Applying for Home Support Services

You can apply for a home support service if you are at home, in hospital or in a nursing home and wish to return home.

Download the Home Support application form (PDF, size 1.36 MB, 19 pages)

Ask your local Home Support Office to send you a form.

Completing the form

You can complete the application form yourself or you can ask someone to complete it on your behalf. 

It is important, that you, as the person who needs the service, signs the Declaration and Consent section on Part 1 of the Home Support Service Application Form (HSS001). The only other person who can sign Part 1 is a person who has legal authority to do so.  

The Assisted Decision Making (Capacity) Act 2015 came into effect on 26th April 2023. This new legislation allows you to nominate a person to assist you in making decisions. This arrangement can be informal (mutual agreement with a family member or trusted friend) or formally through the Decision Support Service, and the person you nominate is known as your decision supporter. Please see page 3 on the Home Support Information Booklet for more detailed information.  There is a section on the application form (Part 2) where your nominated decision supporter explains why they are making the application on your behalf.

The completed application form should be returned to your local Home Support Office. The local Home Support Office can help you to complete the application form, if needed.

If you are in hospital, you or your decision supporter should ask the person dealing with your discharge plan for a Home Support Application Form. This should be done as soon as possible during your hospital stay as it may help to avoid any delays in your discharge home from hospital.

Read the Home Support Service for Older People information booklet (PDF, size 1.4 MB, 17 pages)

After you Apply: The Care Needs Assessment