Developing a Plan B in social care assessments

As someone with moderate to severe cerebral palsy, I have been a user of social care and other services since 1992 when I was 18 and went to university in Coventry. At that age I was a young fit and healthy person with cerebral palsy who was enjoying his new found freedom as a university student.

As the years have gone on, and the freedom of student hood as been replaced by running my own company, my personal assistance needs have increased. Ideally I need assistance 24/7 in order to maximise my lifestyle.

The difficulty with this is I have a level of impairment which is in the middle. I can technically walk and talk and perform many activities but in a fashion which has become increasingly difficult as I got older. Within a traditional needs led assessment it could be argued that I can perform the many tasks needed and I do not need much assistance. However this does not take into account my work commitments as someone who owns my own company which means I need to focus on my work and not my personal assistance.

Also, it does not take into account the effects of performing tasks myself in terms of time management, the use of my energy and the amount of time needed to clean up after me. Within a traditional assessment, the fact I was deemed to be mostly physically independent would have led to cost cutting without any insight into the implications for personal hygiene and mental well being.

Under the individualised budget pilot in Coventry I received an outcome focused assessment. In this kind of assessment, my aspirations and the bigger picture is taken into consideration. Therefore, my ability and desire to work via my own company is taken into consideration as well as the associated needs to this in terms of my general physical and mental well-being. The assessment looks at what is best for me long term and not just short term.

So Plan A is the perfect personal assistance situation when I have all my positions filled with good quality personal assistants that understand me and my needs. With this, I am able to move forward with great leaps as the assistance I have helps me maximise what I can achieve 24/7. I would be able to perform any activity I wish whatever time of day it is.

However, in the real world this does not often work that way. You can struggle to recruit, or staff can go sick, and it’s important to have a backup plan. Hence ‘Plan B’ – which should enable me to cope when I do not have any immediate care.

It works on the assumption that I will receive care at some point and therefore the mess created by looking after myself will be cleaned up. It also works on the assumption that preparation has already taken place so that jars and bottles have been loosened, for example, enabling me to open them myself. It is also good if food and drink is prepared for me.

Plan B also requires an accessible environment. I am currently working on getting a level access walk in shower.

In this way, social care assessments need to look at both Plan A and Plan B in order to promote independence and have coping strategies in place.

While Plan B is not ideal, it is better than no plan at all and I feel its adoption in social care assessments will be good for everyone involved.

Simon Stevens, chief executive of Enable Enterprises

For more from Simon go to



More from Community Care

Comments are closed.