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.