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Suzy Braye looks at one of the most important, yet trickiest, areas of community care: assessment.

How can practitioners respond to the challenges raised when carrying out community care assessments?

Good assessment is the cornerstone of high quality community care, but it is a complex process. It takes place at times of transition in people’s lives. Accustomed living patterns may have been disrupted by sudden events such as illness, or by gradual changes that tip the balance of need. There may be differing views about need or risk, concerns about losing independence, and high hopes of securing protection or support.

Experienced practitioners often bring their concerns about assessment to training workshops. Common themes crop up.

- What if someone does not want to be assessed?

Consent is not a requirement prior to community care assessment. The duty to assess is triggered by the appearance of possible need. It is good practice to secure agreement, but in its absence the assessment can still proceed. The individual’s refusal may frustrate the process, particularly if face-to-face discussion or access is denied, although even here other sources of information may be drawn upon. These may suggest a need to pursue alternative action.

- Does assessment have to take place even if there is no prospect of meeting the person’s needs?

Anyone who may need services that may be arranged by the local authority must be assessed, even where there appears no prospect of meeting needs. It is important for authorities to identify unmet need.

- What if the service user does not want their carer involved?

Carers who provide a substantial amount of care on a regular basis have a right to assessment of their own needs, independently from assessment of the person for whom they provide care. A carer’s assessment can proceed in these circumstances, although without the service user’s co-operation certain services to support the carer may be difficult to provide.

- Where do disabled people stand in relation to assessment?

Disabled people are entitled to request assessment, and do not have to demonstrate potential need before this takes place. The entitlement is to a comprehensive assessment, regardless of where their needs might appear to place them in relation to eligibility criteria.

- What if the assessment identifies needs that the depart-ment has a policy not to meet?

Departmental policies stating that certain needs will never be met would not be lawful. Assessed needs should be recorded, regardless of the separate decision on whether to provide services. Departments may lawfully devise eligibility criteria, which will determine whether a service user’s need crosses the threshold for provision. This decision is an individual one in relation to each person assessed, and cannot be made by reference to a blanket policy.

- What if the service user has needs that meet the eligibility criteria but the budget is exhausted?

Social services may take their resource position into account when setting eligibility criteria, when assessing needs against those criteria and when deciding how needs will be met (for instance in deciding between a care package at home and a residential placement).

However, resources cannot be the sole consideration - there may be other relevant factors. Once the department has accepted that it is necessary to meet the assessed needs, then they must be met. Budgets are artificial creations, and where other resources exist within the authority, in theory these could be used before pleading no resources.

- How should assessment deal with needs outside the responsibility of social services?

If a person being assessed for care services appears to have needs that could be met by health, housing or other agencies, then those agencies must be invited to participate in the assessment.

Clear understandings of how to proceed in circumstances like these can assist practitioners in the delicate balancing acts that must sometimes take place.

Suzy Braye is a reader in social work at the Institute of Social Work, Staffordshire University.