Social worker care situations – referrals and assessment of payment claims 003-12060020

Social work template for CP/CA assessment for carers under 18 and over 80 years - use the following template to document all social work assessments for carers aged under 18 years. The report template should also be used for any assessment for carers aged over 80 years where the social worker is recommending the payment be rejected or cancelled.

Use 'Save As' workaround to download/use attachment.

Attaching social work reports to customer records

Care Receiver at Risk template

Carer Payment

Eligibility for Carer Payment (CP) when a care receiver is aged 16 years or over

Constant Care

In order to qualify for Carer Payment, the carer must be providing constant care which is defined as personally providing care on a daily basis for a significant period’ during each day. See 1.1.C.310 Constant care (CP) | Social Security Guide (dss.gov.au) for a full description of constant care. There may be situations where it is indicated constant care is not being provided. In assessing if constant care is being provided, the social worker needs to consider the care receivers medical condition(s), the responses provided by the Treating Health Professional (THP) on the medical report and the carer and care receivers description of the care provided to make sure consistency and that the care is provided due to the care receivers medical condition or disability. Time spent undertaking general household chores, shopping and transport would not normally be considered personal care, as these tasks are not directly related to the care receiver’s disability.

25 hour rule

Carers can participate in study or employment and still qualify for CP, provided the total time they are away from their care receiver to participate in these activities (including travel time) does not exceed 25 hours per week. See Carer Payment (CP) and Carer Allowance (CA) carer undertakes paid employment, self-employment, voluntary work, education or training activities for full details.

Carer Allowance

Eligibility for Carer Allowance (CA) when the care receiver is aged 16 years or over

In order to qualify for Carer Allowance, a carer must provide at least some additional care and attention to a person because of a disability or severe medical condition. See 1.1.C.10 Care & attention (CA) | Social Security Guide.

If the carer does not reside with the care receiver, they may still be eligible to receive carer allowance if they are providing care on a Daily basis (1.1.D.10 Social Security Guide) and at least 20 hours per week. Care and attention in these situations must address special care needs as assessed under the ADAT. Special care needs help with bodily functions and care to sustain life including help with:

• mobility,
• personal hygiene,
• eating and drinking,
• communication, and
• treatment

Special care needs do not include other tasks such as shopping and housework. See Social Security Guide 3.6.7.45 Qualification for CA - carer & care receiver not co-resident for further explanation of the care to be considered during the assessment.

Assessing level of care provided

A key purpose of the social work assessment is to assess if the carer can and does provide care to the care receiver to meet the qualifications for carer allowance or carer payment. The social worker will need to gather detailed information about the care situation and the carer and care receiver’s daily tasks and routines.

The care must be provided to the care receiver. In situations where the care receiver has dependent children, child care provided to these children cannot be considered when assessing eligibility for carer payment/allowance. This includes where an older sibling helps with the care of younger siblings due to a parent’s medical condition.

The following are some of the questions that social workers may ask to ascertain the level of care provided. The social worker should tailor the interview to the specific care situation and the care receiver’s medical diagnosis and care needs and explore the situation in detail.

Physical care

• Does the care receiver need help dressing?
• Does the care receiver need help with personal hygiene tasks such as brushing hair, cleaning teeth?
• Does the care receiver need help to use the toilet?
• Does the care receiver need help to shower? If so, is this physical help or supervision? (in the case of young carers, the social worker may need to discuss the appropriateness of this level of care)
• How does the care receiver move around? For example, do they need mobility aids? Help getting in and out of bed?
• If the care receiver need helps to move around, does the carer use aids to do so or do they have the physical capacity to undertake this task without risk of injury to themselves?
• Does the care receiver need attention during the night?
• Does the care receiver need help to manage their finances?

Supervision

• Is the care receiver able to be left alone for periods? If so, how long and how often does this occur? How does the care receiver manage when the carer is not present?
• Does the care receiver need help with memory tasks? For example, reminders to take medication and attend appointments
• Does the care receiver need supervision due to wandering?
• Does the care receiver need monitoring for medical episodes? For example, seizures, fainting. If so, what care does the care receiver need during these episodes?
• Does the care receiver need prompting to undertake tasks such as bathing and brushing hair?

About the carer

• Does the carer have any health conditions that may affect their ability to provide care?
• Does anyone else help with providing care? This may be friends, family members or support services
• What opportunities does the care receiver have to engage in social activities?
• Does the care receiver participate in education or employment? If so, what is the nature of this and does it meet the 25 hour rule?

Third Party Verification

Given the complex nature of the care situations referred for social work assessment, third party verification is often needed to help the social worker in determining the level of actually being provided by each person claiming carer payment/allowance.

Possible sources of verification can include:

• Educational institutions - For young carers contact with the school should be made to verify study load and care provided
• Paid in-home care providers such as those funded through the NDIS or MyAgedCare
• Treating Health professionals
• Other family or friends who are helping the carer in their caring role
• Other support agencies that may be involved with the family

It is best practice to seek permission from the care receiver or carer before contacting third parties to discuss their circumstances. If a recent SA332a Medical Report has been provided, the social worker can contact the Treating Health Professional who completed this form as permission to contact is specifically addressed within the form.

Child safe framework explanation

Over 80 Carer Assessments – Community Resources

Young Carer – Community Resources

To contact the Carer Specialist Assessment Team use code CT1 in Office Locator

Level 2 Policy Helpdesk

Family and domestic violence - External Support services

Payment and Service Finder

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• Search the customer's home location
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