Getting a needs assessment

What a needs assessment is

A needs assessment works out what help a person needs. For older people, it is done by the local Needs Assessment and Service Coordination agency, usually called NASC. Health New Zealand (Te Whatu Ora) funds these agencies.

The assessment is sometimes called an interRAI assessment, after the standard tool it uses.

Why it matters

You do not have to get a needs assessment. But without one you cannot apply for financial help from the government towards residential care, and you may have to pay more.

It is also the first step in applying for the Residential Care Subsidy. See our guide to the subsidy.

How to get one

You can contact your local NASC agency, or be referred to it. If you are not sure how referrals work in your area, ask your GP or the hospital team.

Government timeframes for help at home are:

• You should hear from your local NASC service within 2 weeks of being referred.
• If NASC treats your assessment as urgent, a Needs Assessor will contact you within 2 working days.
• The assessment itself may take up to 3 hours.

These are published for help at home. Ask NASC whether the same timeframes apply to an assessment for residential care.

General guidance for the day: have a family member or friend with you if you can. Before the visit, write down what has become hard, such as washing, cooking, getting around or remembering medicines, along with any falls or recent hospital stays. Describe the hard days, not just the good ones.

The levels of care

There are 4 types of full-time residential care. Each one matches a level of assessed need. The staffing below is the minimum Health New Zealand describes.

• Rest home. 24-hour care for older people who cannot live safely at home. A registered nurse is there for some hours each week, and at least 1 care staff member is on duty at all times.
• Dementia care. The same minimum as a rest home, with another staff member readily available on site. A person with dementia does not automatically need a dementia unit. It depends on what the assessment recommends.
• Hospital (private hospital) care. For people who need nursing because of illness and disability. There are 2 staff on duty at all times: 1 registered nurse and 1 caregiver.
• Specialist (psychogeriatric) hospital care. For people with high needs and, often, challenging or noisy behaviours. There is a minimum of 2 staff on duty at all times: 1 registered nurse and 1 caregiver.

The weekly maximum a home can charge for contracted care is the same at every level. See our guide to what a care home costs.

Respite care

Respite care is short-term care in an aged care facility to give a carer a break. If you meet the criteria, you will be allocated up to 28 days of planned respite care a year.

Choosing a home

You choose the rest home or hospital you want to move to and can afford. But you can only move into your preferred home if it has a suitable vacancy, even if your need is urgent.

If you need care urgently and your first choice is full, you may have to take a place somewhere else. You can transfer to your preferred home later, when it has a suitable vacancy, as long as it can provide the care you need.

General guidance: ask your preferred homes to put you on their waiting list and to call you when a room at your level comes up. Keep a short list of homes you would accept, so you are ready if a place is needed quickly.

When you move in, you sign an Admission Agreement. This contract sets out your rights and responsibilities.

Questions to ask

Ask NASC:

• What level of care have I been assessed as needing?
• Can I have a copy of the assessment?
• Is my situation being treated as urgent?
• What happens if my needs change after I move in?
• Do I meet the criteria for respite care?

Ask a care home:

• Do you have a vacancy at my assessed level of care?
• If not, can I go on your waiting list, and how will you contact me?
• Can you meet my care needs now, and as they change?
• How many staff, and how many registered nurses, are on duty during the day and at night?