Round Table Discussion: Care Act (2014) - Assessments and Effective Conversations

Participants:

David Brindle The Guardian, Carole Croxford People2People & Shropshire Council, Chris Denovan Somerset County Council, Clenton Farquharson TLAP and person who uses care and support services, Bill Love NDTi, Shona McFarlane Leeds City Council, Lyn Romeo Chief Social Worker for Adults, Jenny Pitts NDTi, Caroline Spiers TLAP, Gordon Waigand Derby City council, Emma Watt Anthony Collins Solicitors, Julia Winter Person who uses care and support services

Discussion Overview:

The Care Act 2014 (section 9) places on local authorities a duty to carry out assessments that understand:

• the impact of the adult's needs for care and support on their wellbeing
• the outcomes that the adult wishes to achieve in day to day life
• to what extent, the provision of care and support could contribute to the achievement of those outcomes

Challenge 1: To meet this duty, most local authorities have introduced complex and time consuming assessment processes. The content of the process is frequently driven not by the individual but by perceptions about: the need to gather data that will be of use to the authority and regulators (even if there is no evidence of the data ever being of any actual use); risk and; the need to identify who is eligible or not for precious resources.

Challenge 2: The processes for undertaking assessments are driving waiting lists and frustrations. Frequently staff go into the person’s home, whether it is needed or not (and often some months after the initial contact), and ask pages of questions, whether they are relevant or not, and invest significant time in writing up the assessment and seeking permissions to act.

Challenge 3: Many people being assessed do not understand the point of much of the process and are not satisfied that their needs have been explored or the outcomes offered are suitable.

The processes adopted by most local authorities are not necessary and do not deliver a responsive or effective service

A Care Act compliant assessment can comprise a good conversation carried out in a way that is proportionate to the person’s needs and circumstance if the person is informed of its purpose and has a record of that conversation.

A number of local authorities have been exploring how to replace ineffective assessment processes with meaningful conversations. A good assessment is a process which should start with that conversation. In many situations, it may need to go no further to comply with the terms of the Act.

Having a conversation with the person is not simply rebranding the current data gathering and recording process

The style, content and recording of the conversation has to be genuinely coproduced with people with experience of being subject to assessment processes. Conversations need to be about the person. This means being led by their needs, aspirations and assets. It also means having an appropriate and proportionate style in terms of how the conversation takes place, where and how it is recorded and followed up.

The systems used by local authorities to support conversations also need to be appropriate and proportionate

This will include staff training, staff support, delegated decision making, monitoring and review.

Effective Conversations are already having positive results

As a result of this change, local authorities are identifying improved satisfaction from people and staff, significantly reduced waiting lists and better targeting of resources.

There is a need for clarity of the legal framework and a sharing of the emerging evidence about effective, proportionate conversations.

Download the Notes to Read Reflections from Participants...

including:

• Reflecting on the implications for social care
  David Brindle Public Services Editor, The Guardian
• Reflecting on the legal position
  Emma Watt Solicitor, Anthony Collins Solicitors
• Reflecting on people who receive an assessment
  Clenton Farquarson Person who uses care and support services, Chair of TLAP
• Reflecting on good conversations
  Jenny Pitts NDT

For more information on this note contact Bill.Love@ndti.org.uk