This article provides an excerpt from the Community Care Inform Adults guide on assessments. The full guide offers in-depth and comprehensive coverage on carrying out person-centred, strengths-based assessments. Inform Adults subscribers can access the full content here. The guide is written by Elaine Aspinwall-Roberts, a qualified social worker and senior lecturer at Liverpool John Moores University.
Assessment is one of the most important social care tasks. There are many different types, from pre-birth to carers’, and it often signals the beginning of a social worker or occupational therapist’s involvement with a person.
For social workers in adult services, assessment of a person’s care and support needs is vital. It determines whether they are deemed eligible for local authority services. In a climate of cuts and scarce resources this can make assessment seem like a tick-box exercise, rather than a chance to work collaboratively with the person, get to know them and help them achieve their goals and improve their wellbeing.
The Care Act 2014 has attempted to reframe assessment, calling it a “a critical intervention in its own right” (Department of Health, 2016, paragraph 6.2). And there is increasing interest in ‘strengths-based’ approaches to assessment – where the focus is not on what the person can’t do, but on where their strengths lie and the supports they have around them in their family and the community.
On paper, assessments may follow a very rigid questioning format. But how you ask those questions is your choice. Be bold about reframing and rethinking questions in ways that help individuals define the problem themselves and decide how big a problem it is, but avoid intrusion into areas that they don’t see as a problem (Richards, 2000, p43).
Other questioning approaches that can be considered:
- Borrowing ‘the miracle question’ from solution-focused brief therapy (Howe, 2009, p93). “Suppose that one night, while you are asleep, a miracle happened and the problem was solved. How would you know? What would be different?”
- Thinking about what you would ask someone if you only had five questions to ask as you began working with them (Saleebey, 2012).
- Thinking about how you would like your questions to be phrased if they were directed at your loved ones.
- Thinking about phrasing. Bolger’s study (2014, p429) found that questions phrased ‘do you struggle with?’ or ‘how do you manage?’ invite a statement of need from the service user, while those phrased ‘you manage okay?’ suggest there is no need to be met.
Pritchard (2007, p148) suggests that in interviewing people in safeguarding investigations you should try to avoid the word ‘why’ to start a question, and instead use ‘how’, ‘who’, ‘what’, ‘when’, or ‘where’, as these are less accusatory. She also suggests that framing questions with words like ‘tell me’, ‘explain’, and ‘describe’ is good policy in many assessment situations, not just safeguarding.
It takes practice and confidence to be good at asking questions. As Graybeal (2001, p241) says, “learning to ask questions that open up possibilities is an art form that takes practice”. Sometimes questions won’t work or will be misinterpreted or misunderstood, but practitioners should always aspire to find better ways of asking questions. O’Connor (2001, p139) suggests practitioners can ask themselves:
- What is the most useful question I can ask right now?
- What don’t I know that would make a difference if I did?
- What question will get me closer to my outcome?
- Do I need to ask a question at all?
Bolger, A (2014)
‘The assessment is in the chat’: Analysing conversations in community care’
Qualitative Social Work, Volume 13, Number 3, p421-35
Department of Health (2016)
Care and Support Statutory Guidance
Graybeal, C (2001)
‘Strengths-based social work assessment: Transforming the dominant paradigm’
Families in Society, Volume 82, Number 3, pp233-42
Howe, D (2009)
A Brief Introduction to Social Work Theory
Basingstoke, Palgrave Macmillan
O’Connor, J (2001)
‘NLP Workbook: A Practical Guide to Achieving the Results You Want’
in Holroyd, J (2012), Improving Personal and Organisational Performance in Social Work
Sage, Learning Matters
Pritchard, J (2007)
Working with Adult Abuse
London, Jessica Kingsley Publishers
Richards, S (2000)
‘Bridging the Divide: Elders and the Assessment Process’
British Journal of Social Work, Volume 30, Number 1, pp37-49
Saleebey, D (2012)
The Strengths Perspective in Social Work Practice
Boston MA, Pearson Education