SCOPE OF THIS CHAPTER
This applies to anyone who requests social care related support from Hull City Council and who appears to have a need for that support, regardless of whether those needs would appear to meet the national eligibility criteria or whether the person would be likely to be liable to pay the full cost of their care (a self funder).
RELEVANT INFORMATION
Evidence for Strengths and Asset-based Outcomes: A Quick Guide for Social Workers (NICE)
Strengths-Based Approaches (SCIE)
LOCAL INFORMATION
For the Care Act Assessment writing guidance, template form and appendices please see the Local Policies and Guidance section of the APPP (password required).
1. Principles
Assessment is one of the most important elements in the social care and support system. It should be seen as a critical intervention in its own right which can help people to understand their situation and the needs they have in order to prevent, reduce or delay the development of further needs as well as to clarify the strengths they have and how they can best use those strengths while being able to access the support they require.
The assessment must be person led and should be proportionate to the needs being presented. All assessments should use the same documentation but not all will have the same depth.
The assessment must seek to establish what needs the person has and the impact of those needs on their day to day life and overall well-being. It should also establish what outcomes the person wants to achieve.
An assessment can be carried out in one of three ways; the person can complete a self assessment, they can receive a supported self assessment with the support being provided by a friend, family member or anyone who knows them well or they can receive an assessment carried out by a worker from the city council.
Only after the assessment is complete can any judgement about eligibility for local authority funded support be made and only after the financial assessment can any decision be made about whether the person will be expected to pay the full cost of their care.
2. Strengths Based Approaches in Assessment
Strengths-Based Approaches (SCIE)
In the context of assessment, strengths-based approaches focus on the strengths of adults, their families and friends and the services they use, applying their personal strengths to support recovery and empowerment. The goal is to promote positive capabilities. It focuses on active listening to what is strong rather than what is wrong, and what matters to the person rather than what is the matter with them. Using this approach should not ignore problems, but focuses on enabling people to find the best solutions for themselves.
Assessments must consider what else, other than the provision of care and support, might assist the adult in meeting the outcomes they want to achieve.
A person’s strengths and capabilities and the support available from their wider support network or within the community should be included. Using a strengths-based approach can improve social networks and enhance wellbeing.
Any suggestion that support could be available from family and friends should be considered in the light of their appropriateness, willingness and ability to provide any additional support and the impact on them of doing so. It should also have the agreement of the adult in question.
When completing assessments, staff should make sure they value the skills, life knowledge, social connections and potential of all those involved. But they should also make sure they do not ignore the challenges an adult faces; the assessment must be realistic and a true reflection of the adult’s views, opinions, capabilities and circumstances.
Practitioners using a strengths based approach during assessment must work in collaboration with people, helping them to do things for themselves so they become co-producers of their own support.
Local authorities might also consider the ways a person’s cultural and spiritual networks can support them in meeting needs and building strengths, and explore this with the person.
See also Assessment Case Studies.
3. Procedure Steps
Step | Action | By Whom |
1. | When a person requests an assessment, they must be assumed to have the mental capacity to lead or participate fully in that assessment unless there are compelling reasons for believing otherwise. If those compelling reasons exist at this or at a later stage, an assessment of capacity must be carried out as set out in the Mental Capacity Act 2005. Please see Assessing Mental Capacity Guidance for detail. If the person is found to lack capacity, an Independent Mental Capacity Advocate should be appointed and any decisions made must be demonstrably in the person’s best interests. | Advice and information co-ordinator/ suitably qualified mental capacity assessor. |
2. | Prior to the assessment taking place, the person should be provided with relevant advice and information and should be encouraged to make best use of it to help them to prevent, reduce or delay the development of further needs and to meet as many of their existing needs as possible prior to assessment. | Advice and information co-ordinator |
3. | If the person has mental capacity but for other reasons is not able to participate fully in the assessment process, or would have substantial difficulty in doing so, consideration should be given to the appointment of an advocate. See Advocacy. | Advice and information co-ordinator/ Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
4. | If the person does appear able to lead or fully participate in the assessment they should be offered the choice of completing a self assessment, having a supported self assessment or an assessment carried out with them by a worker. The self assessment paperwork is available from the Live Well Hull website. Whatever the form of assessment, the person must be given information about the assessment process so they know what to expect. If the person completes a self assessment or supported self assessment, the worker must seek assurance that the information is accurate and comprehensive. This may entail a visit to discuss the assessment or contact with someone who knows the person’s needs such as a GP or healthcare worker but it should not entail a repeat of the assessment itself. | Advice and information co-ordinator/ Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
5. | The person must be informed at the beginning of the assessment process that a financial assessment will take place to determine whether the person will be expected to contribute towards the cost of their care and the level of that contribution. They must also be informed that some people will be expected to contribute the full cost of their care if they have substantial assets. See Charging and Financial Assessment. | Advice and information co-ordinator/ Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
6. | The assessment must consider all of a person’s needs, regardless of whether or not they are being met by a carer. This ensures the local authority considers the entirety of a person’s needs and can respond appropriately if the carer feels unable to continue to provide care. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
7. | Decisions about eligibility must be made after the assessment is complete. See Establishing Eligibility for Adult Social Care. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
8. | If the person has full mental capacity to choose, they have the right to refuse an assessment but if they do not have capacity, a decision must be made on their behalf in their best interests. If there are reasons to believe the person is experiencing or is at risk of neglect or abuse and is refusing an assessment, then the decision about whether or not to assess must be made on their behalf and in their best interests and a referral must be made to the safeguarding adults team. If a child living in the household or with any other connection to the person being assessed appears to have needs for support or to be at risks of abuse or neglect, this information should be shared with the EHASH (Early Help and Safeguarding Hub). | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
9. | If the person appears to have an urgent need for support, an immediate response must be provided to meet those needs, before the assessment is completed. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
10. | The assessment should be proportionate to the needs and abilities of the person who is the being assessed which means that some assessments can be carried out online or over the phone while others will need the input of a specialist assessor and a range of people. People who are deafblind should always have a specialist assessor. The timescale of the assessment will vary but unnecessary delays must be avoided and the person must be kept informed of the progress of their assessment. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
11. | The assessment must use the common assessment paperwork and must be led by the person as far as they are able. It must involve the person, any carer they have and anyone else they ask to be involved. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
12. | The assessment must consider the person’s strengths and capabilities and must be focussed on the outcomes they want to achieve. It should be based around key questions:
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Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker |
13. | Once the assessment is completed, a worker must make a decision about whether the needs identified are eligible for local authority funded support. The worker should use the form attached to the assessment paperwork to do this and must send the person being assessed a copy of this to inform them in writing of the detail of the eligibility decision. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker/ Team manager |
14. | If it appears that the person may be eligible for Continuing Healthcare (CHC) funding, the worker must notify the relevant body and complete the CHC checklist with the person. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker/ Team manager |
15. | Following the assessment, the person must be given a copy of the whole document. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker/ Team manager |
16. | If the person is not eligible for local authority funded support, they must be provided with advice and information about what support exists in the local community or in universal services which may be of benefit to them and how to access it. They must also be provided with information about things which may help prevent, delay or reduce needs from arising. See Prevention, Reduction and Delay in the Development of Need. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker/ Team manager |
17. | If the person is eligible, the Resource Allocation System tool should be used to ascertain the amount of money which may be available to them. Outcome focused support planning should take place with adult so they can design their support. See Outcome Focused Support Planning. | Social worker/ social work assistant/ Occupational therapist/ sensory impairment worker/ Team manager |