Twenty-three questions about what is actually in the records, and an ordered list of what to strengthen before it goes in. It measures completeness, not eligibility.
It measures one thing: how complete a set of records is, against the evidence an assessment is normally built from. It does not assess need, does not apply the primary health need test, and does not estimate the outcome of a decision. A high score means the paperwork is in order. It says nothing about whether a person is eligible.
The checks are organised around the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care and its Decision Support Tool. That is a policy framework issued by the Department of Health and Social Care, not statute, and nothing here is an official instrument or approved by any body. The twelve care domains it uses are:
Behaviour · Cognition · Psychological and emotional needs · Communication · Mobility · Nutrition, food and drink · Continence · Skin and tissue viability · Breathing · Drug therapies and medication, symptom control · Altered states of consciousness · Other significant care needs.
The four key characteristics an MDT weighs are nature, intensity, complexity and unpredictability.
On enhanced monitoring. Funded additional support, often called one-to-one, is commissioned locally and is not a National Framework process. The routes differ; the evidence expectations overlap heavily. Checks specific to it are held in their own theme rather than mixed into the CHC ones.
Each check is scored Yes (full), Partly (half) or No (nil). A theme score is the share of its checks met. The overall figure is the weighted average across only the themes you have answered, so an unanswered theme neither inflates nor deflates the result.
| Theme | Weight | Why it carries that weight |
|---|---|---|
| Risk is demonstrated, not asserted | 20% | Asserted risk is the most common reason a pack is returned. Dated, counted, severity-rated events are the hardest thing to reconstruct later. |
| Core evidence in place | 18% | Without contemporaneous records the rest cannot be corroborated. |
| Enhanced monitoring is evidenced | 18% | Intervention and outcome are what show the support is doing something, rather than simply being in place. |
| Needs mapped to the care domains | 16% | Domains nobody owned are routinely the ones left unevidenced. |
| Professional and MDT input | 16% | Independent professional corroboration carries weight a provider record alone does not. |
| Consistency and assembly | 12% | Contradictions between documents undermine otherwise sound evidence, but are the cheapest to fix. |
Weights were set from practitioner judgement about which gaps most often cause a pack to be returned. They are not derived from published outcome data, because none exists at this level of granularity. They are shown here so they can be disagreed with.
Unmet checks are ranked by weight times the score still available, so the list reflects what would move the total most, not what is easiest or what appears first.
Written by a team leader in adult social care in England with five years in the sector, two of them running funded one-to-one support, who assembles this evidence as part of the job. It is an independent tool built outside of any employer, and it carries the biases of one practitioner's experience. Corrections from assessors, commissioners and registered managers are welcome and will be reflected in later versions.