carried out over an appropriate and reasonable timescale according to the urgency of those needs.

4. Where it is thought that the amount of the personal budget is not sufficient to fully meet eligible needs, this is sometimes described as under-met need. This can occur where a social worker's professional judgement has not been properly taken into consideration in determining what is sufficient to meet needs.

5. Where the decision-making is clear and transparent, as outlined below, potential unmet and under-met need can be identified openly and honestly. If it is clear how the personal budget has been worked out and how a social worker's professional judgment is taken into account, then disagreements with the final decision can be addressed.

When you are not receiving the care or support you need, or not receiving as much as you need. This may be because you haven't asked for it, or you have been assessed and services have not been provided.

1. Paragraph 2.30 of CASSG refers to aggregate unmet needs across the population, not individual need. The only reference in CASSG to individual unmet need is in 10.25. Unmet need is more often referred to in relation to individuals, so this distinction should be made clear. 2. Paragraph 10.25 is reasonably clear, by inference, that an individual should not have any unmet eligible need because a local authority is under a duty to meet any such need. Also, sections 18 and 20 of the Care Act are clear about the duty to meet eligible need. However, whilst the law is clear about whether or not a need must be met, it is understandably less clear about how, and the extent to which, need must/should be met, as this requires the exercise of judgement. 3. Unmet need is often used to describe eligible need that is not being met satisfactorily, but of course this is technically inaccurate. Sometimes this is better described as under-met need. It can happen when the personal budget is judged as not meeting the requirement in the statutory guidance for the personal budget to be 'sufficient' (see CASSG 11.24). BASW's document An Ethical Approach to Meeting Needs in Adult Social Care clarifies this. 4. The data in NHS Digital's Health Survey relates to need that is below the eligibility threshold, i.e. non-eligible need.