On judgement day

    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.

     

     

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