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    <title>Latest Health and adult social care Forms from Ealing Council</title>
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    <pubDate>Fri, 10 Apr 2026 05:08:42 +0000</pubDate>
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    <item>
      <title>Adult social care referral form</title>
      <link>https://www.ealing.gov.uk/forms/form/288/adult_social_care_referral_form</link>
      <description>&lt;p&gt;&lt;strong&gt;This is a referral form, to be used by representatives referring a resident of Ealing.&lt;/strong&gt;&lt;/p&gt;&#13;
&#13;
&lt;p&gt;&lt;strong&gt;It is appropriate to make a referral to adult social care when:&lt;/strong&gt;&lt;/p&gt;&#13;
&#13;
&lt;ul&gt;&#13;
	&lt;li&gt;An individual is struggling with daily living tasks and has not been able to make improvements by accessing community support or equipment available on the high street.&lt;/li&gt;&#13;
	&lt;li&gt;An individual wants to make changes to their life and is not able to do so by themselves or with the help of a carer/family/friends.&lt;/li&gt;&#13;
&lt;/ul&gt;&#13;
&#13;
&lt;p&gt;Under the Care Act 2014, there is an eligibility criteria for some services. Questions will be asked about what the referred person can and cannot do to determine their eligibility.&lt;/p&gt;&#13;
&#13;
&lt;p&gt;&lt;strong&gt;In addition to a referral to adult social care you can provide information and advice by:&lt;/strong&gt;&lt;/p&gt;&#13;
&#13;
&lt;ul&gt;&#13;
	&lt;li&gt;Visiting&amp;nbsp; &lt;a href="http://www.careplace.org.uk/"&gt;www.careplace.org.uk&lt;/a&gt; (Care Place) to find out about community support and other services available in Ealing&lt;/li&gt;&#13;
	&lt;li&gt;Recommending equipment which can be purchased cheaply on the high-street, from pharmacies and local specialist shops (where qualified to do so).&lt;/li&gt;&#13;
&lt;/ul&gt;&#13;
&#13;
&lt;p&gt;&lt;strong&gt;Please note:&lt;/strong&gt; The care and support the council arranges and/or provides is not free. We will complete a financial assessment with the individual to work out how much he/she can afford to pay. The council may contribute towards the cost.&lt;/p&gt;&#13;
&#13;
&lt;h2&gt;Safeguarding&lt;/h2&gt;&#13;
&#13;
&lt;p&gt;If the matter is urgent or you are raising a safeguarding alert, please call social services on&amp;nbsp;020 8825 8000 (adults&amp;rsquo; option) to discuss the referral.&lt;/p&gt;&#13;
&#13;
&lt;p&gt;If there is a medical emergency, immediate danger to life, risk of injury or if a crime is being committed, dial 999.&lt;/p&gt;&#13;
&#13;
&lt;h2&gt;You will need&lt;/h2&gt;&#13;
&#13;
&lt;ul&gt;&#13;
	&lt;li&gt;GP details&lt;/li&gt;&#13;
	&lt;li&gt;details of person being referred&lt;/li&gt;&#13;
	&lt;li&gt;next of kin&lt;/li&gt;&#13;
	&lt;li&gt;tenancy details&lt;/li&gt;&#13;
	&lt;li&gt;to explain their situation or recent changes for the referral&lt;/li&gt;&#13;
	&lt;li&gt;information on any difficulty with daily activities and mobility&lt;/li&gt;&#13;
&lt;/ul&gt;&#13;
&#13;
&lt;h2&gt;Filling in the form&amp;nbsp;&lt;/h2&gt;&#13;
&#13;
&lt;p&gt;The form cannot be saved and each page will time out after 20 minutes. If you think you will need more time, prepare your answers before you start the form. This helps make sure your information is not lost.&amp;nbsp;&lt;/p&gt;&#13;
&#13;
&lt;p&gt;Copying and pasting answers into a form can cause an error. If pasted from Microsoft Word or PDF, these characters may show an error -.,&amp;#39;&amp;quot;&amp;pound;#:;=/\()?&amp;amp;+@!&amp;nbsp;&lt;/p&gt;</description>
      <pubDate>Mon, 15 Feb 2021 13:22:45 +0000</pubDate>
    </item>
    <item>
      <title>Adult social care self referral form</title>
      <link>https://www.ealing.gov.uk/forms/form/293/adult_social_care_self_referral_form</link>
      <description>&lt;p&gt;It is appropriate to refer yourself to adult social care when:&lt;/p&gt;&#13;
&#13;
&lt;ul&gt;&#13;
	&lt;li&gt;You are struggling with daily living tasks and you have not been able to make improvements by accessing community support or equipment available on the high street.&lt;/li&gt;&#13;
	&lt;li&gt;You want to make changes to your life, and you are not able to do so by yourself or with the help of a carer / family / friends.&lt;/li&gt;&#13;
	&lt;li&gt;Under the Care Act 2014, there is eligibility criteria for some services. Questions will be asked about what you can and cannot do to determine your eligibility.&lt;/li&gt;&#13;
&lt;/ul&gt;&#13;
&#13;
&lt;p&gt;In addition to a referral to adult social care you can find information and advice by:&lt;/p&gt;&#13;
&#13;
&lt;ul&gt;&#13;
	&lt;li&gt;Visiting Care Place to find out about community support available in Ealing at &lt;a href="http://www.careplace.org.uk"&gt;www.careplace.org.uk&lt;/a&gt;.&lt;/li&gt;&#13;
	&lt;li&gt;Purchasing recommended equipment on the high-street, from pharmacies and local specialist shops.&lt;/li&gt;&#13;
&lt;/ul&gt;&#13;
&#13;
&lt;p&gt;Please note: The care and support the council arranges and/or provides is not free. We will complete a financial assessment with you to work out how much you can afford to pay. The council may contribute towards the cost.&lt;/p&gt;&#13;
&#13;
&lt;p&gt;&lt;strong&gt;If the matter is urgent or you are raising a safeguarding alert, please call social services on&amp;nbsp;020 8825 8000 (adults&amp;rsquo; option) to discuss the referral.&lt;/strong&gt;&lt;/p&gt;&#13;
&#13;
&lt;p&gt;&lt;strong&gt;If there is a medical emergency, immediate danger to life, risk of injury or if a crime is being committed, dial 999.&lt;/strong&gt;&lt;/p&gt;&#13;
&#13;
&lt;h2&gt;You will need&lt;/h2&gt;&#13;
&#13;
&lt;ul&gt;&#13;
	&lt;li&gt;next of kin details&lt;/li&gt;&#13;
	&lt;li&gt;GP surgery name, address and telephone number&lt;/li&gt;&#13;
	&lt;li&gt;explain your situation or recent changes&amp;nbsp;&lt;/li&gt;&#13;
	&lt;li&gt;information on any difficulty with daily activities and mobility&lt;/li&gt;&#13;
&lt;/ul&gt;&#13;
&#13;
&lt;h2&gt;Filling in the form&amp;nbsp;&lt;/h2&gt;&#13;
&#13;
&lt;p&gt;The form cannot be saved and each page will time out after 20 minutes. If you think you will need more time, prepare your answers before you start the form. This helps make sure your information is not lost.&amp;nbsp;&lt;/p&gt;&#13;
&#13;
&lt;p&gt;Copying and pasting answers into a form can cause an error. If pasted from Microsoft Word or PDF, these characters may show an error -.,&amp;#39;&amp;quot;&amp;pound;#:;=/\()?&amp;amp;+@!&amp;nbsp;&lt;/p&gt;</description>
      <pubDate>Wed, 10 Mar 2021 14:35:15 +0000</pubDate>
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