Esprit Rock

As a health and social care worker

As a health and social care worker, there is great emphasis on the importance of including the service users when carrying out all tasks, from the daily personal care provided, any decisions regarding their care and/or finances and when creating and documenting assessments and evaluations such as care plans. Service users’ relatives, friends and/or guardians are to be included in these also, this not only safeguards the individual from potential abuse or neglect, it also ensures that all information is current and relevant.

Assessment has an important role within a care setting, as it involves the collecting of information regarding an individual and analysing it to understand what they require to meet their safety and wellbeing needs.

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Within St. Mary’s we require assessment tools to ensure that our residents are safeguarded from harm and that their wellbeing is paramount. As a manager it is my responsibility to audit the assessments which the care staff carry out monthly, such as Pain assessment scales, risk assessments, MUST nutrition assessment, WATERLOW pressure sore assessments etc. This means that I ensure that staff are carrying out assessments correctly and that if there are any concerns which have been highlighted by the assessments that I carry out the actions necessary to ensure that the individual’s needs are met. For example, if I notice that an individual has lost 5% body weight within a 6 month period, it is my responsibility to speak to the individual to see if they feel that there are reasons for this, to speak to the relatives of the individual, and to implement a plan to resolve the problem, such as to monitor their intake to see if there are any problems to suggest this weightloss. Then using this information gathered I can refer the individual to a dietician, and/or the GP.

“Assessment is widely agreed to be of great importance, but that is where agreement ends and contestation over what it is begins. For the purpose of their literature review, Crisp and colleagues stated that assessment ‘involves collecting and analysing information about people with the aim of understanding their situation and determining recommendations for any further professional intervention’ (2003, p 3).” https://www.scie.org.uk/publications/guides/guide18/natureofassessment/definitions.asp

There are no specific theories which explain the process or reasons behind the need to carry out assessments within the care industry. Each service and professional may have a different approach or system when it comes to carrying out assessments. Therefore, it is essential to work in partnership and to include all information and knowledge from a range of professions and individuals regarding a service user.

The Basic Helping Cycle (Taylor and Devine, 1993) can be a useful tool to apply during the care planning process. The cycle explains how the service user and their care professionals can work together in order to assess their particular needs, resources and potential risks. Through following the cycle we are responding to the individual needs of the service user while working in conjunction with the policies and procedures set by my organisation. By assessing the care needs, we can then plan to meet these agreed needs, putting them into action in the third stage and finally reviewed before starting the cycle all over again.

In 2005 Thompson created the “ASIRT” model of care planning.

A Assessment stage, this is the start of the process and the first part of the plan
S

I Intervention stage, this is when objectives for the intervention are chosen

R Review stage, this is when the evaluation of what has occurred takes place

T Termination stage, this is when the intervention is no longer required and can stop

The care planning process is just one part of the assessment process. Smale et al 1993 proposed three different models of assessment.

“• The Questioning Model – in which the care worker leads the process and questions and listens, before processing the information. This means that the process is service led.

• The Procedural Model – in which information is gathered by the care professional who then makes a judgement as to ‘best fit’ for the service. This is criterion based and a range of checklists is used to determine which service is best for the service user.

• The Exchange Model – in which the care workers view the service users as the expert in their own care needs. This is really the most person-centred approach of the three. This model seems to describe the most holistic form of assessment, with the care professional managing a more client-centred approach.”
Tilmouth, Tina. Level 5 Diploma in Leadership for Health and Social Care 2nd Edition (pp. 246-247). Hodder Education.

An assessment must be appropriate and proportionate, meaning that using a person-centred approach to talk to an individual, within appropriate formats, to gather the knowledge to create outcomes for the individual to continue their day-to-day life.

“Assessment can be conducted through any one, or a mix, of these approaches as required.
• A face-to-face assessment between the person and an assessor. This format may for example be appropriate if there are any communication needs, or other people who need to be present (e.g. another professional).

• A supported self-assessment, where the individual completes the assessment themselves and the local authority assures itself that it is an accurate reflection of the individual’s needs. This format may for example be appropriate if the individual has capacity, ability and personal resources/awareness of their situation or can be supported to have it so they can lead in the process.

• An online or phone assessment. This format may for example be appropriate if there are no communication needs, the level of needs is not complex and the individual is capable and able to express themselves by phone, or has the access, knowledge and ability to do an online assessment and feels comfortable doing so.

• A joint assessment, where relevant agencies work together to avoid the person undergoing multiple assessments. This format may for example be appropriate across social work and occupational therapist assessments, or children and adult services, or housing and social work, etc. The central question to ask is: is the practitioner the best placed person to carry out the assessment, or is there another organisation that can do it on their behalf, as someone closer or better known to the individual

• A combined assessment, where an adult’s assessment is combined with a carer’s assessment and/or an assessment relating to a child. It is, of course, important to recognise that where there is a young carer involved, the assessment will be conducted by children’s services and by an appropriately qualified assessor.”

https://www.scie.org.uk/care-act-2014/assessment-and-eligibility/appropriate-proportionate/how-to-conduct-an-assessment-thats-appropriate-proportionate.asp

Assessments will be implemented according to the setting that they asre being carried out in and according to the type of needs an individual has. For example, within the community, older people are assessed via the single assessment process. Individuals with mental health problems are assessed by the Care Programme approach (CPA) which assesses their risk and safety, psychological thoughts and behaviours and Psychiatic experiences and symptoms. Mental health issues require the support of mental healthcare professionals whom create a care plan which is regularly reviewed.

Another type of assessment is the Need’s led assessment which focuses on an individual’s particular needs in a specific situation. User-led assessment is when an individual is at the forefront in decision making by the responsible person, such as their care worker and the individual together. A single assessment process (SAP) is when multiple care agencies work together to ensure that the care plan is effective and coordinated. “The Single Assessment Process (SAP) was introduced in the National Service Framework for Older People (2001) in Standard 2: Person-centred care, the aim of which was to ensure that the NHS and social care services treat older people as individuals, enabling them to make choices about their own care.”

Tilmouth, Tina. Level 5 Diploma in Leadership for Health and Social Care 2nd Edition (p. 247). Hodder Education. Kindle Edition.

Older people usually have a wide range of needs, therefore their care must be centred around the individual and have a holistic approach. The Single Assessment Process was developed due to this knowledge, reflecting a person-centred health and social care framework, sharing information appropriately between a variety of relevant agencies to ensure the individuals needs are assessed thoroughly and accurately, without duplication between the agencies.

An assessment must be appropriate and proportionate, meaning that using a person-centred approach to talk to an individual, within appropriate formats, to gather the knowledge to create outcomes for the individual to continue their day-to-day life.

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