Pre-Admission Assessment Form

Complete this assessment before or at the point of admission to gather key information about the prospective resident. This form covers personal details, health history, mental capacity, and personal preferences — ensuring a smooth transition into the home and an accurate initial care plan.

Good practice: The pre-admission assessment should ideally be completed in person during a visit to the prospective resident (at their home, in hospital, or at the care home). Involve the person, their family, and any existing care professionals in the assessment. Under the Care Act 2014, local authorities have a duty to assess needs before placement, and the care home should ensure this information is available and incorporated into the care plan.

Personal Details

Full Name

Preferred Name

Date of Birth

NHS Number

Address

Telephone Number

Next of Kin Name

Next of Kin Relationship

Next of Kin Contact Number

Health Information

GP Name and Practice

GP Telephone Number

Known Medical Conditions / Diagnoses

Current Medications (including doses and frequency)

Known Allergies (including type of reaction)

Recent Hospital Admissions (last 12 months)

Communication Needs (sensory, language, cognitive)

Mobility Level and Aids Used

Personal Preferences

Cultural and Religious Needs

Dietary Requirements and Preferences

Daily Routine Preferences

Likes and Interests

What Is Important to the Person

Assessment Notes

Overall Assessment Summary

Identified Risks and Mitigation

Assessor Name

Signature & Date

Key Principles

1.Involve the person and their family in the assessment — person-centred care starts before admission.
2.Check mental capacity for key decisions at the time of admission — do not assume capacity or lack of capacity.
3.Obtain and review all existing care plans, risk assessments, and medical records from the referring agency or hospital.
4.Ensure the home can meet the person's assessed needs before confirming admission.
5.Store all assessment information securely and in accordance with GDPR and data protection requirements.

Authoritative Resources

Important Notice:This pre-admission assessment form provided by Care Handbook is a template for guidance only. It does not replace your organisation's approved assessment forms. Always follow your employer's policies and procedures. All personal data collected must be handled in accordance with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018.